The great escape: How metastases of melanoma and other carcinomasavoid elimination

摘要

Cancer mortality ensues from metastatic growths. Cancers use two strategies toallow for this unrelenting expansion. The first way is that early metastases areoften cryptic or dormant, being invisible to both innate suppressive actions andundetected clinically. Second, both the micrometastases and later clinicallylethal growths are resistant to therapies, whether standard chemotherapies,targeted biologics, or even immunotherapies. These two modes of resistancenecessitate new approaches to treatments if we are to eliminate mortality fromsolid tumors. However, to develop such therapeutic strategies, we first need tobetter understand the cellular behaviors and molecular events that enable theresistances. Herein, we present a comprehensive model of changing methods ofavoidance and resistance that occur during tumor progression, and doublyconfound treatment by mixing survival strategies throughout the continuumcreating moving targets. Melanoma is presented as the model cancer, as it isbeing targeted by all three types of agents for disseminated disease, withbreast and prostate cancer as two other key carcinomas.