Cancer stem cells and individualized therapy.

The concept of individualized cancer chemotherapy emerged three decades ago from the observation that a small fraction of cells in primary tumors can form colonies in soft agar similar to stem cells of the hematopoietic system. In a series of retrospective and prospective clinical studies, clonogenic tumor growth and effects of anticancer agents on the putative cancer stem cells were assessed as predictive factors. The results of these trials showed that clonogenic growth is associated with poor outcome and drug resistance. Recent breakthroughs enabling isolation and the molecular classification of cancer stem cells have renewed interest in cancer stem cells as a therapeutic target. Here, we provide a current overview of cancer stem cell biology and highlight possibilities for targeted intervention with existing and novel experimental anticancer agents.