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 This could possibly cause cancer to metastasize, or spread, even
before a tumor has developed, according to Dr. Julio Aguirre-Ghiso
of The Tisch Cancer Institute at the Icahn School of Medicine at
Mount Sinai in New York City and colleagues. The study was published
online January 2 in Nature Communications.
In previous work, the team identified a group of early cancer cells
that get disseminated into the body during the earliest stages of
breast cancer, before any cancer can be detected.
In the current study, they report that immune cells called
macrophages play an important part in this process. Working in mice
and in human cells in the laboratory, the team found that
dissemination occurs when macrophages are attracted to the milk
ducts, where they trigger a chain reaction that enables the early
cancer cells to leave the breast.
“We show that by disrupting this (process), we can prevent early
dissemination and, ultimately, deadly metastasis,” Aguirre-Ghiso
said in an email to Reuters Health.
“Our study challenges the dogma that early diagnosis and treatment
means sure cure,” he said.
It could also be a “starting point” for a test that could identify
patients with the earliest form of breast cancer, known as ductal
cell carcinoma in situ, who may already have disseminated disease,
he suggested.
Future work will involve identifying the type of macrophages
involved in early dissemination and exactly how the process occurs,
which potentially could lead to the development of novel therapies
to prevent it.
The kind of large, double-blind clinical trial that could prove this
approach is still far in the future, Aguirre-Ghiso noted.
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“Even so,” he said, “our findings point to the notion that early
treatment of high-risk patients may prevent the formation of deadly
metastasis better than the current standard of treating metastatic
disease (only after it has appeared).”
Cancer geneticist and researcher Dr. Theodora Ross of UT
Southwestern in Dallas told Reuters Health by email, “The concept
that macrophages are assisting in early metastases is so
intriguing.” But for now, she cautioned, “the extension of this
hypothesis to humans remains speculative.”
However, “the point that patients with small ‘early’ breast cancers
are not necessarily cured (by early treatment) is a good one,” she
said. “What if metastases happen way before you ever see the cancer
on a screening test?”
(This version of the story fixes date in source link at end of story
from 2017 to 2018)
SOURCE: http://go.nature.com/2A6Funy Nature Communications, online
January 2, 2018.
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