Do Distant Cancer Metastases Have the Ability to Re-Metastasise?

Check out this answer from Consensus:

Distant cancer metastases have the potential to re-metastasize. This is facilitated by the ability of metastatic cells to enter dormancy, evade immune defenses, and later reactivate to form new metastatic sites. Understanding these mechanisms is crucial for developing effective treatments to prevent metastatic relapse.

Metastasis is a critical and often fatal aspect of cancer progression, involving the spread of cancer cells from the primary tumor to distant organs. A key question in cancer research is whether these distant metastases have the ability to re-metastasize, further complicating treatment and prognosis.

Key Insights

• Metastatic Colonization and Dormancy:
  • Metastatic cells can enter a state of dormancy in distant organs, where they resist therapy and can later reactivate to form new metastases1 3.
• Mechanisms of Metastatic Spread:
  • Circulating tumor cells (CTCs) must infiltrate distant tissues, evade immune defenses, and adapt to new environments to establish metastases. These cells can survive as latent seeds and later proliferate, indicating a potential for re-metastasis2.

Do distant cancer metastases have the ability to re-metastasise?

Stanley P. L. Leong MD has answered Likely

An expert from California Pacific Medical Center Research Institute in Cancer Metastasis, Cancer Immunology, Immunotherapy

Cancer metastasis may spread to another distant site, that is the reason for surgical resection of isolated metastasis, so called oligometastais, the data is based primarily on deduction that a certain group of patients will be benefitted by resecting their “oligometastasis” (1). Further, recent mouse studies showed systemic metastasis has resulted from lymph node metastasis (2-3). Future genomic studies are necessary to finger print the cancer from the primary site and multiple metastatic sites to evaluate conclusively whether distant metastasis to have the ability to re-metastasise or do they all come from the primary cancer. 

I am co-chairing a research conference specifically on this topic coming up in San Francisco. Please visit the 2019 8th International Cancer Metastasis Congress if interested at http://cancermetastasis.org/. You can also view last years presentations here to help.

References:

1. Hellman S and Weichselbaum RR. Oligometastases. JCO 13 (1): 8-10, 1995
2. Pereira ER et al. Lymph node metastases can invade local blood vessels, exit the node, and colonize distant orangs in mice. Science 23;359(6382):1403-1407, 2018
3. Brown M et al. Lymph node blood vessels provide exit routes for metastatic tumor cell dissemination in mice. Science 23;359(6382):1408-1411, 2018

Do distant cancer metastases have the ability to re-metastasise?

Yong Wu has answered Near Certain

An expert from University of California, Los Angeles in Breast Cancer

Metastatic cancer is more aggressive than the primary cancer, for example, EMT marker (Biomarkers for epithelial-mesenchymal transitions) expression increases.

Do distant cancer metastases have the ability to re-metastasise?

Alan Wells has answered Near Certain

An expert from University of Pittsburgh in Cancer Metastasis

In addition to the parabiotic studies in rats, the cancer biology of the metastatic cells is similarly plastic to those in primary site. The activation to mesenchymal in the recurrent metastases repeats that of the primary escape. There is no reason to think that these cells do not further disseminate (finding of cancer cells in the circulation after surgery for primary tumors supports the ability to reach the conduits).

Do distant cancer metastases have the ability to re-metastasise?

Peter J Campbell has answered Near Certain

An expert from Wellcome Sanger Institute in Cancer, Oncology

A metastasis is a deposit of cancer that has spread from its original (primary) site to a new (secondary) site. We now have strong evidence that cancer cells can spread not just from primary cancer to metastasis; but also from metastasis to metastasis. This evidence comes through a form of ‘genetic fingerprinting’ – cancers develop through the accumulation of genetic changes (mutations) throughout the lifespan. These genetic changes together represent a unique fingerprint of the cancer cells – no other cell in the body will have that particular set of genetic changes. When we look at the genetic changes in different metastases and the primary cancer from a given patient, we can sometimes tell that the metastases are more closely related to one another than they are to the primary cancer. This suggests that the pattern of spread is from the primary cancer to one site of metastasis; and then from that metastasis to another site of metastasis. This has been seen in several cancer types, including ovarian cancer, prostate cancer, breast cancer and pancreatic cancer.