imlop ments in cancer treatment. However, several im portant issues still remain to be resolved. Most of the key pathways important to CSCs are also shared by normal stem NVP-BEP800 VER-82576 progenitor cells and drugs targeting these pathways could have a detrimental effect on normal cells. For example, little is known about CSC directed therapies. Initial results are promising, but its po tential short and long term side effects of these therapies are unclear. Such therapies will, if not spe cific for CSCs, lead to tissue and or organ damage due to the depletion of the reserve regenerative stem cells. Such treatment with off target effects lead to acute and irreversible organ failure. Therefore, it is critical in delineating the molecular differences be tween CSCs and their tissue specific stem cell coun terparts, to prevent damage to normal somatic stem cells and to ensure selectively targeting CSCs.
This growing knowledge base has the potential to identify candidate genes Camptothecin and pathways that are important for CSC survival and propagation but are not important for normal stem cell function. In addition, CSCs clearly have a complex path ogenesis, with the potential for considerable crosstalk and redundancy in signaling pathways, and hence targeting single molecules or pathways may have a limited benefit in treatment. Use of combinations of therapies may be needed to overcome the complex network of signaling pathways, and ultimately inhibit the signaling that controls tumor growth and survival.
However, use of a combination regimen can lead to tolerability and drug drug interaction problems, and hence an alternative approach is to use molecularly targeted agents that have multiple modes of action. It is useful to understand which combination regimen is the most effective for inhibiting CSC survival and propagation with the least impact on normal stem cell function. When a sufficient number of CSC markers become available and an ideal combination therapy identify, CSC specific therapies might be developed that spare healthy stem cells and thus reduce side effects and retain regenerative tissue capacities. Dis coveries made in the CSC field will feed back into other areas of stem cell research because many marker gene products found in CSCs are shares with the normal stem cell population.
It is also expected that a better understanding of the processes that control autonomous growth, differentiation and cell migra tion will contribute to novel regenera tive medicine based treatments that will revolution ize therapeutic strategies and bring renewed hope to cancer patients. Liver cancer is the sixth most common cancer worldwide, accounting for 5.7 of new cancer cases, and the third most common cause of cancer related death. The majority of cases and deaths occur in developing countries. Of the primary liver tumors in adults, hepatocellular carcinoma is the commonest. HCC frequently occurs in the setting of a diseased cirrhotic liver. It has well defined risk factors, the mo