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Epithelial-Mesenchymal Transition and Cell Cooperativity in Metastasis

¹ Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; ² Department of Oral and Maxillofacial Surgery, Okayama University Graduate School, Okayama, Japan; and ³ Department of Pathology, Harvard Medical School, Boston, Massachusetts

Requests for reprints: Guo-fu Hu, Department of Pathology, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115. Phone: 617-432-6582; Fax: 617-432-6580; E-mail: guofu_hu{at}hms.harvard.edu.

The role of epithelial-mesenchymal transition (EMT) in metastasis remains controversial. EMT has been postulated as an absolute requirement for tumor invasion and metastasis. Three different models including incomplete EMT, mesenchymal-epithelial transition (MET), and collective migration have been proposed for the role of EMT in cancer invasion and metastasis. However, skepticism remains about whether EMT truly occurs during cancer progression, and if it does, whether it plays an indispensible role in metastasis. Our recent findings suggest that EMT cells are responsible for degrading the surrounding matrix to enable invasion and intravasation of both EMT and non-EMT cells. Only non-EMT cells that have entered the blood stream are able to re-establish colonies in the secondary sites. Here, we discuss an alternative model for the role of EMT in cancer metastasis in which EMT and non-EMT cells cooperate to complete the entire process of spontaneous metastasis. [Cancer Res 2009;69(18):7135–9]