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Old 01-04-2010, 07:49 PM   #49
Rich66
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Re: Novel Cancer Therapies Aim to Destroy the Disease at Its Root: The Cancer Stem Ce

Immunologic targeting of the cancer stem cell.

Wu CJ.
In: Melton D, Girard L, editors. StemBook [Internet]. Cambridge (MA): Harvard Stem Cell Institute; 2008-.
2008 Dec 15.



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Growing evidence has suggested that lack of eradication of the malignant stem cell forms the basis for cancer relapse and progression. In this regard, the clinical experiences of treating chronic myelogenous leukemia (CML), a prototypical stem cell disease, have been instructive, and are illustrative of the challenges facing the treatment of cancer when using potent cytoreductive agents that incompletely eradicate minimal residual disease. On the other hand, several decades of clinical and laboratory experience have demonstrated the curative potential of allogeneic stem cell transplantation for CML and other hematologic malignancies. As reviewed in this chapter, these studies have clearly demonstrated the curative potential of immune-based recognition of tumor cells, including the malignant progenitor cell population. These data set the stage for newer approaches that focus on immune targeting of antigens that are present on the cancer stem cell. Rational immune targeting of the tumor-initiating population critically depends on (1) identifying the unique surface markers of these cells so that they may be isolated, and on (2) defining antigens that are uniquely or preferentially expressed within the malignant cells with stem-cell like functions compared to normal cells. While debate continues as to the exact nature and defining characteristics of the cell population that is capable of propagating tumor, and hence the critical tumor cell sub-population that is required for immune targeting, several promising approaches for cancer immunotherapy are under investigation. Ultimately, combination therapy that includes both pharmacologic cytoreductive agents together with immunologic targeting of malignant stem cell populations may provide an effective curative approach with acceptable toxicity for the treatment of malignant diseases.

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