This article was first published by The Times of Israel and was re-posted with permission.
Metastatic melanoma is the deadliest of the skin cancers; when malignant melanoma metastasizes to the brain, it is a death sentence for most patients. The mechanisms that govern early metastatic growth and interactions of metastatic cells with the brain’s microenvironment are still shrouded in mystery.
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Now, a Tel Aviv University study shows a new way of detecting brain micrometastases months before they transform into malignant and inoperable growths. According to the research, micro-tumor cells hijack astrogliosis, the brain’s natural response to damage or injury, to support metastatic growth. This knowledge may lead to the detection of brain cancer in its first stages and permit early intervention, the university said in a statement.
The study was led by Dr. Neta Erez of the Department of Pathology at TAU’s Sackler Faculty of Medicine and published in Cancer Research.
Erez and her team used mouse models to study and follow the spontaneous metastasis of melanoma in the brain. She and her partners went over all the stages of metastasis: the initial discovery of melanoma in the skin, the removal of the primary tumor, the micrometastatic dissemination of cancer cells across the body, the discovery of a tumor and eventual death.
Imaging techniques used today cannot detect micrometastases. Melanoma patients whose initial melanoma was removed may believe that everything is fine for months, or years, following the initial procedure.
Yet after the removal of the primary tumor, micrometastatic cells travel across the body to the brain or other organs, and are undetectable at the micro level. These cells learn to communicate with cells in their new microenvironment in the brain — cells which are, at first, hostile to them. But eventually a tumor appears. And then it generally is too late for treatment.
Erez calls the period of the initial growth of disseminated micrometastatic cells in distant organs the “black box” of metastasis. “We believe that we have found the tools to characterize this black box,” said Erez. “And this is key to developing therapeutic approaches that may prevent brain metastatic relapse.”
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