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Table 6 Summary of MSC suitability for experimental cancer cytotherapy applications

From: Mesenchymal stem cells in preclinical cancer cytotherapy: a systematic review

  MSC suitability for cytotherapy
Most favorable attributes
Best option
Some favorable attributes
Alternative use
()
Detrimental effects questionable/contraindicated
?
(+ 1) (+ 0.5) (− 0.5)
Cytotherapy evaluation areas
[links to supportive evidence in the review]
Adequacy 1 MSC donor tissue abundance/availability
Ease of isolation/derivation
Harvest yield
[4.1.3, 4.1.4]
UC
AT
BM  
2 Ease of sub-culture manipulation
Expansion/upscaling potential [4.1.4]
UC AT
GM-BM
 
Safety 3 Genomic stability [4.2] UC AT BM
GM-MSC
4 Host integration/immunogenicity [4.2, 4.3.1, Table 4] UC GM-AT  
Efficacy 5 Robust target-specific anti-cancer action [Table 5, Additional file 6: Figure S6] UC (vs. breast)
GM-BM (vs. lung)
GM-BM (vs. neural)
GM-UC (vs. breast)
GM-UC (vs. lung)
GM-AT (vs. neural)
BM (vs. breast)
6 % frequency anti- vs. pro-tumorigenic events [Table 1, Figs. 3, 4, 5b, and 6] UC (breast, lung)
GM-MSC
AT (neural) BM (breast, colorectal
  MSC total scores UC:
 6 * (+1) = + 6
GM-BM:
 2 * (+1) = + 2
AT:
 1 * (+1) = + 1
GM-MSC:
 1 * (+1) = + 1
AT:
 3 * (+0.5) = + 1.5
BM:
 1 * (+0.5) = + 0.5
GM-AT:
 2 * (+0.5) = + 1
GM-UC:
 2 * (+0.5) = + 1
BM:
 3 * (-0.5) = - 1.5
GM-MSC
 1 * (-0.5) = - 0.5
Ranking:
Tissue-specific Cord (+ 7) > fat (+ 3.5) > marrow (+ 1)
Fetal vs. adult Fetal (+ 7) > adult (+ 4.5)
Naïve vs. GM Naïve (+ 7.5) > GM (+ 4.5)
  1. MSC, both naïve (UC/AT/BM), as well as genetically modified (GM-UC, GM-BM, GM-AT) were evaluated using an arbitrary scoring system based on the possession of favorable (positive scoring) or detrimental (negative scoring) characteristics with respect to six main cytotherapy evaluation areas pertaining to adequacy, safety and efficacy. The evaluation points/areas on which MSC are judged are listed on the left hand–side columns; the links in brackets provide the relative evidence presented throughout the review in support of the allocation of scores which are given to MSC according to the conformity of their traits to the specific cytotherapy requirements. This grading of the suitability of MSC across various aspects of cytotherapy results in the build of a matrix (shadowed area of the table) in which each of the MSC entries in the first, second, and third columns are valued as + 1, + 0.5, and − 0.5, respectively. A score of + 1 is assigned to the MSC that possess the most favorable attributes (e.g., highest isolation yield, greatest expansion potential) and which are classified as an ideal cell choice. The MSC that gather fewer or to a lesser extent favorable characteristics, are regarded as a second, alternative MSC option and score + 0.5, while those associated with detrimental effects (e.g., mutation events, tumor promotion) get a negative score (− 0.5) and are considered of questionable value or contraindicated, for certain cytotherapy applications at least. Final ranking of the MSC types is done by calculating the total sum of points for each of them within the matrix and then listing them in descending order, i.e., from highest suitability score to lowest (bottom row of table, scores in brackets). Note that ranking is only indicative of the relative suitability of MSC for cancer treatment based on experimental work hitherto and does not take into account the relative misrepresentation of some MSC types (e.g., under-representation of UC-GM-MSC against colorectal, prostate, and neural tumors)