Review Article

Cancer Stem Cells and Their Microenvironment: Biology and Therapeutic Implications

Table 1

Strategies of targeting the CSC niches for cancer treatment and their respective development status.

Inhibitors/antibodiesMolecular targetsPhases of developmentReferences

CAFs
PT630 (FAP inhibitor)FAP-αPreclinical[5]
NK4 (anti-HGF monoclonal antibody)HGF/METPreclinical[6]
AMG337 (MET kinase inhibitor)METPreclinical[7]
Rebimastat (MMP inhibitor)MMPsPhase II clinical trialNCT00040755
AMD3100 (CXCR4 antagonist)SDF-1/CXCR4Preclinical[8]
GC1008 (anti-TGF-β monoclonal antibody)TGF-βPhase II clinical trialNCT01401062

Tumor vasculatures
Sorafenib (tyrosine kinase inhibitor)VEGFRs, PDGFRs, KITFDA-approvedNDA021923
Sunitinib (tyrosine kinase inhibitor)VEGFRs, PDGFRs, KITFDA-approvedNDA021938
MK0752 (γ-secretase inhibitor)γ-secretasePhase I clinical trialNCT00106145
OMP21M18 (anti-DLL4 monoclonal antibody)DLL4Phase I clinical trialNCT01189968
OMP52M51 (anti-Notch1 monoclonal antibody)Notch1Phase I clinical trialNCT01778439

TAMs
PLX3397 (CSF-1R inhibitor)CSF-1RPhase I/II clinical trialNCT01596751
AMG820 (anti-CSF-1R monoclonal antibody)CSF-1RPhase I/II clinical trialNCT02713529
Zoledronate, clodronate, ibandronateDeplete macrophagesPhase III clinical trialNCT00127205
NCT00009945
852A (TLR7 agonist)TLR7Phase II clinical trialNCT00319748
Imiquimod (TLR7 agonist)TLR7Phase II clinical trialNCT00899574
NCT00821964

MDSCs
Tadalafil (PDE-5 inhibitors)PDE-5Pilot studyNCT00843635
Phase II clinical trialNCT00752115
NCX4016 (Nitric oxide-releasing aspirin derivative)iNOS and arginasePhase I clinical trialNCT00331786
(Prevention purpose)
L-NAME (arginase inhibitor)ArginasePreclinical[9]
All-trans retinoic acidInducing MDSC differentiationPhase II clinical trialNCT00617409

Treg cells
MEDI6383 (OX40 agonist)OX40Phase I clinical trialNCT02221960
Ipilimumab (anti-CTLA4 monoclonal antibody)CTLA4FDA-approvedBLA125377

Hypoxia
TH-302 (hypoxia-activated prodrug)HypoxiaPhase III clinical trialNCT01746979
AQ4N (hypoxia-activated prodrug)HypoxiaPhase I/II clinical trialNCT00394628

ECM
PEGPH20 (recombinant hyaluronidase)HyaluronanPhase II clinical trialNCT01839487
Phase III clinical trialNCT02715804