Notch signalling: the true driver of small cell lung cancer?

Small cell lung cancer (SCLC), accounting for up to 15% of all cancers, is characterised by high grade neuroendocrine tumours with short doubling time, a high growth fraction and rapid metastatic spread (1). The dramatic lethal outcomes result from the inevitable development of a resistance to front line chemotherapy, possibly due to the expansion of the cancer cell subpopulation with stem cell like (2) and neuroendocrine properties (3). In the study by Dr. Julien Sage et al. entitled “Intratumoural heterogeneity generated by Notch signalling promotes small-cell lung cancer”, the authors demonstrate a direct action of the Notch pathway in the promotion of this resistant subpopulation (4).