title: Brain metastasis-initiating cells: survival of the fittest.
abstract: Brain metastases (BMs) are the most common brain tumor in adults, developing in about 10% of adult cancer patients. It is not the incidence of BM that is alarming, but the poor patient prognosis. Even with aggressive treatments, median patient survival is only months. Despite the high rate of BM-associated mortality, very little research is conducted in this area. Lack of research and staggeringly low patient survival is indicative that a novel approach to BMs and their treatment is needed. The ability of a small subset of primary tumor cells to produce macrometastases is reminiscent of brain tumor-initiating cells (BTICs) or cancer stem cells (CSCs) hypothesized to form primary brain tumors. BTICs are considered stem cell-like due to their self-renewal and differentiation properties. Similar to the subset of cells forming metastases, BTICs are most often a rare subpopulation. Based on the functional definition of a TIC, cells capable of forming a BM could be considered to be brain metastasis-initiating cells (BMICs). These putative BMICs would not only have the ability to initiate tumor growth in a secondary niche, but also the machinery to escape the primary tumor, migrate through the circulation, and invade the neural niche.
authors.affiliation: McMaster Stem Cell and Cancer Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. msingh0285@hotmail.com.
authors.forename: Mohini
authors.initials: M
authors.lastname: Singh
authors.affiliation: McMaster Stem Cell and Cancer Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. branavan.manoranjan@medportal.ca.
authors.forename: Branavan
authors.initials: B
authors.lastname: Manoranjan
authors.affiliation: McMaster Stem Cell and Cancer Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. smahendram@gmail.com.
authors.forename: Sujeivan
authors.initials: S
authors.lastname: Mahendram
authors.affiliation: McMaster Stem Cell and Cancer Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. mcfarln@mcmaster.ca.
authors.forename: Nicole
authors.initials: N
authors.lastname: McFarlane
authors.affiliation: McMaster Stem Cell and Cancer Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. venugop@mcmaster.ca.
authors.forename: Chitra
authors.initials: C
authors.lastname: Venugopal
authors.affiliation: McMaster Stem Cell and Cancer Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. ssingh@mcmaster.ca.
authors.forename: Sheila K
authors.initials: SK
authors.lastname: Singh
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000378:metabolism; D001932:Brain Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating / Q000378:metabolism; D014411:Neoplastic Stem Cells / Q000378:metabolism*; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology