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Old 01-05-2009, 01:06 PM   #1
Lani
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understanding metastasis(and how to prevent it) may have taken a big leap forward!

'Relocation' plan of metastatic cancer cells uncovered by Stanford researchers

STANFORD, Calif. — Few things are as tiresome as house hunting and moving. Unfortunately, metastatic cancer cells have the relocation process down pat. Tripping nimbly from one abode to another, these migrating cancer cells often prove far more deadly than the original tumor. Although little has been known about how these rogue cells choose where to put down roots, researchers at the Stanford University School of Medicine have now learned just how nefarious they are.

"Metastasis is not a passive process," said cancer biologist Amato Giaccia, PhD. "Cells don't just break off the primary tumor and lodge someplace else. Instead the cells actually secrete substances to precondition target tissue and make it more amenable to subsequent invasion."

In other words, the cells plan ahead by first sending molecular emissaries to orchestrate a breach in the body's natural defenses. Blocking this cascade of events in mice hobbled the cells' migration and prevented the metastatic cancer that developed in control animals. The researchers are hopeful that a similar tactic will be equally successful in humans.

Giaccia, the Jack, Lulu and Sam Willson Professor and professor of radiation oncology at Stanford, is the senior author of the research, which will be published in the Jan. 6 issue of Cancer Cell. Giaccia is also a member of the Stanford Cancer Center.

Scientists have known for some time that certain primary cancers metastasize preferentially to other organs — breast cancer often spreads to the lungs, for example. This is in part due to the patterns of blood flow in the body. They also knew that such future colonization sites, called pre-metastatic niches, harbor large numbers of cells derived from the bone marrow that somehow facilitate the cancer cells' entry. What they didn't know is how the bone-marrow-derived cells were summoned, and what, if any, role the primary tumor cells played in site selection.

Giaccia and his colleagues turned their attention to a substance that they had previously shown to be involved in metastasis: a protein called lysyl oxidase, or LOX. In healthy people, LOX works to strengthen developing connective tissue by modifying collagen and elastin, which are components of the extracellular matrix surrounding many organs. LOX expression increases in cancer cells deprived of oxygen — a condition called hypoxia that begins to occur when blood vessels fail to reach the inner cells of a growing tumor mass. Inhibiting LOX expression decreases tumor cell invasion and metastasis in the lungs of mice implanted with human breast cancer cells.

The researchers wanted to know how LOX affected metastasis. In the current study, they found that blocking LOX expression in the mice not only prevented metastases, it also kept the bone-marrow-derived cells necessary for niche formation from flocking to the site. When LOX was present, it accumulated in the lungs of the mice and was associated with one particular type of bone-marrow-derived cell known as a CD11b cell. CD11b cells, in turn, secreted a protein that breaks apart collagen and provides a handy entry point for the soon-to-arrive cancer cells.

