Figure 3. The fate of tumour cells in the metastatic microenvironment.

Following cancer cell intravasation, a series of rate-limiting steps affect the ability of these cells to establish secondary tumours in the metastatic site. At each step, the tumour cells can meet several different fates (death, dormancy or survival), which can be modulated by microenvironmental factors, including shielding by platelet aggregates in the circulation, the activation of resident stromal cells, and the recruitment and differentiation of bone marrow-derived cells (BMDCs).