Growth of Tumor Cells at Secondary Sites

As described above, a cancer cell needs to overcome a series of challenges in order to successfully metastasize. Once it has gained the capacity to invade and migrate, allowing it to leave the primary tumor and enter the vasculature, the cell must survive transit within the vasculature and arrest at the secondary site. The latter steps have been proposed to be rate-limiting in the metastatic process, as a correlation between metastatic efficiency and resistance to apoptosis at the site of extravasation has been experimentally observed.196

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