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. Author manuscript; available in PMC: 2020 May 15.
Published in final edited form as: Science. 2020 Apr 10;368(6487):eaaw5473. doi: 10.1126/science.aaw5473

Fig. 3. Tumor metabolism supports multiple steps of the metastatic cascade.

Fig. 3.

Bottlenecks occur at several steps of metastasis, and metabolic reprogramming supports successful navigation of some of these barriers. Extracellular acidification promotes intravasation of cells from the primary tumor. A major bottleneck occurs after cells enter the circulation, when survival requires mechanisms to produce NADPH and glutathione (GSH) to counteract oxidative stress. Successful seeding of distant organs and survival during dormancy may require harmony between the new microenvironment and the needs of cancer cells in micrometastatic lesions. Last, anabolic metabolism is reactivated during macrometastatic tumor growth.