Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Pathophysiol. Feb 15, 2012; 3(1): 1-9
Published online Feb 15, 2012. doi: 10.4291/wjgp.v3.i1.1
Regulation of colon cancer recurrence and development of therapeutic strategies
Shailender Singh Kanwar, Anuradha Poolla, Adhip PN Majumdar
Shailender Singh Kanwar, Anuradha Poolla, Adhip PN Majumdar, Veterans Affairs Medical Center, Department of Internal Medicine, Karmanos Cancer Institute, Wayne State University-School of Medicine, Detroit, MI 48201, United States
Author contributions: Kanwar SS carried out the review of literature, conception, analysis and wrote the first draft of the manuscript; Poolla A helped in the analysis and interpretation of the data; Majumdar APN, the principal investigator, was responsible for discussion, critical evaluation of the review and overall supervision of the final preparation of the manuscript.
Supported by The National Institutes of Health/National Institute on Aging, AG014343; and the Department of Veterans Affairs, to Adhip PN Majumdar
Correspondence to: Adhip PN Majumdar, PhD, DSc, Veterans Affairs Medical Center, Department of Internal Medicine, Karmanos Cancer Institute, Wayne State University-School of Medicine, Research Service, 4646 John R, Room-B4238, Detroit, MI 48201, United States. a.majumdar@wayne.edu
Telephone: +1-313-5754460 Fax: +1-313-5761112
Received: August 1, 2011
Revised: September 8, 2011
Accepted: February 8, 2012
Published online: February 15, 2012
Abstract

Recurrence of colon cancer still remains a major issue which affects nearly 50% of patients treated by conventional therapeutics. Although the underlying causative factor(s) is not fully understood, development of drug-resistance has been associated with induction of cancer stem or stem-like cells (CSCs) which constitute a small sub-population of tumor cells known to be highly resistant to chemotherapy. In fact, the discovery of CSCs in a variety of tumors (including colon cancer) has changed the view of carcinogenesis and therapeutic strategies. Emerging reports have indicated that to improve patient outcomes, conventional anticancer therapies should be replaced with specific approaches targeting CSCs. Thus, therapeutic strategies that specifically target CSCs are being sought to reduce the risk of relapse and metastasis. In order to specifically target colon CSCs (while sparing somatic intestinal stem cells), it is critical to identify unique deregulated pathways responsible for self-renewal of CSCs and colon cancer recurrence. Colon CSCs present a unique opportunity to better understand the biology of solid tumors. Thus, a better understanding of the clinical signs and symptoms of colon cancer patients (undergoing surgery or chemotherapy) during perioperative periods, along with the underlying regulatory events affecting the stem/progenitor cell self-renewal and differentiation of colon epithelial cells, is of immense importance. In this review we discuss the implication of clinical factors and the emerging role of CSCs during recurrence of colon cancer along with the development of new therapeutic strategies involving the use of natural agents.

Keywords: Chemo-resistance; 5-Fluorouracil; Oxaliplatin; β-catenin; Cancer stem cells