Hedgehog signaling: from the cuirass to the heart of pancreatic cancer.
Exocrine pancreatic cancer is the fifth cause of cancer-related death in Europe and carries a very poor prognosis for all disease stages. To date no medical treatment has significantly increased patients' survival. One of the reasons for pancreatic cancer's chemoresistence is the complex tumor architecture: cancer cells are surrounded by a dense desmoplastic stroma that blocks drug delivery. Moreover, pancreatic cancer is characterized by a marked heterogeneity of cells, including cancer stem cells (CSCs) that act as tumor-initiating cells and hierarchically control the differentiated cancer cells. In particular, this subpopulation is resistant to classic cytotoxic therapies, and seems to be responsible for disease renewal. Hedgehog signaling (HH) is implicated in pancreatic gland development during embryogenesis and is reactivated during tumorigenesis and the maintenance of pancreatic cancer. Some studies demonstrated that the Hedgehog-secreted signaling proteins are overexpressed in both the stromal and CSCs pools, implying an abnormal activation of HH in the main compartment of pancreatic cancer. For this reason, the Hedgehog pathway could be an interesting target for clinical trials to increase drug concentration in neoplastic cells and hence deplete the stroma and directly kill tumor-initiating cells.
L & A Seràgnoli Department of Hematology and Oncological Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Mariacristina
M
Di Marco
Marina
M
Macchini
Silvia
S
Vecchiarelli
Sokol
S
Sina
Guido
G
Biasco
D000813:Anilides / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D053823:Hedgehog Proteins / Q000037:antagonists & inhibitors / Q000235:genetics / Q000502:physiology*; D006801:Humans; D014411:Neoplastic Stem Cells / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000503:physiopathology; D011725:Pyridines / Q000627:therapeutic use; D015398:Signal Transduction
D000813:Anilides; D053823:Hedgehog Proteins; C538724:HhAntag691; D011725:Pyridines; D066246:ErbB Receptors