Abstract
Ovarian cancer (OC) is a heterogeneous disease usually diagnosed at a late stage. Cancer stem cells (CSCs) that exist within the bulk tumor survive first-line chemotherapy and contribute to resistant disease with metastasis. Understanding the key features of CSC biology provides valuable opportunities to develop OCSC-directed therapeutics, which will eventually improve the clinical outcomes of patients. Although significant developments have occurred since OCSCs were first described, the involvement of CSCs in ovarian tumor metastasis is not fully understood. Here, we discuss putative CSC markers and the fundamental role of CSCs in facilitating tumor dissemination in OC. Additionally, we focus on promising CSC-targeting strategies in preclinical and clinical studies of OC and discuss potential challenges in CSC research.
Highlights
Ovarian cancer (OC) is the leading cause of death from gynecologic malignancies, with approximately 22,240 new cases reported in the United States annually [1]
Recent data have pointed to the persistence of quiescent ovarian cancer stem cells (OCSCs) not eliminated by chemotherapy that are able to regenerate tumors as the main contributor to tumor relapse and metastasis
We focus on how cancer stem cells (CSCs) are defined and isolated in OC, discuss the driver role of OCSCs in both passive and hematogenous metastasis models, and summarize promising agents targeting OCSCs in preclinical and clinical settings
Summary
Ovarian cancer (OC) is the leading cause of death from gynecologic malignancies, with approximately 22,240 new cases reported in the United States annually [1]. The standard therapy for OC comprises debulking surgery followed by taxane- and platinum-based chemotherapy. This regimen is initially effective, up to 80% of women with advanced stage ovarian high-grade serous carcinoma (HGSOC) experience recurrence with metastatic disease, and the five-year survival rate is approximately 30% [1,2,3]. Recent data have pointed to the persistence of quiescent ovarian cancer stem cells (OCSCs) not eliminated by chemotherapy that are able to regenerate tumors as the main contributor to tumor relapse and metastasis. Understanding the molecular and biological features of OCSCs may allow for effective targeting and eradicating of these cells, resulting in potential tumor remission. Anti-CSCs strategies remain in the early stage of research, targeting OCSCs represents an extraordinary opportunity to improve the chance of progression-free survival among OC patients
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