title: Self-seeding in cancer.
abstract: Despite significant progress in our understanding and treatment of metastatic cancer, nearly all metastatic cancers are incurable. In this Review, we use breast cancer as a model to highlight the limitations and inconsistencies of our existing treatment paradigms for metastatic disease. In turn, we offer a new theory of metastasis, termed "self-seeding. " The self-seeding paradigm, well validated in mathematical, experimental and animal models, challenges the notion that cancers cells that leave a primary tumor cell, unidirectionally seed metastases in regional lymph nodes and/or distant sites. In contrast, there is mounting evidence that circulating tumor cells can move multi-directionally, seeding not only distant sites but also their tumors of origin. Here, we show that the self-seeding model may answer many of the quandaries intrinsic to understanding how cancer spreads and ultimately kills. Indeed, redirecting our research and treatment efforts within the self-seeding model may offer new possibilities for eradicating metastatic cancer.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA. comene@mskcc.org
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Comen
authors.forename: Larry
authors.initials: L
authors.lastname: Norton
mesh_terms: D006801:Humans; D008962:Models, Theoretical; D009362:Neoplasm Metastasis / Q000473:pathology*; D009369:Neoplasms / Q000473:pathology*; D009360:Neoplastic Cells, Circulating / Q000473:pathology