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First, metastatic cells are not shed from a primary tumor until the tumor has become neovascularized. Second, once metastatic cells have colonized a target organ, they will again only grow to a metastasis of clinically detectable size if they can induce neovascularization. Tumor blood vessels are architecturally different from their normal counterparts – they are irregularly shaped, dilated, tortuous, and can have dead ends [41]. During physiological angiogenesis, new blood vessels rapidly mature and become stable, while tumor blood vessels fail to become quiescent.

Approaches combining the analysis of complex serum protein patterns with advanced bioinformatics have been shown to detect ovarian, prostate, breast, pancreatic, and bladder cancer with outstanding accuracy, and are paving the way for population screening. It appears that, over the last 10 years, proteomics has matured from a collection of tools to a novel science. What is coming next? Many physicians taking part in the modern saga of proteomics have the strong feeling that these powerful validation tools and the resulting scientific knowledge will change their everyday practice.

L. Corthals, D. F. Hochstrasser Copyright © 2004 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim ISBN: 3-527-30807-5 8 1 Proteomics in Biomedicine – A Tool, a Science, or an Art? pected to increase massively over the next few years. Conventional technologies such as two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) and novel tools such as protein chips allow disease or risk patterns to be recognized and linked with patient-specific outcomes. Proteomics tools, much better than genetic techniques, will allow the investigation of the evolution of disease and the influence of treatment over time.

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