Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies

Abstract The success of cancer therapy has been significantly hampered by various mechanisms of therapeutic resistance. Chief among these mechanisms is the presence of clonal heterogeneity within an individual tumor mass. The introduction of the concept of cancer stem cells (CSCs)—a rare and immatur...

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Main Authors: Yunhan Tan, Siyuan Qin, Zhe Zhang, Yongen Liu, Li Zhou, Bowen Li, Edouard C. Nice, Yuanyuan Zhang, Jing Jing
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:MedComm – Oncology
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Online Access:https://doi.org/10.1002/mog2.70009
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author Yunhan Tan
Siyuan Qin
Zhe Zhang
Yongen Liu
Li Zhou
Bowen Li
Edouard C. Nice
Yuanyuan Zhang
Jing Jing
author_facet Yunhan Tan
Siyuan Qin
Zhe Zhang
Yongen Liu
Li Zhou
Bowen Li
Edouard C. Nice
Yuanyuan Zhang
Jing Jing
author_sort Yunhan Tan
collection DOAJ
description Abstract The success of cancer therapy has been significantly hampered by various mechanisms of therapeutic resistance. Chief among these mechanisms is the presence of clonal heterogeneity within an individual tumor mass. The introduction of the concept of cancer stem cells (CSCs)—a rare and immature subpopulation with tumorigenic potential that contributes to intratumoral heterogeneity—has deepened our understanding of drug resistance. Given the characteristics of CSCs, such as increased drug‐efflux activity, enhanced DNA‐repair capacity, high metabolic plasticity, adaptability to oxidative stress, and/or upregulated detoxifying aldehyde dehydrogenase (ALDH) enzymes, CSCs have been recognized as a theoretical reservoir for resistant diseases. Implicit in this recognition is the possibility that CSC‐targeted therapeutic strategies might offer a breakthrough in overcoming drug resistance in cancer patients. Herein, we summarize the generation of CSCs and our current understanding of the mechanisms underlying CSC‐mediated therapeutic resistance. This extended knowledge has progressively been translated into novel anticancer therapeutic strategies and significantly enriched the available options for combination treatments, all of which are anticipated to improve clinical outcomes for patients experiencing CSC‐related relapse.
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spelling doaj-art-5f575703db714ecbb80faa998e8475cd2025-08-20T02:40:52ZengWileyMedComm – Oncology2769-64482025-03-0141n/an/a10.1002/mog2.70009Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategiesYunhan Tan0Siyuan Qin1Zhe Zhang2Yongen Liu3Li Zhou4Bowen Li5Edouard C. Nice6Yuanyuan Zhang7Jing Jing8Department of Biotherapy, Institute of Oxidative Stress Medicine, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu People's Republic of ChinaDepartment of Biotherapy, Institute of Oxidative Stress Medicine, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu People's Republic of ChinaMOE Joint International Research, Laboratory of Pancreatic Diseases, Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou People's Republic of ChinaState Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu Sichuan People's Republic of ChinaKey Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital Chongqing Medical University Chongqing People's Republic of ChinaDepartment of Biotherapy, Institute of Oxidative Stress Medicine, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu People's Republic of ChinaDepartment of Biochemistry and Molecular Biology Monash University, Clayton Victoria AustraliaKey Laboratory of Drug‐Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy Sichuan University Chengdu People's Republic of ChinaFrontiers Medical Center Tianfu Jincheng Laboratory Chengdu People's Republic of ChinaAbstract The success of cancer therapy has been significantly hampered by various mechanisms of therapeutic resistance. Chief among these mechanisms is the presence of clonal heterogeneity within an individual tumor mass. The introduction of the concept of cancer stem cells (CSCs)—a rare and immature subpopulation with tumorigenic potential that contributes to intratumoral heterogeneity—has deepened our understanding of drug resistance. Given the characteristics of CSCs, such as increased drug‐efflux activity, enhanced DNA‐repair capacity, high metabolic plasticity, adaptability to oxidative stress, and/or upregulated detoxifying aldehyde dehydrogenase (ALDH) enzymes, CSCs have been recognized as a theoretical reservoir for resistant diseases. Implicit in this recognition is the possibility that CSC‐targeted therapeutic strategies might offer a breakthrough in overcoming drug resistance in cancer patients. Herein, we summarize the generation of CSCs and our current understanding of the mechanisms underlying CSC‐mediated therapeutic resistance. This extended knowledge has progressively been translated into novel anticancer therapeutic strategies and significantly enriched the available options for combination treatments, all of which are anticipated to improve clinical outcomes for patients experiencing CSC‐related relapse.https://doi.org/10.1002/mog2.70009cancer stem cells (CSCs)combination therapyCSC‐targeted therapydrug resistance
spellingShingle Yunhan Tan
Siyuan Qin
Zhe Zhang
Yongen Liu
Li Zhou
Bowen Li
Edouard C. Nice
Yuanyuan Zhang
Jing Jing
Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
MedComm – Oncology
cancer stem cells (CSCs)
combination therapy
CSC‐targeted therapy
drug resistance
title Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
title_full Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
title_fullStr Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
title_full_unstemmed Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
title_short Unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
title_sort unraveling the underlying mechanisms of cancer stem cells in therapeutic resistance for optimizing treatment strategies
topic cancer stem cells (CSCs)
combination therapy
CSC‐targeted therapy
drug resistance
url https://doi.org/10.1002/mog2.70009
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