Tumor Cell Dissemination: Emerging Biological Insights from Animal Models and Cancer Patients  Yibin Kang, Klaus Pantel  Cancer Cell  Volume 23, Issue 5, Pages 573-581 (May 2013) DOI: 10.1016/j.ccr.2013.04.017 Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 1 Schematic Representation of the Steps in the Dissemination, Survival, and Expansion of Metastatic Tumor Cells Under the influence of stromal cells in the primary tumor microenvironment, tumor cells undergo EMT or use other means of invasion to escape from the primary tumor (Friedl and Alexander, 2011). Platelets protect CTCs in circulation and further stimulate EMT by TGF-β and NF-κB signaling. Tumor-derived factors and exosomes mobilize bone marrow-derived cells to form premetastatic niche to promote the seeding and expansion of metastasis. Stromal component at the metastasis niches enhances tumor survival, stemness, and immune evasion. CTCs derived from the primary tumor or metastasis may engage in multidirectional seeding to the primary tumor or other metastasis sites. Examples of genes mediating different steps of tumor dissemination are listed in Table 1. Cancer Cell 2013 23, 573-581DOI: (10.1016/j.ccr.2013.04.017) Copyright © 2013 Elsevier Inc. Terms and Conditions