Metastatic Cancer Disease

Among pediatric patients with solid tumors, endothelial progenitor cells might play a pivotal role in metastatic cancer disease progression. The research issue of Clinical Cancer Research, is the first to evaluate circulating endothelial cells, bone-marrow-derived (BMD) endothelial progenitor cells, and angiogenic plasma proteins in the peripheral blood of pediatric cancer patients.

It showed that there were increased levels of circulating vascular endothelial growth-factor receptor (VEGFR) BMD progenitor cells in pediatric patients with metastatic solid malignancies. “Not only were these cells found in higher levels in patients [than in] healthy volunteers, but endothelial progenitor cells were found in strikingly higher amounts in patients with metastatic disease,” said author Françoise Farace, PhD, from the Institut Gustave Roussy in Villejuif, France, in a statement.

“Understanding these vascular precursor cells and seeing the changes over time may represent a real strategy for helping to identify drugs that might work in the pediatric population,” noted James L. Abbruzzese, MD, FACP, chair of the Department of Gastrointestinal Medical Oncology at the University of Texas MD Anderson Cancer Center in Houston.

“Insights as to which patients are likely to develop metastases may help us to identify a subset of patients that require more extensive therapy,” he added. Dr. Abbruzzese is also deputy editor of Clinical Cancer Research.

Cells Play Pivotal Role in Metastatic Cancer Disease

Generally, Pediatric patients with solid tumors have better outcomes than adults, but the prognosis for those with cancer metastasis or relapsed disease is poor. The authors note, to improve prognosis for these patients, novel therapeutic approaches are urgently needed. One possible strategy is antiangiogenic therapy, which has emerged as “one of the most significant advances in clinical oncology.” Antiangiogenesis represents a potential therapeutic strategy for pediatric patients as well, although most of the studies to date have focused on adult oncology patients.

In pediatric patients, solid tumors display a strong angiogenic profile because they are nearly exclusively undifferentiated tumors characterized by high proliferation rates and increased vascularity, the researchers explain. In addition, preliminary data support the potential role of antiangiogenic agents in treating this population, and have shown the pivotal role of BMD progenitor cells in metastatic disease progression.

Dr. Farace and colleagues, as a prerequisite to clinical trials with antiangiogenic therapy, evaluated the role of endothelial cells and progenitors in pediatric cancer patients. They drew blood samples from 23 children with localized cancer, 22 with metastatic disease, and 20 healthy children.

“These results support and extend recent preclinical findings indicating that these cells may play a pivotal role in metastatic cancer disease progression,” write the authors. These data suggest that “monitoring and targeting of BMD endothelial progenitor cells could be of interest to guide the optimal use of antiangiogenic treatments in patients with pediatric solid malignancies,” they add.

The study was supported by grants from the Association pour la Recherche sur le Cancer and the Société Française des Leucémies et Cancers de l’Enfant. The authors have disclosed no relevant financial relationships

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Tags: cancer metastasis, lung cancer metastasis, metastases cancer, metastasis breast cancer, metastatic breast cancer, metastatic cancer, metastatic colon cancer, metastatic liver cancer, metastatic lung cancer

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