Epithelial-mesenchymal transition, cancer stem cells and treatment resistance
Cet article passe en revue les travaux récents sur les liens entre cellules souches cancéreuses, transition épithélio-mésenchymateuse et résistance thérapeutique dans le cancer du sein
Mortality from breast cancer has steadily been declining over the last decade, primarily due to earlier detection, adjuvant therapies and the advent of targeted therapies for ER positive and HER2 positive cancers [1, 2]. Despite these advances, a large number of patients relapse after an initial response to standard of care therapy. Novel therapies that prevent breast cancer relapse and metastasis are needed. An emerging hypothesis is that tumors contain a subpopulation of cells, called cancer stem cells (CSCs), which have the ability to self renew and regenerate the tumor. Increasingly, clinical evidence points to an intrinsic resistance to endocrine therapy and chemotherapy of this subpopulation of cancer stem cells [3]. The residual tumors after chemotherapy are enriched for CSCs and have a gene signature with hallmarks of epithelial-mesenchymal transition (EMT) like properties [3, 4]. This review is a step in developing an understanding of the nature of treatment resistance and the role that EMT and cancer stem cells play in this process.