Putative tumor-initiating progenitor cells predict poor lung cancer prognosis

Adult lung stem cells, vital to injury repair, associated with poor cancer prognosis, News release, UCLA Newsroom, August 17, 2010. Excerpts:

Adult stem cells that are vital for airway repair in the lung but that persist in areas where pre-cancerous lesions are found are associated with a poor prognosis in patients who develop cancer, even those with early-stage disease, researchers at UCLA's Jonsson Comprehensive Cancer Center have found.

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In this study, Gomperts and her team screened around 900 tumors removed from patients with non-small cell lung cancer at UCLA and the University of Texas' MD Anderson Cancer Center, looking to see whether the adult stem cells could be found in the tumor. In her lab, Gomperts is now studying the pre-cancerous lesions where the adult stem cells persist in an attempt to uncover the cascade of molecular events that may transform these cells into lung cancer stem cells.

The news release is based on this publication: Presence of a Putative Tumor-Initiating Progenitor Cell Population Predicts Poor Prognosis in Smokers with Non–Small Cell Lung Cancer by Aik T Ooi and 19 co-authors, including Brigitte N Gomperts, Cancer Res 2010(Aug 15); 70(16): 6639-48. [PubMed citation][Full text]. Abstract:

Smoking is the most important known risk factor for the development of lung cancer. Tobacco exposure results in chronic inflammation, tissue injury, and repair. A recent hypothesis argues for a stem/progenitor cell involved in airway epithelial repair that may be a tumor-initiating cell in lung cancer and which may be associated with recurrence and metastasis. We used immunostaining, quantitative real-time PCR, Western blots, and lung cancer tissue microarrays to identify subpopulations of airway epithelial stem/progenitor cells under steady-state conditions, normal repair, aberrant repair with premalignant lesions and lung cancer, and their correlation with injury and prognosis. We identified a population of keratin 14 (K14)-expressing progenitor epithelial cells that was involved in repair after injury. Dysregulated repair resulted in the persistence of K14+ cells in the airway epithelium in potentially premalignant lesions. The presence of K14+ progenitor airway epithelial cells in NSCLC predicted a poor prognosis, and this predictive value was strongest in smokers, in which it also correlated with metastasis. This suggests that reparative K14+ progenitor cells may be tumor-initiating cells in this subgroup of smokers with NSCLC.

CSC may be related to prognosis in primary breast cancer

Cancer Stem Cells May Be Related To Prognosis In Primary Breast Cancer, ScienceDaily, May 14, 2009. The first two paragraphs:

Breast cancer patients who received chemotherapy prior to surgery had heightened levels of cancer-initiating stem cells in their bone marrow, and the level of such cells correlated to a tumor's lymph node involvement, according to research from The University of Texas M. D. Anderson Cancer Center.

James Reuben, Ph.D., associate professor in the Department of Hematopathology, will present the findings in an oral presentation at the upcoming American Society of Clinical Oncology's annual meeting. It's the first prospective study to investigate the presence of breast cancer stem cells of primary breast cancer patients. The results suggest the need for additional biological therapies, as well as a potential and promising new direction for the study of micro-metastasis.

Prognostic potential of CSC analysis in glioblastoma

Cancer stem cell analysis and clinical outcome in patients with glioblastoma multiforme by Roberto Pallini and 10 co-authors, including Ruggero De Maria, Clin Cancer Res 2008(Dec 15); 14(24): 8205-12. PubMed Abstract:

PURPOSE: Cancer stem cells (CSC) are thought to represent the population of tumorigenic cells responsible for tumor development. The stem cell antigen CD133 identifies such a tumorigenic population in a subset of glioblastoma patients. We conducted a prospective study to explore the prognostic potential of CSC analysis in glioblastoma patients. EXPERIMENTAL DESIGN: We investigated the relationship between the in vitro growth potential of glioblastoma CSCs and patient death or disease progression in tumors of 44 consecutive glioblastoma patients treated with complete or partial tumorectomy followed by radiotherapy combined with temozolomide treatment. Moreover, we evaluated by immunohistochemistry and immunofluorescence the prognostic value of the relative presence of CD133(+) and CD133(+)/Ki67(+) cells in patient tumors. RESULTS: In vitro CSC generation and the presence of >/=2% CD133(+) cells in tumor lesions negatively correlated with overall (P = 0.0001 and 0.02, respectively) and progression-free (P = 0.0002 and 0.01, respectively) survival of patients. A very poor overall (P = 0.007) and progression-free (P = 0.001) survival was observed among patients whose tumors contained CD133(+) cells expressing Ki67. Taking into account symptom duration, surgery type, age, O(6)-methylguanine-DNA methyltransferase promoter methylation, and p53 status, generation of CSCs and CD133/Ki67 coexpression emerged as highly significant independent prognostic factors, with an adjusted hazard ratio of 2.92 (95% confidence interval, 1.37-6.2; P = 0.005) and 4.48 (95% confidence interval, 1.68-11.9; P = 0.003), respectively. CONCLUSIONS: The analysis of CSCs may predict the survival of glioblastoma patients. In vitro CSC generation and presence of CD133(+)/Ki67(+) cells are two considerable prognostic factors of disease progression and poor clinical outcome.

See also: Prognostic relevance of SOCS3 hypermethylation in patients with glioblastoma multiforme by Maurizio Martini and 5 co-authors, including Luigi Maria Larocca, Int J Cancer 2008(Dec 15); 123(12): 2955-60 [Epub 2008(Sep 3)][PubMed Citation].

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