Department of Oncology, Xiangya Hospital, Central South University, Changsha, 410008, China.
Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China.
Signal Transduct Target Ther. 2024 Jul 5;9(1):170. doi: 10.1038/s41392-024-01851-y.
Cancer stem cells (CSCs), a small subset of cells in tumors that are characterized by self-renewal and continuous proliferation, lead to tumorigenesis, metastasis, and maintain tumor heterogeneity. Cancer continues to be a significant global disease burden. In the past, surgery, radiotherapy, and chemotherapy were the main cancer treatments. The technology of cancer treatments continues to develop and advance, and the emergence of targeted therapy, and immunotherapy provides more options for patients to a certain extent. However, the limitations of efficacy and treatment resistance are still inevitable. Our review begins with a brief introduction of the historical discoveries, original hypotheses, and pathways that regulate CSCs, such as WNT/β-Catenin, hedgehog, Notch, NF-κB, JAK/STAT, TGF-β, PI3K/AKT, PPAR pathway, and their crosstalk. We focus on the role of CSCs in various therapeutic outcomes and resistance, including how the treatments affect the content of CSCs and the alteration of related molecules, CSCs-mediated therapeutic resistance, and the clinical value of targeting CSCs in patients with refractory, progressed or advanced tumors. In summary, CSCs affect therapeutic efficacy, and the treatment method of targeting CSCs is still difficult to determine. Clarifying regulatory mechanisms and targeting biomarkers of CSCs is currently the mainstream idea.
癌症干细胞（CSCs）是肿瘤中一小部分具有自我更新和持续增殖能力的细胞，导致肿瘤发生、转移，并维持肿瘤异质性。癌症仍然是一个重大的全球疾病负担。过去，手术、放疗和化疗是癌症的主要治疗方法。癌症治疗技术不断发展和进步，靶向治疗和免疫疗法的出现为患者提供了一定程度的更多选择。然而，疗效和治疗耐药性的局限性仍然不可避免。我们的综述首先简要介绍了 CSCs 的历史发现、原始假说和调控途径，如 WNT/β-连环蛋白、Hedgehog、Notch、NF-κB、JAK/STAT、TGF-β、PI3K/AKT、PPAR 途径及其串扰。我们重点关注 CSCs 在各种治疗结果和耐药性中的作用，包括治疗如何影响 CSCs 的含量和相关分子的改变、CSCs 介导的治疗耐药性，以及针对难治性、进展或晚期肿瘤患者的 CSCs 靶向治疗的临床价值。总之，CSCs 影响治疗效果，靶向 CSCs 的治疗方法仍难以确定。阐明 CSCs 的调控机制和靶向生物标志物是目前的主流思路。
