The discovery that the ribonucleoprotein telomerase is responsible for the
immortality of human cancer cells represents a major advance in our quest t
o identify a distinguishing biochemical feature of the malignant phenotype
that could be useful as a target for novel anti-cancer drug development. Ho
wever, recent observations on telomere dynamics and cell lifespan using tel
omerase 'knockout' mouse models together with improved techniques to assay
telomerase in normal human tissues have raised certain questions regarding
potential side effects of anti-telomerase treatments. More importantly, suc
h work has also demonstrated the propensity of mouse cell populations, in w
hich telomerase has been experimentally inactivated, to generate immortal v
ariants capable of maintaining their telomeres by alternative mechanisms. T
hese recent findings and their implications for the potential success of an
ti-telomerase therapies are subjected to critical review, The wide differen
ces between telomerase and telomere biology in mouse and human cells are hi
ghlighted, and the urgent need to obtain direct experimental evidence conce
rning the behaviour of a wide variety of human cancer cells under condition
s of telomerase inhibition is stressed. It is concluded that, despite the c
aveats, the development of small molecule drugs that powerfully inhibit tel
omerase should remain a top priority area for those engaged in the rational
design of novel cancer therapeutics.