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      Targeting Cancer Stem Cells to Overcome Chemoresistance

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          Abstract

          Cancers are heterogeneous at the cell level, and the mechanisms leading to cancer heterogeneity could be clonal evolution or cancer stem cells. Cancer stem cells are resistant to most anti-cancer treatments and could be preferential targets to reverse this resistance, either targeting stemness pathways or cancer stem cell surface markers. Gold nanoparticles have emerged as innovative tools, particularly for photo-thermal therapy since they can be excited by laser to induce hyperthermia. Gold nanoparticles can be functionalized with antibodies to specifically target cancer stem cells. Preclinical studies using photo-thermal therapy have demonstrated the feasibility of targeting chemo-resistant cancer cells to reverse clinical chemoresistance. Here, we review the data linking cancer stem cells and chemoresistance and discuss the way to target them to reverse resistance. We particularly focus on the use of functionalized gold nanoparticles in the treatment of chemo-resistant metastatic cancers.

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          Identification of pancreatic cancer stem cells.

          Emerging evidence has suggested that the capability of a tumor to grow and propagate is dependent on a small subset of cells within a tumor, termed cancer stem cells. Although data have been provided to support this theory in human blood, brain, and breast cancers, the identity of pancreatic cancer stem cells has not been determined. Using a xenograft model in which primary human pancreatic adenocarcinomas were grown in immunocompromised mice, we identified a highly tumorigenic subpopulation of pancreatic cancer cells expressing the cell surface markers CD44, CD24, and epithelial-specific antigen (ESA). Pancreatic cancer cells with the CD44(+)CD24(+)ESA(+) phenotype (0.2-0.8% of pancreatic cancer cells) had a 100-fold increased tumorigenic potential compared with nontumorigenic cancer cells, with 50% of animals injected with as few as 100 CD44(+)CD24(+)ESA(+) cells forming tumors that were histologically indistinguishable from the human tumors from which they originated. The enhanced ability of CD44(+)CD24(+)ESA(+) pancreatic cancer cells to form tumors was confirmed in an orthotopic pancreatic tail injection model. The CD44(+)CD24(+)ESA(+) pancreatic cancer cells showed the stem cell properties of self-renewal, the ability to produce differentiated progeny, and increased expression of the developmental signaling molecule sonic hedgehog. Identification of pancreatic cancer stem cells and further elucidation of the signaling pathways that regulate their growth and survival may provide novel therapeutic approaches to treat pancreatic cancer, which is notoriously resistant to standard chemotherapy and radiation.
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            CD44: from adhesion molecules to signalling regulators.

            Cell-adhesion molecules, once believed to function primarily in tethering cells to extracellular ligands, are now recognized as having broader functions in cellular signalling cascades. The CD44 transmembrane glycoprotein family adds new aspects to these roles by participating in signal-transduction processes--not only by establishing specific transmembrane complexes, but also by organizing signalling cascades through association with the actin cytoskeleton. CD44 and its associated partner proteins monitor changes in the extracellular matrix that influence cell growth, survival and differentiation.
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              Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer.

              ABI-007, the first biologically interactive albumin-bound paclitaxel in a nanameter particle, free of solvents, was compared with polyethylated castor oil-based standard paclitaxel in patients with metastatic breast cancer (MBC). This phase III study was performed to confirm preclinical studies demonstrating superior efficacy and reduced toxicity of ABI-007 compared with standard paclitaxel. Patients were randomly assigned to 3-week cycles of either ABI-007 260 mg/m(2) intravenously without premedication (n = 229) or standard paclitaxel 175 mg/m(2) intravenously with premedication (n = 225). ABI-007 demonstrated significantly higher response rates compared with standard paclitaxel (33% v 19%, respectively; P = .001) and significantly longer time to tumor progression (23.0 v 16.9 weeks, respectively; hazard ratio = 0.75; P = .006). The incidence of grade 4 neutropenia was significantly lower for ABI-007 compared with standard paclitaxel (9% v 22%, respectively; P < .001) despite a 49% higher paclitaxel dose. Febrile neutropenia was uncommon (< 2%), and the incidence did not differ between the two study arms. Grade 3 sensory neuropathy was more common in the ABI-007 arm than in the standard paclitaxel arm (10% v 2%, respectively; P < .001) but was easily managed and improved rapidly (median, 22 days). No hypersensitivity reactions occurred with ABI-007 despite the absence of premedication and shorter administration time. ABI-007 demonstrated greater efficacy and a favorable safety profile compared with standard paclitaxel in this patient population. The improved therapeutic index and elimination of corticosteroid premedication required for solvent-based taxanes make the novel albumin-bound paclitaxel ABI-007 an important advance in the treatment of MBC.
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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                13 December 2018
                December 2018
                : 19
                : 12
                : 4036
                Affiliations
                [1 ]Institut National de la Santé et de la Recherche Médicale (INSERM), U1165, F-75010 Paris, France; toni.nunes@ 123456outlook.fr (T.N.); diaddin_h@ 123456hotmail.com (D.H.); christophe.leboeuf@ 123456univ-paris-diderot.fr (C.L.); morad.elbou@ 123456gmail.com (M.E.B.); guillaume.gapihan@ 123456gmail.com (G.G.); thuylinh.nong@ 123456gmail.com (T.T.N.); solveig.meles@ 123456edu.univ-paris13.fr (S.M.); eurydice.angeli@ 123456gmail.com (E.A.); philipperatajczak@ 123456gmail.com (P.R.); he.lu@ 123456inserm.fr (H.L.); melanie.dibenedetto@ 123456univ-paris13.fr (M.D.B.)
                [2 ]Laboratoire de Pathologie, Université Paris Diderot, Sorbonne Paris Cité, UMR_S1165, F-75010 Paris, France
                [3 ]Hôpital de La Porte Verte, F-78004 Versailles, France
                [4 ]Université Paris 13, F-93430 Villetaneuse, France
                [5 ]Service d’Oncologie Médicale, AP-HP-Hôpital Avicenne, F-93008 Bobigny, France
                [6 ]Service de Pathologie, AP-HP-Hôpital Saint-Louis, F-75010 Paris, France
                Author notes
                [* ]Correspondences: guilhem.bousquet@ 123456aphp.fr (G.B.); anne.janin1165@ 123456gmail.com (A.J.); Tel.: +33-142-385-428 (G.B.); +33-142-494-570 (A.J.)
                [†]

                These authors are co-premier authors.

                [‡]

                These authors are co-senior authors.

                Author information
                https://orcid.org/0000-0001-6935-7073
                https://orcid.org/0000-0002-2212-0287
                https://orcid.org/0000-0002-6537-0550
                https://orcid.org/0000-0003-1592-0355
                https://orcid.org/0000-0003-1119-3752
                https://orcid.org/0000-0002-9595-6261
                Article
                ijms-19-04036
                10.3390/ijms19124036
                6321478
                30551640
                ea14f96b-f87a-4ef8-8451-42033b50e319
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 November 2018
                : 10 December 2018
                Categories
                Review

                Molecular biology
                cancer,chemoresistance,cancer stem cell,gold nanoparticles,functionalization,photo-thermal therapy

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