Mimeault M, Batra S K
Department of Biochemistry and Molecular Biology, Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA.
Panminerva Med. 2008 Mar;50(1):3-18.
The rapid progression from aggressive primary cancers into locally advanced and invasive and/or metastatic diseases remains a big obstacle for an early diagnosis and curative therapeutic intervention for cancer patients. The late-stage leukemias and disseminated and metastatic sarcomas, melanomas, brain tumors and epithelial cancers are the devastating diseases associated with a high rate of recurrence after treatment with the conventional clinical therapies including surgery, ionizing radiation, hormonal therapy and systemic chemotherapy, which generally lead to the death of patients. Therefore, the establishment of the molecular events underlying cancer initiation and progression into locally invasive and metastatic diseases is of major interest in basic cancer research as well as for the development of new effective clinical therapeutic options against the recurrent and lethal cancers. Recent advances have led to the identification of specific oncogenic products that are implicated in the malignant transformation of adult stem/progenitor cells into leukemic or tumorigenic and migrating cancer stem/progenitor cells during cancer progression. Of therapeutic interest, the molecular targeting of deregulated signaling elements in cancer stem/progenitor cells and their local microenvironment represents a new potential strategy for the development of more effective clinical treatments against aggressive cancers. Particularly, the combined use of chemotherapeutic drugs to eradicate cancer-initiating cells with hematopoietic stem cell or genetically-modified stem cell transplant is emerging as potential cancer treatments that hold great promise in the area of clinical cancer research. These targeting and stem cell-based therapies may offer the ultimate hope for treating and even curing the patients diagnosed with locally advanced cancers at high risk of recurrence, metastatic and/or relapsed cancers in the clinics.
侵袭性原发性癌症迅速发展为局部晚期、侵袭性和/或转移性疾病,仍然是癌症患者早期诊断和根治性治疗干预的一大障碍。晚期白血病、播散性和转移性肉瘤、黑色素瘤、脑肿瘤及上皮癌,都是常规临床治疗(包括手术、电离辐射、激素治疗和全身化疗)后复发率很高的毁灭性疾病,这些治疗通常会导致患者死亡。因此,确定癌症起始以及发展为局部侵袭性和转移性疾病背后的分子事件,在基础癌症研究以及开发针对复发性和致命性癌症的新的有效临床治疗方案方面都具有重大意义。最近的进展已导致鉴定出特定的致癌产物,这些产物与癌症进展过程中成年干细胞/祖细胞恶性转化为白血病性或致瘤性且具有迁移能力的癌症干细胞/祖细胞有关。在治疗方面,针对癌症干细胞/祖细胞及其局部微环境中失调的信号元件进行分子靶向,代表了一种开发更有效临床治疗侵袭性癌症的新潜在策略。特别是,联合使用化疗药物根除癌症起始细胞与造血干细胞或基因改造干细胞移植,正成为临床癌症研究领域具有巨大潜力的潜在癌症治疗方法。这些靶向治疗和基于干细胞的疗法可能为治疗甚至治愈临床上被诊断为局部晚期癌症、具有高复发风险、转移性和/或复发性癌症的患者带来最终希望。