Cancer stem cells (CSCs) are a small subpopulation of tumor cells that are thought to be responsible for recurrence and metastasis of cancer due to their ability for self-renewal and differentiation into multiple cancer cell types.
CSCs are also known to play a key role in the development of metastases. Cancer cells undergoing Epithelial to Mesenchymal Transition (EMT) have also been shown to attain CSC phenotypes and acquire invasive and migratory properties. Therefore, understanding the characteristics of CSCs may help to develop better treatment strategies.
The sphere formation assay has been widely used to isolate CSCs using anchorage-independent sphere culture. CSCs can grow on ultra-low attachment plates that are coated with a layer to inhibit the attachment of cells. When cells are grown in serum-free and non-adherent conditions, CSCs can survive and clonally expand to form spheres, whereas differentiated tumor cells undergo apoptosis due to their anchorage dependence.