Purpose of review: Metastatic melanoma is the most aggressive skin cancer and despite tremendous efforts and considerable progress in clinical treatment of melanoma patients within recent years, it remains a deadly disease. Current treatments affect melanoma cells indiscriminately, while accumulating evidence suggests that melanoma might be a disease of stem cells. This review aims to summarize the important accomplishments in the field and to emphasize the common molecular and cellular mechanisms regulating self-renewal of neural crest stem cells (NCSCs) and melanoma cells.
Recent findings: A growing number of publications highlight the existence of phenotypic and functional similarities between embryonic NCSCs and melanoma cells. These studies provide compelling evidence that the propagation of melanoma cells critically depends on genes instrumental in neural crest development. The example of Sox10 and Rac1 genes provides detailed illustration of how interfering with these important genes for neural crest development can prevent melanoma formation.
Summary: The development of new therapies, targeting RAF-MEK-ERK pathway, provided major improvements in outcomes for patients with metastatic melanoma; however, acquired resistance followed by tumor recurrence represents a major clinical challenge. The striking parallels between embryonic NCSCs (eNCSCs) and melanoma cells might lead to the development of new targeted therapeutics selectively eliminating cell populations accountable for tumor initiation, progression and relapse.