In April, The Scientist asked,     Are Cancer Stem Cells Ready for Prime Time? The    controversial hypothesis posits that cells with stem-cell-like    characteristicssuch as the ability to self-renew and give rise    to more tumor cellscontribute to cancers ability to evade    traditional therapies. But despite previous investigations,    which found subsets of tumor cells with the ability to grow in    immunocompromised mice, not everyone is convinced that    endogenous tumor development is stimulated by cells with    self-renewal capacity.  
    Now, using genetic labeling techniques, three new studies trace    cell lineages in new tumors to provide strong evidence for the    existence of cancer stem cells. Published today (August 1) in    Nature and Science, the technically elegant    studies provide support for the cancer stem cell model across    three different types of solid tumorsskin, intestinal, and    brainsaid Max    Wicha, an oncologist at the University of Michigan who    helped develop the cancer stem cell hypothesis and in 2004    co-founded OncoMed Pharmaceuticals to develop therapies    targeting cancer stem cells, but was not involved in the    research.  
    The cancer stem cell hypothesis states that cells in tumors    display a similar hierarchy to normal tissues that are    renewed by stem cells, like the skin or intestinal epithelium,    explained     Sunit Das, a neurobiologist at the University of Toronto    who did not participate in the research. Stem cells self-renew    slowly, spending long periods in a quiescent non-dividing    state, and produce a variety of faster-growing cell types.    Because radiation and chemotherapy therapies target    fast-growing cells, slow-growing cancer stem cells are thought    to survive treatment, only to later repopulate the tumor.  
    Previous studies examining the existence and function of cancer    stem cells used transplantation models, said Cdric Blanpain    at the Universit Libre de Bruxelles, who led one of the two    Nature studies. In the past, researchers would    isolate different tumor cell populations and transplant them    into immunocompromised mice, Blanpain explained. They found    that some tumor fractions grow better than others. They called    them cancer stem cells, thinking the cells were feeding pure    tumor growth.  
    But critics argued that rather than demonstrating the existence    of cancer stem cells, this just showed selection of cells    capable of growing in the new environment. Luis Parada,    whose group at University of Texas Southwestern Medical Center    published the second Nature paper, noted that these    criticisms are especially valid for solid tumors, which need a    great deal of manipulation before any subsets of cells can be    transplanted. The question we wanted to address was, Is it    possible to probe the existence of cancer stem cells in a    natural setting, where the cancer arose naturally and    spontaneously without manipulation?  
    To identify and track cancer stem cells directly, all three    groups used genetics. Blanpains group engineered mice so skin    tumor cells would express a fluorescent protein after    administration of the carcinogen tamoxifen and tracked the    growth dynamics of the glowing tumor cells. Shortly after being    exposed to the carcinogen, the mice developed non-malignant    papillomas on their skin, in which Blanpain and his colleagues    identified two major cell types: a progenitor population with a    limited ability to differentiate and a surprisingly short life    span, and stem-cell-like cells, which were long-lived and could    self-renew or divide to produce new progenitors.  
    Its generally accepted that cancer cells acquire excessive    proliferative abilities, so Blanpain expected the progenitor    cells to be immortal, he said. But only the cancer stem cells    survived long term, highlighting their importance for    supporting tumor growth.  
    Work by a group in The Netherlands provided similar evidence in    intestinal cancer, published in Science. This team    used a combination of genetic mutations that promoted colon    cancer development from intestinal stem cells, and again marked    the tumor cells with fluorescence. Tracing the lineage of the    marked cells, the researchers showed that the many different    cell types of a tumor were all derived from the cancer stem    cells, said co-first author Hugo Snippert at University Medical    Center Utrecht. We saw that the cancer stem cells were    producing new cells so fast they were taking over the tumor.  
      White arrows point to a subset of glioblastoma cells that      express green fluorescent protein (GFP) but rarely stain for      Ki67, a marker of proliferation. This indicates that the      tumor cells that appear green are in a resting state.      Nature    
    The third study, published in Nature by Paradas    group, examined the brain cancer glioblastoma, and provided    evidence for another facet of the cancer stem cell    hypothesisthat cells with stem-cell-like properties promote    cancer recurrence after treatment. Once again, the researchers    used fluorescent markers in mice to show that after    chemotherapy, stem-cell-like cells drove regrowth of the tumor.    Engineering this population of cells to be sensitive to the    anti-viral drug ganciclovir, the scientists were able to    selectively kill the cancer stem cells in the tumor. Doing so    slowed the progression of pre-cancerous lesions and prevented    malignancies from infiltrating surrounding normal brain tissue.    Combining ganciclovir with chemotherapy significantly prolonged    the mices lives.  
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Cancer Stem Cells Really Do Exist?