Awakening of Dormant Breast Cancer Cells in the Bone Marrow.
Robert WiederPublished in: Cancers (2023)
Up to 40% of patients with breast cancer (BC) have metastatic cells in the bone marrow (BM) at the initial diagnosis of localized disease. Despite definitive systemic adjuvant therapy, these cells survive in the BM microenvironment, enter a dormant state and recur stochastically for more than 20 years. Once they begin to proliferate, recurrent macrometastases are not curable, and patients generally succumb to their disease. Many potential mechanisms for initiating recurrence have been proposed, but no definitive predictive data have been generated. This manuscript reviews the proposed mechanisms that maintain BC cell dormancy in the BM microenvironment and discusses the data supporting specific mechanisms for recurrence. It addresses the well-described mechanisms of secretory senescence, inflammation, aging, adipogenic BM conversion, autophagy, systemic effects of trauma and surgery, sympathetic signaling, transient angiogenic bursts, hypercoagulable states, osteoclast activation, and epigenetic modifications of dormant cells. This review addresses proposed approaches for either eliminating micrometastases or maintaining a dormant state.
Keyphrases
- induced apoptosis
- bone marrow
- cell cycle arrest
- oxidative stress
- endoplasmic reticulum stress
- end stage renal disease
- breast cancer cells
- squamous cell carcinoma
- mesenchymal stem cells
- signaling pathway
- minimally invasive
- randomized controlled trial
- newly diagnosed
- small cell lung cancer
- gene expression
- systematic review
- blood brain barrier
- endothelial cells
- climate change
- chronic kidney disease
- risk assessment
- dna damage
- percutaneous coronary intervention
- big data
- free survival
- electronic health record
- atrial fibrillation
- human health