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World J Stem Cells. Apr 26, 2015; 7(3): 547-555
Published online Apr 26, 2015. doi: 10.4252/wjsc.v7.i3.547
New insights into pancreatic cancer stem cells
Chinthalapally V Rao, Altaf Mohammed
Chinthalapally V Rao, Altaf Mohammed, Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology-Oncology Section, PC Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
Author contributions: Mohammed A prepared the original draft; Rao CV revised and finalized the manuscript.
Supported by In part by Kerley Cade Endowed Chair (Chinthalapally V Rao), University of Oklahoma Health Sciences Center; and in part support from the National Cancer Institute, No. 5R03CA181584-02 (Altaf Mohammed).
Conflict-of-interest: The authors declare no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Altaf Mohammed, PhD, Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology-Oncology Section, PC Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 975 NE 10th Street, BRC II, Room 1209B, Oklahoma City, OK 73104, United States. amohamme@ouhsc.edu
Telephone: +1-405-2713224 Fax: +1-405-2713225
Received: August 11, 2014
Peer-review started: August 13, 2014
First decision: November 3, 2014
Revised: December 2, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: April 26, 2015
Processing time: 254 Days and 23.5 Hours
Abstract

Pancreatic cancer (PC) has been one of the deadliest of all cancers, with almost uniform lethality despite aggressive treatment. Recently, there have been important advances in the molecular, pathological and biological understanding of pancreatic cancer. Even after the emergence of recent new targeted agents and the use of multiple therapeutic combinations, no treatment option is viable in patients with advanced cancer. Developing novel strategies to target progression of PC is of intense interest. A small population of pancreatic cancer stem cells (CSCs) has been found to be resistant to chemotherapy and radiation therapy. CSCs are believed to be responsible for tumor initiation, progression and metastasis. The CSC research has recently achieved much progress in a variety of solid tumors, including pancreatic cancer to some extent. This leads to focus on understanding the role of pancreatic CSCs. The focus on CSCs may offer new targets for prevention and treatment of this deadly cancer. We review the most salient developments in important areas of pancreatic CSCs. Here, we provide a review of current updates and new insights on the role of CSCs in pancreatic tumor progression with special emphasis on DclK1 and Lgr5, signaling pathways altered by CSCs, and the role of CSCs in prevention and treatment of PC.

Keywords: Pancreatic cancer; Cancer stem cells; DclK1; Lgr5; Prevention; Treatment

Core tip: Despite aggressive treatment modalities, pancreatic cancer represents most lethal malignancy with uniform lethality. The pancreatic cancer stem cells (CSCs) have been found to be resistant to chemotherapy and radiation therapy. This review summarizes the important role of CSCs in pancreatic cancer tumor progression with emphasis on DclK1 and Lgr5 CSCs, molecular signaling altered by CSCs and the important role of pancreatic CSCs in prevention and treatment of pancreatic cancer.