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Annals of Oncology Advance Access first published online on May 3, 2006
This version published online on September 29, 2006

Annals of Oncology, doi:10.1093/annonc/mdl074
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© 2006 European Society for Medical Oncology
Received February 22, 2006
Accepted March 7, 2006

review

Tumour stem cell-targeted treatment: elimination or differentiation

C. Massard 1, E. Deutsch 2, and J.-C. Soria 1 *

1 Department of Medicine, Institut Gustave Roussy, Villejuif, France
2 Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France

* To whom correspondence should be addressed.
J.-C. Soria, E-mail: soria{at}igr.fr


   Abstract

A wide range of studies suggest that most cancers are clonal and may represent the progeny of a single cell, a cancer stem cell (CSC) endowed with the capacity to maintain tumour growth. The concept of a cancer stem cell emerged decades ago, and the haematopoietic system is where it has mostly gained ground. More recently, CSC have been described in breast cancer and brain tumours. Growing evidence suggests that pathways regulating normal stem cell self-renewal and differentiation are also present in cancer cells and CSC. Malignant tumours can be viewed as an abnormal organ in which a small population of tumourigenic cancer stem cells have escaped the normal limits of self-renewal giving rise to abnormally differentiated cancer cells that contribute to tumour progression and growth. This new model has important implications for the study and treatment of cancer. Understanding the molecular circuitry which contributes to the maintenance of stem cells may provide an insight into the molecular mechanisms of cancer and thus new approaches for elimination or differentiation therapy. Therapies targeting CSC should focus on pathways such as Wnt, Shh and Notch which are required for the maintenance of cancer stem cells, but also on the ABC transporter family and other specific properties of cancer stem cells.

Keywords: cancer stem cell; differentiation; leukaemia; self-renewal; solid tumours; targeted therapy.
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