"We've never really understood before how normal tissues are modified to allow metastases to target and successfully invade them," said Giaccia, who is hoping to devise a clinical trial to study the effect of blocking LOX activity in humans with primary cancers. "Now we know that LOX goes to the target tissue and attracts CD11b and other bone-derived cells to the pre-metastatic niche. If the mouse data is transferable to humans, and we have reasons to think it will be, we really believe way may have found an effective way to treat human disease."
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Old 01-05-2009, 01:29 PM   #2
Belinda
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Wow Lani - thank you - this is very exciting news - Bx
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Belinda
  • Diagnosed 3 Jan 2007, Stage IIb, Mastectomy and axillary clearance 10 Jan 07, 6 of 19 nodes affected, multi-focal cancer, HER2 positive. Second mastectomy (prophylactic). Chemo - AC 3 months, Taxol 3 months - then radiation 5 weeks.
  • Aug 2011 - Diagnosed with Stage IV mets to lung, sternum and 12 or so thoracic nodes - Rads to Sternum, then weekly abraxane and herceptin for 12 weeks.
  • May 2012- good scans - all nodes still about normal size, hole in sternum repairing, lung tumour 'obliterated'.
    Ongoing herceptin every 3 weeks. Bloods still all good! Life good!
  • March 2013 - recurrence - tumours in lungs and mediastinum (coughing up blood) - immediate radiation treatment to right lung and mediastinum, still on Herceptin, and 3 months of Vinoralbine - stable for a little while!
  • Coughing and breathlessness started again September 2013, treated as radiation-induced fibrosis (which can be seen on scans - albeit stable). ie puffers, steroids
  • January 2014 - cough becomes bloody again, scans show big mediastinal tumour wrapped around and choking the life out of my right main bronchus, radiation deemed off limits as my lungs are hypersensitive to radiation (measured by existing damage from 2013) .....................- ie I am in the 5% of people likely to suffer severe radiation damage to the lungs that they warn you about before starting treatment! (so special! :) )
  • Started chemo Feb 2014 - continuing Herceptin (continuous since Aug 2011), with Carboplatin and Gemcitabine. Discontinued Gemcitabine because of se's. Starting cycle 5 Herc/Carbo 5 May 2014.
  • Meantime.....coughing and breathlessness increased to SCARY levels with racing heartbeat that won't slow down, breath that won't come back, even just walking to the bathroom or up 3 or 4 steps.
  • ICU from May 5 2014, collapsed right lung due to tumour, small pulmonary embolism (left), tumours growing in mediastinum left and right, dvt lower right leg
  • Plan seems to be bronchoscope next week to see if tumour can be lasered and stent inserted in right bronchus to reopen air access to lower parts of right lung. If that is successful might be able to have brachytherapy to worst tumour, otherwise no more options for external radiotherapy.
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Old 01-05-2009, 01:31 PM   #3
Believe51
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Location: RHODE ISLAND (Ed getting me a latte on 2nd Cancerversary Cruise 2008) 'BELIEVE': To accept as true or real, To have faith in, To presume ALWAYS BELIEVE
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Lani, sounds like we are one step closer to understanding one more important component to this nasty disease. Article is very interesting. Thanks again.>>Believe51
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9/7/06Husband 50yrs=StageIV IBC/HER2+,BoneMets10/06TaxotereX10,'H'1X wk,Zometa,Tamoxifen4/12/07Last Tax5/18/07Pet=Rapid Cell Activity,No Organ Mets,Lytic Lesions,Degeneration,Some Bone Repair5/07ChemoFail6/01/07Pleural Thoracentisis=Effusions,NoMalignantCells6/19/07+7/2/07DFCI
6/25/07BrainMRI=BrainMets,Many<9mm7/10/07WBR/PelvisRad37.5Gx15&Nutritionist8/19/07T/X9/20/07BrainMRI=2<2mm10/6/07Pet=BoneProgression
10/24/07ChemoFail11/9/07A/Cx10,EndTam12/7/07Faslodex12/10/07Muga7512/13/07BlasticLesions1/7/08BrainMRI=Clear4/1/08Pet=BoneImprovement,
NoProgression,Stable4/7/08BrainPerfect5/16/08Last A/C8/26/08BrainMets=10(<9mm)9/10/08Gamma10/30/08Met=5mm12/19/08Gamma5mets5
12/22/08SpinalMets1/14/09SpinalRads2/17/09BrainMRI=NoNewMets4/20/09BoneScan5/14/09Ixempra6/1/09BrainMRI=NumerousMets6/24/09DFCIw/DrBurstein6/26/09Continue
Ixempra/Faslodex/Zometa~TM now lower7/17/09Stop Ixempra By Choice9/21/09HOSPICE10/16/09Earned His Deserved Wings And Halo=37 Month Fight w/Stage 4 IBC, Her2+++,My Hero!!
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Old 01-05-2009, 01:39 PM   #4
karenann
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I actually understood this article. Thanks Lani.

Karen
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Old 01-06-2009, 08:32 PM   #5
vickie h
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Thumbs up

Lani, Thanks so much for this article. I, too, actually understood it and hope to hear more about it. Again, thank you for thinking of us and posting this important research. Love, Vickie
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Life's not about waiting for the storm to pass,
It's about learning to dance in the rain.


Feb 04 IBC IIIC/IV er-/pr- her2+++
3/04 TCH X4
7/ 04 MRM 9/04 Taxol/herceptin wkly 1 yr 33X rads
11/04 skin mets 33x rads,10/05 Avast/Herc. 11 mos.
8/ 06 PET mets lymphs, neck
9/ 06 Navelbine/herceptin
11/ 06 PET NED
2/ 07 skin mets, 4/07 Xeloda, 5/07 add Tykerb
2/ 08 Tykerb failed. Doxil /Herceptin 6 months
8/08 PET skin mets, 8/08 Abraxane/Avastin
11/ 08 PET prog., skin mets
1/09 PET/CT progress, 1/09 Ixempra, 2/09 add Xeloda and low dose Naltrexone
2/09 off Ixempra/Xeloda
3/09 navelbine/herc/cytoxin 4/09 PET shows regress.7/09 start Topotecan. Failed.
8/09 extensive mets rgt brst, back and torso. starting Pazopanib clinical trial.
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