Stem cell-based treatments for gynecological solid tumors.

Background and objective: We have recently assisted to an increasing sci- entific interest and a new research effort in the field of stem cell-based therapy. Since the late 1980s hematopoietic stem cells (HSC) have been used to set up therapeutic strategies for the treatment of solid tumors such as gynecological cancers. In this context, different approaches have been suggested and clinically investigated. State of the art: In the autologous setting we can describe the well-known use of HSC as hema- tologic support to high-dose chemotherapy regi- mens, and the use of HSC as a source of dendritic cells for cancer vaccination protocols. In our insti- tution a long-term experience has been developed in high-dose chemotherapy with autologous HSC transplantation as first-line treatment of advanced ovarian cancer, and in the use of cytokines both for HSC collection and for post-transplantation hematopoietic recovery and immune reconstitu- tion. An alternative approach consists of allogenic HSC transplantation following either myeloabla- tive/standard or non-myeloablative/reduced condi- tioning regimens, which have been proposed as new adoptive immunotherapeutic treatments for different non-hematologic malignancies. Perspectives: Future strategies in the use of HSC in oncology comprise the possibility of HSC ex-vivo expansion, the use of umbilical cord blood HSC, and the development of HSC-based gene-therapy programs. Further investigations are expected in the new field of cancer stem cells.