Cancer stem cells targets and combined therapies to prevent cancer recurrence

Life Sci. 2021 Jul 15:277:119465. doi: 10.1016/j.lfs.2021.119465. Epub 2021 Apr 5.

Abstract

Cancer stem cells (CSCs) control the dynamics of tumorigenesis by self-renewal ability and differentiation potential. These properties contribute towards tumor malignancy, metastasis, cellular heterogeneity, and immune escape, which are regulated by multiple signaling pathways. The CSCs are chemoresistant and cause cancer recurrence, generally recognized as a small side-population that eventually leads to tumor relapse. Despite many treatment options available, none can be considered entirely efficient due to a lack of specificity and dose limitation. This review primarily highlights the processes involved in CSCs development and maintenance. Secondly, the current effective therapies based on stem cells, cell-free therapies that involve exosomes and miRNAs, and photodynamic therapy have been discussed. Also, the inhibitors that specifically target various signaling pathways, which can be used in combination to control CSCs kinetics have been highlighted. Conclusively, this comprehensive review is a detailed study of recently developed novel treatment strategies that will facilitate in coming up with better-targeted approaches against CSCs.

Keywords: Cancer recurrence; Cancer stem cells; Combination therapy; Exosomes; Inhibitors; miRNA.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacology
  • Cell Differentiation / drug effects
  • Drug Resistance, Neoplasm / drug effects
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • MicroRNAs / metabolism
  • Molecular Targeted Therapy / methods
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Neoplastic Stem Cells / metabolism*
  • Neoplastic Stem Cells / physiology*
  • Signal Transduction / drug effects

Substances

  • Antineoplastic Agents
  • MicroRNAs