EMT, CTCs and CSCs in tumor relapse and drug-resistance.
EMT, CTCs and CSCs in tumor relapse and drug-resistance.
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DOI：
10.18632/oncotarget.4037
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发表时间：
2015-05-10
期刊：
影响因子：
--
通讯作者：
Li S
中科院分区：
文献类型：
--
作者：
Mitra A;Mishra L;Li S
肿瘤复发和转移是晚期癌症患者生存率低的主要原因，尽管手术切除或化疗成功。复发和转移的一个主要原因是肿瘤干细胞(CSCs)的持续存在，这种细胞对化疗具有高度耐药性。尽管在各种组织特异性癌症中有抑制几种CSCs亚群的高效药物可用，但在患者中复发仍然很常见。为了找到更适合复发的治疗方法，需要确定与复发启动的CSCs相关的潜在转移和耐药机制。最近对一些癌症患者的循环肿瘤细胞(CTCs)的研究表明，CSCs的表型和上皮-间充质转化(EMT)的表型都存在。这些患者对标准化疗无效，无进展存活率低，这表明EMT阳性的CTCs与复发启动的CSCs共存或转化为复发启动的CSCs。此外，癌细胞中的EMT编程使细胞外基质的重塑能够打破启动复发的CSCs的休眠状态。在这篇综述中，我们广泛讨论了EMT计划与CTC和CSCs的关系，以表征易复发的患者亚群。确定EMT转化的CTCs和CSCs启动复发的机制可以促进新的或增强的个性化治疗方案的开发。
Tumor relapse and metastasis are the primary causes of poor survival rates in patients with advanced cancer despite successful resection or chemotherapeutic treatment. A primary cause of relapse and metastasis is the persistence of cancer stem cells (CSCs), which are highly resistant to chemotherapy. Although highly efficacious drugs suppressing several subpopulations of CSCs in various tissue-specific cancers are available, recurrence is still common in patients. To find more suitable therapy for relapse, the mechanisms underlying metastasis and drug-resistance associated with relapse-initiating CSCs need to be identified. Recent studies in circulating tumor cells (CTCs) of some cancer patients manifest phenotypes of both CSCs and epithelial-mesenchymal transition (EMT). These patients are unresponsive to standard chemotherapies and have low progression free survival, suggesting that EMT-positive CTCs are related to co-occur with or transform into relapse-initiating CSCs. Furthermore, EMT programming in cancer cells enables in the remodeling of extracellular matrix to break the dormancy of relapse-initiating CSCs. In this review, we extensively discuss the association of the EMT program with CTCs and CSCs to characterize a subpopulation of patients prone to relapses. Identifying the mechanisms by which EMT-transformed CTCs and CSCs initiate relapse could facilitate the development of new or enhanced personalized therapeutic regimens.
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