title: Therapeutic implications of Cancer Initiating Cells.
abstract: BACKGROUND
  Until few years ago, all neoplastic cells within a tumour were suggested to have tumorigenic capacity, but recent evidences hint to the possibility that such feature is confined to a subset of Cancer Initiating Cells (CICs), also called Cancer Stem Cells (CSCs). These cells are the reservoir of the heterogeneous populations of differentiated cancer cells constituting the tumour bulk. Mechanisms shared with somatic stem cells, such as quiescence, self-renewal ability, asymmetric division and multidrug resistance, allow to these cells to drive tumour growth and to evade conventional therapy.
  
  
  OBJECTIVE
  Here, we give a brief overview on the origin of CICs, the mechanisms involved in chemoresistance and therapeutic implications.
  
  
  CONCLUSIONS
  Current cancer treatments, based on the assumption that tumour cell population responds homogeneously, have been developed to eradicate proliferating cells. The new model of tumorigenesis entails significant therapeutic implications, in fact if a small fraction of CICs survives conventional therapy it may lead to recurrence after month or years of apparent remission. Selective targeting of CICs could eliminate the tumour from the root, overcoming the emergence of clones capable of evading traditional therapy and increasing overall disease free survival.
authors: University of Palermo, Department of Surgical and Oncological Sciences, Laboratory of Cellular and Molecular Pathophysiology, Palermo, Italy.
authors: Alessandro
authors: A
authors: Scopelliti
authors: Patrizia
authors: P
authors: Cammareri
authors: Veronica
authors: V
authors: Catalano
authors: Vitanna
authors: V
authors: Saladino
authors: Matilde
authors: M
authors: Todaro
authors: Giorgio
authors: G
authors: Stassi
mesh_terms: D000071916:AC133 Antigen; D000818:Animals; D015703:Antigens, CD / Q000096:biosynthesis; D017209:Apoptosis; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D006023:Glycoproteins / Q000096:biosynthesis; D006801:Humans; D008495:Medical Oncology / Q000639:trends; D051379:Mice; D009362:Neoplasm Metastasis; D009368:Neoplasm Transplantation; D009369:Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D014411:Neoplastic Stem Cells / Q000166:cytology*; D010455:Peptides
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; D010455:Peptides