Merkel cell carcinoma on the right calf in association with chronic lymphocytic leukemia: A case report

Abstract

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Improvement of current immunotherapies with engineered oncolytic viruses that target cancer stem cells

“…The capacity of self‐renewal and differentiation into multiple cellular subtypes introduces CSCs as the source or origin of both tumor initiation and tumor maintenance in various cancers. TME‐associated stromal and non‐stromal cells more support tumorigenic function of CSCs through activation of survival‐supportive signaling pathways such as Wnt/β‐catenin, Hh, Notch, and NF‐κB and on the other hand CSCs‐derived immunomodulators (i.e., cytokines and chemokines), angiogenic factors (e.g., VEGF, vascular endothelial growth factor), and metastatic factors (e.g., MMP‐2, matrix metalloproteinase‐2) lead to recruitment of tumor‐supportive immune cells, activation of angiogenesis, and promotion of tumor metastasis 10,11 . Various mechanisms of radio/chemoresistance in CSCs have emerged, resulting in the development of specific approaches for CSC‐directed immunotherapies including: (i) monoclonal and bispecific antibodies targeting CSCs surface biomarkers (e.g., CD44v6, CD44, CD123, EGFR, EpCAM, and CD133) or immune checkpoint molecules using immune checkpoint inhibitors (ICIs) (e.g., Letaplimab against CD47), (ii) adoptive cell therapy in the format of chimeric antigen receptor (CAR) T‐cells and CAR NK‐cells, and (iii) CSCs‐based vaccines 12 (Figure 1 and Table 1).…”