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The metastatic cascade refers to the multistep biological process by which cancer cells detach from the primary tumor, invade surrounding tissue, enter the circulation (intravasation), survive transport through blood or lymphatic systems, exit into distant tissues (extravasation), and colonize secondary organs. Each stage involves specific molecular interactions, cell types, and microenvironmental factors, such as epithelial–mesenchymal transition (EMT), degradation of the extracellular matrix by matrix metalloproteinases, evasion of immune surveillance, and the induction of angiogenesis. The metastatic cascade is a defining feature of malignant cancers and is responsible for more than 90% of cancer-related deaths. Current therapeutic strategies attempt to target specific molecules or pathways within this cascade, but the cascade itself is not a single, druggable target.
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