VCAM1 and metastatic malignant neoplasm: Moreover, in a lung metastasis model of breast cancer, metastatic cancer cells were observed to express vascular cell adhesion protein 1 (VCAM1) on their surface, which binds to α4-integrin, a molecular receptor on the surface of lung macrophages, which in turn activates the PI3K/Akt signaling pathway to maintain the survival of metastatic breast cancer cells in lung tissue (79).