The most commonly used approach in oncology drug development involves identifying molecules responsible for the establishment and progression of the disease, to be targeted with drugs aimed to block their activity.
However, cancer cells have innate properties of survival, proliferation, invasion and metastasis, which are regulated by a plethora of signalling pathways. Unfortunately, it is now known that these signalling pathways can compensate for each other resulting in the lack of success of specific targeting on its own. In addition, multi-targeting using combination treatments does not account for the myriad of redundant signalling pathways coming into effect, and it can increase side effects.
An emerging body of work has shown that, in addition to cancer cells, tumours contain cancer stem cells (CSCs), which are capable of regenerating the tumour. In addition, CSCs are involved in cancer metastasis and drug resistance. It is therefore clear that for cancer therapy to successful in the long term the treatment must also remove the cancer stem cells.
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