Growth factor LPA may be key player in metastatic ovarian cancer.(Gynecology)

The growth factor lysophosphatidic acid (LPA) is emerging as a key player in the cascade of events that lead to metastatic ovarian cancer, Dr. Fishman said.

"It's intraabdominal disease that kills," he said, emphasizing that numerous processes have to fall into place for cells to migrate, adhere to a distant site, invade, and proliferate.

"You can't shut down cancer by attacking one" element, he said. "Tumor cells are very clever."

Stymied on one front, they seek alternatives. Seemingly captured, they escape.

But it turns out that LPA fulfills so many stimulatory functions that targeting it has the potential of substantially crippling the metastatic process, Dr. Fishman predicted.

"This lysophospholipid pretty much does every bad thing you can think of. It stimulates every bad process that helps the cancer to grow," he said.

It upregulates proteinase activity, triggering movement of enzymes to the cell surface; organizes and directs tumor cells; stimulates cell proliferation; and makes cell membranes more fluid, thus allowing tumor cells to "squeeze through the tight walls of the cell matrix."