The combined forces of researchers from the University of Alabama at Birmingham and the University of Kansas Cancer Center have identified four hallmarks of cancer metastasis when cancer spread to different parts of the body from where it started. The belief is metastasis is the cause of up to 90 percent of cancer deaths.

Assistant professor in the UAB Department of Pathology, Douglas Hurst, and associate director of Education at the KUCC, Danny Welch, conducted a literature review of more than 10,000 publications on metastasis and published their findings in Cancer Research, from the American Association for Cancer Research.

It can be quite challenging to treat metastasis. Virtually any cancer type can form metastasis tumors. The most common sites for cancers to metastasis include the brain, bones, lungs, and liver. Other areas include the adrenal gland, lymph nodes, skin, and other organs.

While making a definition of unique properties of metastasis cancer cells, Hurst explains that he hopes to offer a conceptual framework to accelerate the discovery of treatment strategies.

In the review, the author said that their attempts to identify the underlying first principles of the metastasis process hopefully provide a means for simplifying processes that are essential for all metastasis to develop.

The four hallmarks of metastasis that Hurst and Welch identified are:

1. Motility and invasion

2. Modulation of the microenvironment

3. Plasticity

4. Ability to colonize

According to the authors of the study, it has been complicated by both heterogeneities among tumor cells to define the hallmarks of metastasis and the myriad interactions with other molecules and cells throughout the process.

Hurst and Welch said they hope that refining definitions and bringing together diverse data will identify vulnerabilities that metastasis researchers can exploit in the quest to treat cancer metastasis.

Also serving as an associate scientist at the O'Neal Comprehensive Cancer Center at UAB, Hurst explained the reason metastasis is hard to understand. The Hurst lab has been funded by grants from American Cancer Society, METAvivor Research and Support, Inc., and the Elsa U. Pardee Foundation, as well as the Department of Pathology. He said that metastasis is a highly complex pathological process. Increased specificity in defining the underlying principles is essential to understand better and interpret the literature to move forward in the development of therapeutic interventions.