ABSTRACT
The most successful pharmacological methods to date have been the cytotoxic chemotherapeutic agents dacarbazine, platinum analogs, nitrosureas, and microtubular toxins. Studies are ongoing to determine the nature of the melanoma-initiating cell niche and whether there are any specific molecules that are amenable to therapeutic targeting. Thus, a dual therapeutic approach may be needed, with one drug to target the cancer stem cell population and another drug to target the daughter cell population. Another series of leukemia studies demonstrated that the direct targeting of the interaction between the tumor-initiating cells and their niche is a promising future therapeutic strategy. An alternative therapeutic strategy to deplete the tumor-initiating cell population involves inhibiting the intracellular signaling pathways responsible for regulating stem cell self-renewal and survival. Ultimately, most solid tumor therapy is associated with eventual relapse and metastatic spread. Treatment of metastatic melanoma remains a challenge and is the focus of intense research.
