Metastatic cancer (also known as Stage IV cancer) is not a single type of cancer, but rather a term used to describe any cancer that has spread from the area it started to other areas of the body. Although cancer can spread to any part of the body, the most common sites of metastasis are the bones, liver and lungs.
- Metastasis causes more than 90% of cancer-related deaths, but receives less than 5% of the funding.
- Metastatic cancer can occur 5, 10, 15 or more years after a person’s original diagnosis and/or after successful treatment checkups and annual screenings.
- Although some types of metastatic cancer may be cured with treatment, most cannot right now.
Source: American Cancer Society’s Cancer Facts & Figures 2020
In addition to specific projects listed below, genomics research is helping us attack childhood cancer – and all types of cancer. NFCR has distinguished itself from other organizations by emphasizing long-term, transformative research and working to move people toward cancer genomics.
The diagnosis of metastatic or as it is sometimes called, advanced cancer, is devastating to patients and their loved ones. Dr. Danny Welch and his team have identified genetic changes that could predict whether or not patients will develop metastasis. This exciting research is ongoing and is under close observation. At least some of these genetic changes occur in mitochondria – where cells convert nutrients into energy. Mitochondrial DNA is present in every cell and is small enough to be rapidly analyzed, which means that a simple blood draw and analysis of mitochondrial DNA could help guide doctors in treating those patients who are susceptible to metastasis and may need more aggressive treatment. Or, such a blood test could spare patients at low risk from having to undergo some of the side effects of treatment.
In another remarkable initiative, Dr. Welch and his team have also discovered eight genes that get turned off when cancer cells become metastatic cells – known as ‘metastasis suppressor genes’. One gene, BRMS1, regulates gene expression to suppress metastasis. BRMS1 also makes metastatic cells remain dormant or in a ‘sleep mode’. KISS1 gene was discovered in melanoma and the scientists determined that cells expressing KISS1 can complete all of the early steps of the metastatic process but do not form a new metastatic site. Continuing research can lead to unique anti-metastasis therapeutics such as ‘mimetics’ that are similar to the KISS1 or BRMS1 protein and could arrest metastasis.
Dr. Daniel Haber developed the CTC-iChip — an advanced micro-engineered device that captures from a blood sample the circulating tumor cells in the bloodstream that may metastasize to a vital organ. His team is using the gene-editing tool, CRISPR, to identify and turn on or off the genes that regulate the ability of CTC’s to metastasize from breast tumors. Several candidate genes have been identified. Ultimately, therapies will be developed that suppress the genes and give women greater hope for surviving the metastatic recurrence of breast cancer. This same approach can be utilized for other types of metastatic cancer.
One of the major signaling proteins in tumor formation and suppression of our immune system found in over 50% of cancers is STAT3. As an activator of the expression of genes, STAT3 controls networks of genes that allow cancer growth and metastasis (spreading). However, the development of a drug that targets STAT3 has been a challenge for the research community, earning STAT3 the label of ‘undruggable’.
Dr. Ron DePinho and his colleagues used computer-based drug screening of hundreds of thousands of compounds from chemical libraries to identify several compounds that inhibit STAT3 protein in complex tumor models of various cancers. With funds from the NFCR AIM-HI Translational Research Initiative, the scientists have brought the lead inhibitor agent to clinical trials to treat liver, colorectal, head and neck, triple negative breast, gastrointestinal and other advanced cancers, giving patients hope that their lives may be saved.