Biological and clinical implications of cancer stem cells in primary brain tumors

• Main Authors: Marcello eMaugeri-Saccà, Simona edi Martino, Ruggero eDe Maria
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2013-01-01
• Series: Frontiers in Oncology
• Subjects: hypoxia; cancer stem cells; Glioblastoma Multiforme; chemo-radioresistance; canonical pathway inhibitors; self-renewal pathway inhibitors
• Online Access: http://journal.frontiersin.org/Journal/10.3389/fonc.2013.00006/full

Despite therapeutic advances, glioblastoma multiforme (GBM) remains a lethal disease. The infiltrative nature of this disease and the presence of a cellular population resistant to current medical treatments account for the poor prognosis of these patients. Growing evidence indicates the existence of a fraction of cancer cells sharing the functional properties of adult stem cells, including self-renewal and a greater ability to escape chemo-radiotherapy-induced death stimuli. Therefore, these cells are commonly defined as cancer stem cells (GBM-SCs). The initial GBM-SC concept has been challenged, and refined according to the emerging molecular taxonomy of GBM. This allowed to postulate the existence of multiple CSC types, each one driving a given molecular entity. Furthermore, it is becoming increasingly clear that GBM-SCs thrive through a dynamic and bidirectional interaction with the surrounding microenvironment. In this article, we discuss recent advances in GBM-SC biology, mechanisms through which these cells adapt to hostile conditions, pharmacological strategies for selectively killing GBM-SCs, and how novel CSC-associated endpoints have been investigated in the clinical setting.