Cancer stem cells in neuroblastoma therapy resistance

Natarajan Aravindan, Drishti Jain, Dinesh Babu Somasundaram, Terence S. Herman, Sheeja Aravindan

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Neuroblastoma (NB) is the most common cancer of infancy and accounts for nearly one tenth of pediatric cancer deaths. This mortality rate has been attributed to the > 50% frequency of relapse despite intensive, multimodal clinical therapy in patients with progressive NB. Given the disease’s heterogeneity and developed resistance, attaining a cure after relapse of progressive NB is highly challenging. A rapid decrease in the timeline between successive recurrences is likely due to the ongoing acquisition of genetic rearrangements in undifferentiated NB-cancer stem cells (CSCs). In this review, we present the current understanding of NB-CSCs, their intrinsic role in tumorigenesis, their function in disease progression, and their influence on acquired therapy resistance and tumor evolution. In particular, this review focus on the intrinsic involvement of stem cells and signaling in the genesis of NB, the function of pre-existing CSCs in NB progression and therapy response, the formation and influence of induced CSCs (iCSCs) in drug resistance and tumor evolution, and the development of a CSC-targeted therapeutic approach.

Original languageEnglish (US)
Pages (from-to)948-967
Number of pages20
JournalCancer Drug Resistance
Issue number4
StatePublished - 2019
Externally publishedYes


  • Cancer stem cells
  • Clonal selection
  • Drug resistance
  • Induced cancer stem cell
  • Neuroblastoma
  • Therapy resistance

ASJC Scopus subject areas

  • Cancer Research
  • Pharmacology (medical)


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