Photodynamic therapy in cancer stem cells — state of the art

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作者
Ana Melissa C. Ibarra
Emilia Maria G. Aguiar
Cássia B. R. Ferreira
Juliana M. Siqueira
Luciana Corrêa
Fabio D. Nunes
Adriana Lino-Dos- Santos Franco
Rebeca B. Cecatto
Michael R. Hamblin
Maria Fernanda S. D. Rodrigues
机构
[1] Postgraduate Program in Biophotonics Applied to Health Sciences,School of Dentistry
[2] Nove de Julho University - UNINOVE,Laser Research Centre, Faculty of Health Science
[3] University of São Paulo – FOUSP,undefined
[4] University of Johannesburg,undefined
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Cancer stem cells; Tumor-initiating cells; Photodynamic therapy; Solid tumors; Therapy resistance;
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摘要
Despite significant efforts to control cancer progression and to improve oncology treatment outcomes, recurrence and tumor resistance are frequently observed in cancer patients. These problems are partly related to the presence of cancer stem cells (CSCs). Photodynamic therapy (PDT) has been developed as a therapeutic approach for solid tumors; however, it remains unclear how this therapy can affect CSCs. In this review, we focus on the effects of PDT on CSCs and the possible changes in the CSC population after PDT exposure. Tumor response to PDT varies according to the photosensitizer and light parameters employed, but most studies have reported the successful elimination of CSCs after PDT. However, some studies have reported that CSCs were more resistant to PDT than non-CSCs due to the increased efflux of photosensitizer molecules and the action of autophagy. Additionally, using different PDT approaches to target the CSCs resulted in increased sensitivity, reduction of sphere formation, invasiveness, stem cell phenotype, and improved response to chemotherapy. Lastly, although mainly limited to in vitro studies, PDT, combined with targeted therapies and/or chemotherapy, could successfully target CSCs in different solid tumors and promote the reduction of stemness, suggesting a promising therapeutic approach requiring evaluation in robust pre-clinical studies.
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