4.6 Review

Cancer Stem Cells-Key Players in Tumor Relapse

Journal

CANCERS
Volume 13, Issue 3, Pages -

Publisher

MDPI
DOI: 10.3390/cancers13030376

Keywords

cancer stem cells; drug resistance; molecular mechanisms; chemotherapy; radiation therapy; targeted therapies; immunotherapies

Categories

Funding

  1. MIUR Progetto di Eccellenza (Department of Pharmacological and Biomolecular Sciences, Universita degli Studi di Milano)
  2. AIRC fellowship for Italy

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Cancer stem cells (CSCs) are a subset of cancer cells with tumor-initiating and self-renewal capacity, as well as high adaptive abilities, contributing to treatment failure and tumor progression/relapse. Understanding the molecular mechanisms associated with stemness-driven resistance is crucial for developing more effective drugs and durable responses. Explored mechanisms by CSCs to overcome different therapeutic strategies highlight their plasticity as an insidious trait responsible for their adaptation/escape, with novel CSC-specific approaches showing promising preclinical and clinical applications.
Simple Summary Cancer is one of the hardest pathologies to fight, being one of the main causes of death worldwide despite the constant development of novel therapeutic strategies. Therapeutic failure, followed by tumor relapse, might be explained by the existence of a subpopulation of cancer cells called cancer stem cells (CSCs). The survival advantage of CSCs relies on their ability to shape their phenotype against harmful conditions. This Review will summarize the molecular mechanisms exploited by CSCs in order to escape from different kind of therapies, shedding light on the potential novel CSC-specific targets for the development of innovative therapeutic approaches. Tumor relapse and treatment failure are unfortunately common events for cancer patients, thus often rendering cancer an uncurable disease. Cancer stem cells (CSCs) are a subset of cancer cells endowed with tumor-initiating and self-renewal capacity, as well as with high adaptive abilities. Altogether, these features contribute to CSC survival after one or multiple therapeutic approaches, thus leading to treatment failure and tumor progression/relapse. Thus, elucidating the molecular mechanisms associated with stemness-driven resistance is crucial for the development of more effective drugs and durable responses. This review will highlight the mechanisms exploited by CSCs to overcome different therapeutic strategies, from chemo- and radiotherapies to targeted therapies and immunotherapies, shedding light on their plasticity as an insidious trait responsible for their adaptation/escape. Finally, novel CSC-specific approaches will be described, providing evidence of their preclinical and clinical applications.

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