The stem and roots of Wilms' tumours

» . . . Pode-Shakked et al. now identify NCAMþALDH1þ cells as WT CSC . . . « 19th century the ‘embryonal rest’ theory proposed that cancers originate from cells that resemble those from an early embryo (for a highly recomendable review and historic overview of the CSC field; see Nguyen et al, 2012). The CSC model that eventually emerged from this has several attractive aspects for the description and treatment of cancer. By postulating that tumours harbour a small subset of cancer stem cells that give rise, through differentiation and proliferation, to the bulk of the tumour, as well as new CSC through self-renewal, the heterogeneity of tumours can be explained. Through parallels with the normal development of the corresponding normal cell types the CSC model can help describe the earliest steps in the tumourigenic process before a fully malignant tumour is formed. Finally it predicts that the CSC should be the preferred targets of therapy, but also that due to their stem cell (-like) state they are often less responsive to the usual therapies. Much early work on CSC has been done in haematopoietic malignancies, maybe not surprisingly as large parts of their developmental cascade happens and can be followed postnatally, followed by a spur in the identification of CSC from adult