The Clock Is Ticking: Countdown to Metastases

Metastases cause more than 90% of the morbidity and mortality associated with human cancers. Gene expression signatures associated with cancer progression and metastasis serve as unique tools to assist in patient diagnosis, prognosis, and treatment. Various types of signatures have been identified, ranging from those that are tumor-intrinsic or specific to a particular cancer subtype [1] to genes associated with a specific clinical outcome (e.g., “poor prognosis gene signature”) [2], as well as to genes associated with the development of metastatic lesions [3]. Of those genes that drive cancer processes, some may function by acting on the primary tumor— causing rise of metastatic lesions—or at the metastatic site to promote colonization, survival, and incorporation of surrounding stroma. Identification of metastasis susceptibility genes is thus key for prediction of cancer risk and metastatic relapse.