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tousled1
12-13-2007, 10:30 PM
Stem Cells in Breast Cancer

Drug resistance in breast cancer has traditionally been explained by acquired or inherent mutations in tumor cells. However, a growing body of research suggests an alternative hypothesis, that of a subpopulation of drug-resistant cancer "stem cells (http://www.curetoday.com/backissues/v4n4/features/future/index.html)" which gives rise to and maintains the primary tumor and recurrences. Although controversial, this hypothesis is supported by significant preclinical research validating the existence of a self-renewing tumor cell subpopulation that can repopulate tumor growth from a small number of residual cancer cells. Specific treatment strategies that target these cancer stem cells may allow for more robust clinical outcomes than traditional drugs currently provide, and optimistically may result in a permanent cure.

In Thursday morning's mini-symposium on stem cells in breast cancer, Jenny Chang, MD, and Michael Lewis, PhD, co-moderated an overview of this fascinating and contested topic. Max Wicha, MD, discussed the latest scientific data supporting the existence of the "cancer stem cell" subpopulation, including the use of ALDH (aldehyde dehydrogenase, a known stem cell marker) as a method of identifying cancer stem cells, in addition to the previously reported markers CD-44 and CD-24.

Jeremy Rich, MD, provided a neuro-oncologist's perspective on potential treatment strategies targeting the purported cancer stem cell subpopulation, and recommended that mechanisms of resistance within this group of cells should be targeted, while being sensitive to the potential systemic toxicity inherent in antagonizing any stem cell population.

Finally, Peter Laird, MD, focused on the importance of epigenetics (the mechanisms regulating genetic function) to the understanding of breast cancer, and provided evidence that the transition from a non-cancerous to a cancerous state involves epigenetic modifications. —Zach Moore, PhD