Breast cancer is currently the largest malignant tumour disease in women, with 1.7 million new cases in the world every year. The prognosis for breast cancer patients is relatively good when the disease is discovered at an early stage. But among the 10-15 per cent of women in whom the disease recurs, metastases are the cause of 90 per cent of deaths.
What has also become increasingly clear is that tumours cannot grow without the support of surrounding tissue. You could say the the tumours trick the body's other cells into helping them by providing support. Blood vessel formation in the tumour is a good example of how tumour cells manipulate the surrounding tissue to enable growth.
Cancer cells need oxygen and nutrients to grow and this is supplied by the blood vessel system, which is lured into growing into the tumour. The blood vessels which infiltrate the tumour also become a route for the cancer cells to wander out into the body, thereby spreading metastases. This was previously considered a passive process but, in recent years, researchers have learned that the blood vessels have an active part in allowing the tumour cells to penetrate them. This is the ALK1 protein, found on the surface of the blood vessel cells, which has proven to play an important role in whether or not tumour cells gain access to the blood vessels.
By investigating almost 2000 breast tumours, the researchers found that patients with high levels of ALK1 in the tumour blood vessels were much more likely to develop metastases. Women with a low level of the protein consequently had fewer relapses and thereby survived longer. They also discovered that they could prevent the tumour cells from getting through the blood system to form metastases in the lung by using the drug Dalantercept. The drug blocked the activity of ALK1, thereby preventing the metastatic spread of the tumour. In combination with chemotherapy, the treatment was even more effective.