Complexity in cancer stem cells and tumor evolution
In a review published just in Seminars in Cancer Biology, Caterina La Porta and Stefano Zapperi from CC&B discuss recent advances on the plasticity of cancer stem cells and highlight their relevance to understand the metastatic process and to guide therapeutic interventions. Recent results suggest that the strict hierarchical structure of cancer cell populations advocated by the cancer stem cell model must be reconsidered since the depletion of cancer stem cells leads the other tumor cells to switch back into the cancer stem cell phenotype. This plasticity has important implications for metastasis since migrating cells do not need to be cancer stem cells in order to seed a metastasis. The article also discusses the important role of the immune system and the microenvironment in modulating phenotypic switching and suggests possible avenues to exploit our understanding of this process to develop an effective strategy for precision medicine.