Nov 7, 2013

A filter-flow perspective of hematogenous metastasis offers a non-genetic paradigm for personalized cancer therapy

BioRxiv : the Preprint Server for Biology
Jacob G ScottPhilip Gerlee


Translational Relevance Since the discovery of circulating tumor cells (CTC), we have struggled for ways to use them to inform treatment. The only currently accepted method for this is a ‘more is worse’ paradigm by which clinicians measure CTC burden before and after treatment to assess efficacy. Research efforts are currently focused almost entirely on genetic classification of these cells, which has yet to bear any fruit translationally. We suggest that we should shift the focus of our investigation to one driven by a physical sciences perspective. Specifically, by understanding the vascular system as a network of interconnected organs and capillary beds as filters that capture CTCs. By ascertaining the distribution of CTCs in this network for individual patients, information about the existence of subclinical metastatic disease, and therefore metastatic propensity, will come to light, and allow for better staging, prognostication and rational use of organ-directed therapy in the setting of oligometastatic disease. Purpose Research into mechanisms of hematogenous metastasis has largely become genetic in focus, attempting to understand the molecular basis of ‘seed-soil’ relationships. However, preceding this biological mechan...Continue Reading

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Mentioned in this Paper

Tumor Cells, Uncertain Whether Benign or Malignant
Circulatory System
Blood Flow
Cancer Treatment

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