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Furthermore, currently available imaging technologies are not sufficiently sensitive for detection of small tumor satellites, which are responsible for recurrence [2].
Since these tumors are highly infiltrative, surgical resection leaves a residuum of cells responsible for recurrence.
Current concepts suggest that CSCs often resist cytotoxic treatments and are therefore responsible for recurrence.
So it seems that the residual tumour during cystectomy is solely responsible for recurrence.
Cancer stem cells have the capacity to initiate tumour formation, metastasis and are believed to be highly resistant to anti-cancer drugs and therefore responsible for recurrence.
Although cells that commence proliferating and continue growing as metastases may be of primary concern clinically, dormant single cells and micrometastases also have clinical implications, as they can be a source of cells responsible for recurrence.
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However the specific biological features responsible for recurrences have not been clearly identified.
Unlike doxorubicin, BS-RNase and HHP-2 RNase are not known to induce, nor do they appear to be influenced by, the multidrug-resistant phenotype, one of the most important mechanisms responsible for recurrences and metastatic invasion after chemotherapy.
As these cells are suggested to be responsible for tumour recurrence, we discontinued treatment and measured tumour recurrence in mice where tumours were no longer detectable using the Vevo 770 Ultrasound Imager.
As it has been widely accepted that most solid tumors, including lung tumors, arise and are maintained by CSCs, and that chemotherapy-spared CSCs are responsible for tumor recurrence, it is clear that biomarkers predicting erlotinib response in EGFR-WT tumors have to be determined at the CSC level.
Self-renewing tumor-initiating cells (TICs) are thought to be responsible for tumor recurrence and chemo-resistance.
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