Figure 7.

A working model of adhesion blockade. Cancer cells locally invade in the primary tumor and intravasate. E-selectin expression is induced at the vessel surface of the premetastatic niche of distant organs. Disseminated cancer cells make an initial contact with the vessel surface at the premetastatic niche through interaction with E-selectin. Successful firm adhesion of cancer cells to the vessel surface lead to extravasation/homing at distant organ. ESTA binds to E-selectin and blocks the interaction with CD44⁺ (HCELL) cancer cell surface. The blockade of shear-resistant adhesion of cancer cells to the vessel surface reduces the chance of homing.