Existence and Significance of Non-Autonomous Cancer Replication for Clinical Management of Cancer: Observations and Hints from Ovarian Cancer Cases

Abstract

Cancer cells progress through replication. What has been puzzling to cancer surgeons and oncologists is not why cancer cells continue to grow, but why some of them do not grow steadily as expected and this behavior varies between cases and even between lesions in the same case. Our previous reports have addressed the issue of tight control of tumor progression by targeting only a minority part of cells in a tumor by targeted drugs such TK inhibitors in lung cancer. The reconciliation of this situation brought out the concepts of autonomous and non-autonomous tumor replication that divide the mode of cancer cell replication into two categories based on the source of molecular signals that drive tumor replication. This establishment of the mode of tumor replication is very useful for clinical management of cancer, especially critical for risk evaluation of post-surgery cancer recurrence in almost every case. In this report, we apply this concept in the analyses and management of two ovarian cancer cases to show that the mode of tumor replication is a new dimension in cancer staging on top of the current TNM staging system and aids individualized case assessment and management.