Oncogenesis and cancer stem cells: current opinions and future directions

There is increasing evidence to show that only a subset of cancer cells drives the growth and progression of a tumour. These cells share similar properties with normal stem cells and are termed 'cancer stem cells'. Cancer stem cells have been identified in acute myeloid leukaemia and in some solid tumours by their distinct expression of cell surface antigens. Their long-term, self-renewing capacity is thought to be a determining factor in the maintenance and regrowth of the tumour. Studies on haematopoietic cancers show that important signalling pathways and genes for normal haematopoiesis, such as Wnt, NF-kappaB, Notch, hedgehog (Hh) and Bmi1, are oncogenic, thereby potentially involved in cancer stem cell regulation. Elimination of cancer stem cells in tumours could result in the degeneration of downstream cells, which makes them potential targets for new cancer therapies.