Current insights into clinical dormancy and metastasis

摘要

Survival after breast cancer diagnosis and treatment has improved markedly, however recurrence is still a treatment challenge for clinicians. The underlying cause for late recurrence after a long disease-free period is still unknown. It is known that undetectable metastases exist in two states, with different mechanisms playing a role in each dormancy state. In tumour mass dormancy, extrinsic factors such as angiogenesis and immune surveillance are in equilibrium with the tumour cells to maintain dormancy. In tumour cell dormancy, mechanisms intrinsic to the isolated tumour cells can dictate a dormant cellular state. The process of senescence, or pathways leading to cell cycle arrest, may be the key to unlocking the mystery behind these tumour cell deposits. With greater knowledge of the mechanisms that control undetectable disseminated disease, we have the opportunity to target these pathways to enable therapeutic strategies against metastatic disease.