Thomas R. Cox, Oct 2014
Linking breast cancer progression and fibrosis through ECM remodelling
My recent editorial piece on ‘Fibrosis, cancer and the pre-metastatic niche’ has recently been published in Breast Cancer Management.
In this short piece we discuss the interplay between cancer and fibrosis and look at the parallels between the two pathologies. In particular we address the concept that early pre-metastatic changes at secondary sites and changes accompanying metastatic outgrowth closely resemble those of fibrotic tissue remodelling.
“The ability of cells to sense and respond to changes in biochemical and biomechanical cues provided by extracellular matrix is now considered an important factor in determining cancer onset and progression to metastasis”
We ask whether given the significant overlap in pathways associated with fibrosis and cancer, should we simultaneously evaluate agents that target the tumour microenvironment and fibrosis for potential roles in both settings? For example when considering adjuvant therapies for metastatic breast cancer, just as antifibrotic therapies are now being proposed for highly fibrotic primary tumours, it may also be necessary to treat patients with antifibrotic therapies aimed at disrupting the establishment and development of metastases.
“Knowing who, when and how long to treat with antifibrotic therapies in the cancer context may prove problematic as the long-term side effects of such treatments are currently unknown.”
In the future, we believe that it is likely that we will be able to block the pro-tumorigenic and pro-metastatic changes in the ECM without disrupting normal regenerative processes to improve the prognosis and outcome of breast cancer patients.
View article on Breast Cancer Management homepage
Cox TR and Erler JT. Fibrosis, cancer and the premetastatic niche
Breast Cancer Management; 3 (6), 453-455 (2014) | doi:10.2217/bmt.14.36