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Local treatment of metastatic cancer—killing the seed or disturbing the soil?

Nature Reviews Clinical Oncology volume 8, pages 504–506 (2011)Cite this article

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Abstract

The fact that local therapy of the primary tumor is futile in the presence of metastatic disease is almost considered axiomatic among oncologists. However, this perception is now being challenged by new laboratory and clinical data. Results from animal models have demonstrated that some primary tumors release factors that enter the circulation which, by mobilizing cells from bone marrow, render distant organs more receptive to metastasis. Clinical observations in renal, breast, and prostate cancer are all consistent with the hypothesis that treatment directed against the primary tumor might retard progression of existing metastases. This hypothesis is amenable to testing by randomized trials of local therapy to the primary site in patients with metastatic cancer.

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Acknowledgements

This work was undertaken in The Royal Marsden NHS Foundation Trust, which receives a proportion of its funding from the NHS Executive; the views expressed in this publication are those of the authors and not necessarily those of the NHS Executive. We acknowledge NHS funding to the NIHR Biomedical Research Center. S. C. Morgan was supported by a research fellowship grant from the Canadian Association of Radiation Oncology and Elekta AB.

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Authors and Affiliations

  1. The Ottawa Hospital, 501 Smyth Road, Box 903, Ottawa, K1H 8L6, ON, Canada

    Scott C. Morgan

  2. Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK

    Chris C. Parker

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  1. Scott C. Morgan
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Both authors researched data and wrote the article, provided substantial contributions to the discussion of content and reviewed and edited the manuscript before submission.

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Correspondence to Chris C. Parker.

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Morgan, S., Parker, C. Local treatment of metastatic cancer—killing the seed or disturbing the soil?. Nat Rev Clin Oncol 8, 504–506 (2011). https://doi.org/10.1038/nrclinonc.2011.88

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