Page 31 - Read Online

ALHulais et al. J Cancer Metastasis Treat 2019;5:3 Journal of Cancer
DOI: 10.20517/2394-4722.2018.71 Metastasis and Treatment

Review Open Access

Cancer stem cells, stemness markers and selected
drug targeting: metastatic colorectal cancer and

cyclooxygenase-2/prostaglandin E2 connection to
WNT as a model system

Reem Ali ALHulais, Stephen John Ralph

School of Medical Sciences, Griffith University, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia.
Correspondence to: Dr. Stephen John Ralph, School of Medical Sciences, Griffith University, Menzies Health Institute
Queensland, Gold Coast, QLD 4222, Australia. E-mail: s.ralph@griffith.edu.au

How to cite this article: ALHulais RA, Ralph SJ. Cancer stem cells, stemness markers and selected drug targeting: metastatic
colorectal cancer and cyclooxygenase-2/prostaglandin E2 connection to WNT as a model system. J Cancer Metastasis Treat
2019;5:3. http://dx.doi.org/10.20517/2394-4722.2018.71

Received: 1 Nov 2018 First Decision: 5 Dec 2018 Revised: 5 Dec 2018 Accepted: 25 Dec 2018 Published: 21 Jan 2019

Science Editor: Umberto Galderisi Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Few studies have reported on the analyses of drugs targeting enriched populations of cancer stem cells (CSCs) as
a means for identifying potent anti-CSC agents. This review evaluates recent information on the identification and
functions of specific CSC surface markers, with particular emphasis on colorectal cancers and the screening of
drugs to eliminate such cells. Many of these CSC markers are found commonly expressed on CSCs from different
cancer types as well as embryonic stem cells. These markers are often related to hypoxic activation of the WNT/
b-catenin pathway, cyclooxygenase-2/prostaglandin E signalling and their relationship to LGR5. By effectively
using drugs that inhibit these pathways to kill the CSC population, or otherwise forcing them out of dormancy
into active cell division, cancers should become more susceptible to chemotherapy. Such combinational therapies
targeting both CSCs and proliferating tumor cells should greatly improve upon the current basis for treatment.

Keywords: Cancer stem cells, colorectal cancer, markers, selective drug targeting

GENERAL BACKGROUND TO CANCER STEM CELLS
Our understanding of the roles played by cancer stem cells (CSCs), their importance during the progression
of cancer and justification for why they should be specifically targeted to eliminate cancer as a disease
remains limited. Evidence supporting the “cancer stem cell” hypothesis is mounting such that CSC existence

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.jcmtjournal.com