Department of Stem Cell Biology and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Protein Cell. 2010 Jul;1(7):638-55. doi: 10.1007/s13238-010-0078-y. Epub 2010 Jul 29.
Glioblastomas (GBMs) are highly lethal primary brain tumors. Despite current therapeutic advances in other solid cancers, the treatment of these malignant gliomas remains essentially palliative. GBMs are extremely resistant to conventional radiation and chemotherapies. We and others have demonstrated that a highly tumorigenic subpopulation of cancer cells called GBM stem cells (GSCs) promotes therapeutic resistance. We also found that GSCs stimulate tumor angiogenesis by expressing elevated levels of VEGF and contribute to tumor growth, which has been translated into a useful therapeutic strategy in the treatment of recurrent or progressive GBMs. Furthermore, stem cell-like cancer cells (cancer stem cells) have been shown to promote metastasis. Although GBMs rarely metastasize beyond the central nervous system, these highly infiltrative cancers often invade into normal brain tissues preventing surgical resection, and GSCs display an aggressive invasive phenotype. These studies suggest that targeting GSCs may effectively reduce tumor recurrence and significantly improve GBM treatment. Recent studies indicate that cancer stem cells share core signaling pathways with normal somatic or embryonic stem cells, but also display critical distinctions that provide important clues into useful therapeutic targets. In this review, we summarize the current understanding and advances in glioma stem cell research, and discuss potential targeting strategies for future development of anti-GSC therapies.
胶质母细胞瘤(GBM)是一种高度致命的原发性脑肿瘤。尽管其他实体瘤的治疗方法取得了进展,但这些恶性神经胶质瘤的治疗仍然主要是姑息性的。GBM 对常规放疗和化疗具有极强的耐药性。我们和其他人已经证明,一种叫做 GBM 干细胞(GSCs)的高度致瘤性癌细胞亚群促进了治疗耐药性。我们还发现,GSCs 通过表达高水平的 VEGF 刺激肿瘤血管生成,并促进肿瘤生长,这已被转化为治疗复发性或进行性 GBM 的一种有用的治疗策略。此外,研究表明,类干细胞样癌细胞(癌症干细胞)可促进转移。尽管 GBM 很少转移到中枢神经系统以外的部位,但这些高度侵袭性的癌症经常侵入正常脑组织,阻止手术切除,而 GSCs 则表现出侵袭性的表型。这些研究表明,针对 GSCs 可能有效减少肿瘤复发,并显著改善 GBM 的治疗效果。最近的研究表明,癌症干细胞与正常体细胞或胚胎干细胞共享核心信号通路,但也显示出重要的区别,为开发针对 GSCs 的治疗方法提供了重要线索。在这篇综述中,我们总结了胶质母细胞瘤干细胞研究的最新进展,并讨论了针对 GSCs 的潜在治疗策略,以促进未来抗 GSCs 疗法的发展。