Gynecologic Cancer, Cancer Stem Cells, and Possible Targeted Therapies

Abstract

Gynecologic cancer is one of the main causes of death in women. In this type of cancer, several molecules (oncogenes or tumor suppressor genes) contribute to the tumorigenic process, invasion, metastasis, and resistance to treatment. Based on recent evidence, the detection of molecular changes in these genes could have clinical importance for the early detection and evaluation of tumor grade, as well as the selection of targeted treatment. Researchers have recently focused on cancer stem cells (CSCs) in the treatment of gynecologic cancer because of their ability to induce progression and recurrence of malignancy. This has highlighted the importance of a better understanding of the molecular basis of CSCs. The purpose of this review is to focus on the molecular mechanism of gynecologic cancer and the role of CSCs to discover more specific therapeutic approaches to gynecologic cancer treatment.

Keywords: cancer stem cells; carcinogenesis; cervical cancer; chemoresistance; endometrial cancer; gynecologic cancer; molecular mechanism; ovarian cancer.

FIGURE 1

Different factors and signaling pathways mediating stem cell self-renewal, differentiation, and metastasis. (The figure was reprinted from Zuber et al.’s (2020) study.)

FIGURE 2

Effectiveness of targeted CSC therapy in combination with conventional chemotherapy. Conventional chemotherapy can decrease tumor size by acting on non-CSC tumor cells; however, tumor recurrence associated with CSCs may lead to treatment failure. Targeting the CSCs could reduce numbers of CSCs followed by better response of tumors to therapy. (The figure was reprinted from Kyo’s (2013) study.)