Molecular determinants in the biology of liver metastasis

A primary goal of cancer research is an increased understanding of the molecular mechanisms mediating the process of cancer metastasis. Analyses of colon cancer cells (the seeds) and the microenvironment (the soil) has increased our understanding of the biologic mechanisms mediating liver-specific metastasis. Insight into the molecular mechanisms regulating the pathobiology of cancer metastasis as well as a better understanding of the interaction between the metastatic cell and the host environment should produce a foundation for new therapeutic approaches. In this article we summarize experimental observations demonstrating the importance of specific factors that regulate various steps in the metastatic cascade. Furthermore, this article emphasizes the importance of the host organ's microenvironment and its role in liver metastasis formation. The production of metastases depends, in part, on the interaction of particular tumor cells with specific organ environments. Therefore, the successful metastatic cell must be viewed currently as a cell receptive to its environment. The analyses presented herein add important evidence to support the concept that cancer metastasis is not a random process; it is a highly regulated process that can be analyzed on the molecular level. To the clinician, it is readily apparent that by the time metastasis forms, most steps in the metastatic cascade have been completed. Therefore, therapy targeted to downregulate or interrupt the last stages of metastasis, proliferation and angiogenesis, should be the areas of greatest investigation in regards to treating established metastasis, whether they are microscopic or macroscopic.