Mechanisms of Spinal Metastases: New Perspectives

Abstract

Metastases are considered to be a key mechanism for the spread of malignant tumors, whereby tumor cells separate from the primary site and form new tumor nodes in various parts of the body. Bone tissue, including the spine, is often affected by metastases, which can significantly worsen the prognosis and quality of life of patients. Metastasis comprises a complex multistep process during which tumor cells undergo molecular and phenotypic changes enabling them to migrate and adapt to new conditions in the body. Bone metastases can be osteolytic, causing bone destruction, or osteoblastic, stimulating excessive bone formation. Tumor cells enter the bone and activate osteoclasts or osteoblasts, thereby leading to remodelling of bone tissue and formation of a closed cycle of bone destruction and tumor growth. The characteristics of tumor cells are determined by their genetic and epigenetic changes, as well as interaction with the environment. Understanding the molecular and pathophysiological aspects of spinal metastasis is essential to developing effective treatments and improving therapeutic approaches. The paper considers new therapeutic approaches aimed at overcoming spinal metastasis in order to improve the prognosis and quality of life of patients.