Colorectal cancer and dormant metastases: Put to sleep or destroy?

Abstract

After reading the review by An et al “Biological factors driving colorectal cancer metastasis”, which covers the problem of the metastasis of colorectal cancer (CRC), I had a desire to discuss with readers one of the exciting problems associated with dormant metastases. Most deaths from CRCs are caused by metastases, which can be detected both at diagnosis of the primary tumor and several years or even decades after treatment. This is because tumor cells that enter the bloodstream can be destroyed by the immune system, cause metastatic growth, or remain dormant for a long time. Dormant tumor cells may not manifest themselves throughout a person’s life or, after some time and under appropriate conditions, may give rise to the growth of metastases. In this editorial, we will discuss the most important features of dormant metastases and the mechanisms of premetastatic niche formation, as well as factors that contribute to the activation of dormant metastases in CRCs. We will pay special attention to the possible mechanisms involved in the formation of circulating tumor cell complexes and the choice of therapeutic strategies that promote the dormancy or destruction of tumor cells in CRCs.

Keywords: Circulating tumor cells; Colorectal cancer; Disseminated tumor cells; Dormant metastases; Metastases; Premetastatic niche

Core Tip: After reading the review by An et al “Biological factors driving colorectal cancer metastasis” (World J Gastrointest Oncol 2024, 16: 259-272), I had a desire to discuss with readers the problem associated with colorectal cancer (CRC) dormant metastases. Metastases can be detected during the initial diagnosis of CRC or can appear many years after treatment. Late metastases are caused by dormant tumor cells. This editorial discusses the most important features of dormant metastases and premetastatic niches, factors that promote the activation of dormant metastases, and possible therapeutic strategies to promote tumor cell dormancy or their killing in CRCs.