Preface

Tumor metastasis results from the spreading of a primary tumor and establishment of secondary tumors, mostly in vital organs such as the lung, liver, and brain. Tumor metastasis is responsible for the majority of cancer deaths, yet it remains the least understood stage of cancer.

Metastatic tumor cells acquire new biological features allowing them to migrate, invade normal tissues, escape the immune system control, and develop drug resistance. Many mechanisms have been shown to play an important role in the metastatic process, particularly through the tumor microenvironment. Many factors present in the tumor microenvironment have been identified and demonstrated to play either a pro- or anti-metastatic role, allowing the development of new targeted therapies.

However, despite an armamentarium of treatments, patients remain at a high risk for metastasis. Better understanding of the mechanisms leading to cancer metastasis is crucial for the development of novel and more efficacious therapies.

Currently many research areas are involved in the identification of novel biological markers and therapeutic targets. Modern approaches including genomics, molecular biology, immunology, imaging and computational biology, are carried out in cancer research, leading to the development of novel therapeutic options. Many therapeutic options based on the manipulation or modulation of the immune system have shown unprecedented results and have provided new hope to cancer patients. The introduction of targeted and immune-based therapies have significantly improved the cancer survival rate. In addition to discussing relevant options of cancer treatment and ongoing clinical trials, recent breakthroughs in cancer development and metastasis are provided in this book.

Important efforts and collaborations with leading experts in cancer research and clinics were crucial for achieving this high quality book. We thank all the contributors for sharing their expertise, discoveries, and their views and bringing new hopes for cancer patients and their families. The readers will appreciate the excellent and reliable knowledge in this book.

Although the cancer survival rate has significantly improved over the years, the improvement is primarily due to early diagnosis and cancer growth inhibition. Limited progress has been made in the treatment of cancer metastasis due to various factors. Current treatments for cancer metastasis are mainly chemotherapy and radiotherapy, though the new generation anti-cancer drugs (predominantly neutralizing antibodies for growth factors and small molecule kinase inhibitors) also have effects on cancer metastasis in addition to their effects on cancer growth. Cancer metastasis begins with detachment of metastatic cells from the primary tumor, travel of the cells to different sites through blood/lymphatic vessels, and settlement and growth of the cells at a distal site. During the process, metastatic cells go through detachment, migration, invasion, and adhesion. These four essential metastatic steps are inter-related and affected by multi-biochemical

**II**

**Section 3**

**Section 4**

*and Mark Roufaiel*

*Nanda Gopal Sahoo*

Artificial Intelligence

*and José Abella*

*Audronė Valerija Kalvelytė*

Prediction of Response to Therapy and Drug Resistance **145**

**Chapter 7 147**

**Chapter 8 195**

New Perspectives for Cancer Diagnosis and Therapy **217**

**Chapter 9 219**

**Chapter 10 237**

**Chapter 11 267**

**Chapter 12 293**

Recent Approaches Encompassing the Phenotypic

*by Wabel AL-Busairi and Maitham Khajah*

Os(II)-Based Complexes as Photosensitizers

in Cancer Imaging, Targeting and Treatment

*by Cheng-Ta Hsieh and Da-Tong Ju*

Cell Heterogeneity for Anticancer Drug Efficacy Evaluation *by Aurimas Stulpinas, Aušra Imbrasaitė, Natalija Krestnikova and* 

The Principles behind Targeted Therapy for Cancer Treatment

Stereotactic Radiosurgery for Recurrent Glioblastoma Multiforme

Anticancer Photodynamic Therapy Using Ruthenium(II) and

*by Pavel Kaspler, Arkady Mandel, Roger Dumoulin-White* 

Theranostics Application of Graphene-Based Materials

An Approach Using the FYC-Index of Spiculation and

*by Fernando Yepes-Calderón, Flor M. Medina, Nolan D. Rea* 

*by Neha Karki, Anita Rana, Himani Tiwari, Pushpa Negi and* 

Tumor Malignancy Characterization in Clinical Environments:

events and parameters. Additionally, it is known that the tumor microenvironment (such as extracellular matrix structure, growth factors, chemokines, matrix metalloproteinases) plays a significant role in cancer metastasis. The biochemical events and parameters involved in the metastatic process and tumor microenvironment have been targeted or can be potential targets for metastasis prevention and inhibition. This review provides an overview of these metastasis essential steps, related biochemical factors, and targets for intervention.

This book offers significant coverage of cancer from risk factors to the mechanisms leading to tumor progression and metastasis. It provides new perspectives for diagnosis and cancer therapy. It also includes new technologies and a new basis for current cancer therapies. Although tremendous progress has been made in cancer treatment, cancer metastasis remains a major unmet clinical need. The life and death of many cancer patients hangs on the degree of metastasis. To guarantee the high quality of this book, important topics are included and rigorously discussed in a simple and authentic way. The book includes new mechanisms leading to tumor progression and metastasis and also new answers for promoting both diagnosis and therapy. This book is an important source of knowledge and will be useful for researchers, medical doctors, graduate and medical students, health care and continued medical providers, and all individuals interested in understanding this devastating disease.

#### **Ahmed Lasfar**

**1**

Section 1

Mechanisms of Tumor

Progression and

Metastasis

Full Member of New Jersey Cancer Institute, Faculty member and laboratory head at Rutgers University, Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Piscataway, New Jersey

#### **Karine A Cohen-Solal**

Chief Scientific Officer, Lambda Pharmaceutical Bridgewater, New Jersey

Adjunct Faculty at Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New Jersey Section 1
