title: Does the mobilization of circulating tumour cells during cancer therapy cause metastasis?
abstract: Despite progressive improvements in the management of patients with locoregionally confined, advanced-stage solid tumours, distant metastasis remains a very common - and usually fatal - mode of failure after attempted curative treatment. Surgery and radiotherapy are the primary curative modalities for these patients, often combined with each other and/or with chemotherapy. Distant metastasis occurring after treatment can arise from previously undetected micrometastases or, alternatively, from persistent locoregional disease. Another possibility is that treatment itself might sometimes cause or promote metastasis. Surgical interventions in patients with cancer, including biopsies, are commonly associated with increased concentrations of circulating tumour cells (CTCs). High CTC numbers are associated with an unfavourable prognosis in many cancers. Radiotherapy and systemic antitumour therapies might also mobilize CTCs. We review the preclinical and clinical data concerning cancer treatments, CTC mobilization and other factors that might promote metastasis. Contemporary treatment regimens represent the best available curative options for patients who might otherwise die from locally confined, advanced-stage cancers; however, if such treatments can promote metastasis, this process must be understood and addressed therapeutically to improve patient survival.
authors.affiliation: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.|Molecular Radiation Biology Laboratory, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.|The Sir Peter MacCallum Department of Oncology, University of Melbourne, Grattan street, Melbourne, Victoria 3000, Australia.
authors.forename: Olga A
authors.initials: OA
authors.lastname: Martin
authors.affiliation: Metastasis Research Laboratory, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.|The Sir Peter MacCallum Department of Oncology, University of Melbourne, Grattan street, Melbourne, Victoria 3000, Australia.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Anderson
authors.affiliation: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.|The Sir Peter MacCallum Department of Oncology, University of Melbourne, Grattan street, Melbourne, Victoria 3000, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Grattan street, Melbourne, Victoria 3000, Australia.
authors.forename: Kailash
authors.initials: K
authors.lastname: Narayan
authors.affiliation: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.|The Sir Peter MacCallum Department of Oncology, University of Melbourne, Grattan street, Melbourne, Victoria 3000, Australia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: MacManus
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D001691:Biological Therapy; D002986:Clinical Trials as Topic; D006801:Humans; D007111:Immunity, Cellular / Q000528:radiation effects; D008297:Male; D009362:Neoplasm Metastasis / Q000473:pathology*; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D059016:Tumor Microenvironment
chemical_list: D000970:Antineoplastic Agents