Targeting ALT: The role of alternative lengthening of telomeres in pathogenesis and prevention of cancer

SummaryTelomere shortening in the course of cell divisions plays an important role in both suppression and pathogenesis of cancer. Telomere maintenance mechanisms such as telomerase and alternative lengthening of telomeres (ALT) are essential for long-term tumor growth. Consequently, interdiction of telomere lengthening has been proposed as an anti-cancer treatment but requires insight in the genes and pathways involved.In this article, the molecular and functional details of ALT are reviewed, and proposed next steps towards a therapy aimed at preventing ALT in human cancers are described.