title: Complexity in cancer stem cells and tumor evolution: Toward precision medicine.
abstract: In this review, we discuss recent advances on the plasticity of cancer stem cells and highlight their relevance to understand the metastatic process and to guide therapeutic interventions. Recent results suggest that the strict hierarchical structure of cancer cell populations advocated by the cancer stem cell model must be reconsidered since the depletion of cancer stem cells leads the other tumor cells to switch back into the cancer stem cell phenotype. This plasticity has important implications for metastasis since migrating cells do not need to be cancer stem cells in order to seed a metastasis. We also discuss the important role of the immune system and the microenvironment in modulating phenotypic switching and suggest possible avenues to exploit our understanding of this process to develop an effective strategy for precision medicine.
authors.affiliation: Center for Complexity and Biosystems, University of Milan, via Celoria 26, 20133 Milano, Italy; Department of Biosciences, University of Milan, via Celoria 26, 20133 Milano, Italy. Electronic address: caterina.laporta@unimi.it.
authors.forename: Caterina A M
authors.initials: CAM
authors.lastname: La Porta
authors.affiliation: Center for Complexity and Biosystems, University of Milan, via Celoria 26, 20133 Milano, Italy; Department of Physics, University of Milan, via Celoria 16, 20133 Milano, Italy; Institute for Scientific Interchange Foundation, Via Alassio 11/C, 10126 Torino, Italy; Department of Applied Physics, Aalto University, P.O. Box 11100, FIN-00076 Aalto, Espoo, Finland; CNR - Consiglio Nazionale delle Ricerche, ICMATE, Via R. Cozzi 53, 20125 Milano, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zapperi
mesh_terms: D019070:Cell Lineage / Q000235:genetics*; D002465:Cell Movement / Q000235:genetics; D006801:Humans; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D014411:Neoplastic Stem Cells; D057285:Precision Medicine; D059016:Tumor Microenvironment / Q000235:genetics*
keywords: Cancer stem cells; Metastasis; Phenotypic switching; Precision medicine