Tumorigenic cancer stem cells [CSCs] are multipotent cells that found
together with their nontumorigenic variants in the same clone. Although sharing the
same genetic battery, CSCs and their non-tumorigenic progenies respond differently to
micro environmental stresses. Thus, hypoxia, inflammation, low pH, shortage in
nutrients and cancer therapies result in broad spectrum of changes in signaling
pathways. These facts paved the road to a new era in cancer treatment strategies where
inhibiting CSCs specific pathways are combined with traditional therapies of bulk
tumor cells. Despite the promise such combination brought to cancer cure
improvement, resistance to some to some CSCs-related therapies is noticed. Thus, this
review focuses on the mechanisms that may involve in such resistance including drug
efflux by ABC transporters, activation of aldehyde dehydrogenase and developmental
pathways, enhanced DNAdamage response and autophagy and microenvironmental
conditions. This review discusses as well the possible therapeutic strategies for
improving cancer treatment.
Keywords: Carcinogenesis, Cancer therapeutic strategies, Cell surface markers,
Inflammatory reactions, Nanotechnology, Role of niche, Tumorigenic cancer stem
cells [CSCs].
