Drugs that Kill Cancer Stem-like Cells

Abstract

The hallmarks of cancer include processes like self-sufficiency for growth signals, insensitivity to growth-inhibitory (anti-growth) signals, evasion of programmed cell death (apoptosis), unlimited replicative potential, sustained angiogenesis, and tissue invasion and metastasis (Hanahan & Weinberg, 2000). Recent research dictates that these definitions, while valid, ought to be enriched. That is, we should also consider tumours as a heterogeneous ‘collection of cancer cells’ with a hierarchy. This ‘hierarchical hypothesis’ tells us that tumours contain a minute (sometimes very small) sub-set of cells with distinct properties from the bulk of the tumour mass (D’Amour & Gage, 2002; Visvader & Lindeman, 2008; Visvader, 2009). These cells feature certain characteristics inherent to stem cells, including the capacity of self-renewal, asymmetric division and differentiation. They have also a very high propensity to form tumours. Therefore these cells are referred to as cancer stem cells (CSC) or cancer stem-like cells or, better, tumour-initiating cells (TICs). The terminology, while not too important, may be misleading though, since the term ‘cancer stem cells’ implies that we are dealing with true stem cells, which is not possible to reconcile with at this stage, perhaps even more so, since the origin of CSCs is not exactly known.