title: Cancer stem cells: impact, heterogeneity, and uncertainty.
abstract: The differentiation of tumorigenic cancer stem cells into nontumorigenic cancer cells confers heterogeneity to some cancers beyond that explained by clonal evolution or environmental differences. In such cancers, functional differences between tumorigenic and nontumorigenic cells influence response to therapy and prognosis. However, it remains uncertain whether the model applies to many, or few, cancers due to questions about the robustness of cancer stem cell markers and the extent to which existing assays underestimate the frequency of tumorigenic cells. In cancers with rapid genetic change, reversible changes in cell states, or biological variability among patients, the stem cell model may not be readily testable.
authors.affiliation: Howard Hughes Medical Institute, Children's Research Institute, and Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Magee
authors.forename: Elena
authors.initials: E
authors.lastname: Piskounova
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Morrison
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D002454:Cell Differentiation; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D006801:Humans; D051379:Mice; D008954:Models, Biological; D009369:Neoplasms / Q000235:genetics / Q000473:pathology*; D014411:Neoplastic Stem Cells / Q000473:pathology / Q000502:physiology*
chemical_list: D014408:Biomarkers, Tumor