title: Approaches for targeting cancer stem cells drug resistance.
abstract: Several reports have suggested that a population of undifferentiated cells known as cancer stem cells (CSCs), is responsible for cancer formation and maintenance. In the last decade, the presence of CSCs in solid cancers have been reported. Areas covered: This review summarizes the main approaches for targeting CSCs drug resistance. It is indeed known that CSCs may contribute to resistance to conventional chemotherapy, radiotherapy and targeted agents. Among the mechanisms by which CSCs escape anticancer therapies, removal of therapeutic agents by drug efflux pumps, enhanced DNA damage repair, activation of mitogenic/anti-apoptotic pathways; the main features of CSCs, stemness and EMT, are involved, as well as the capability to evade immune response. Expert opinion: Different approaches are suitable to target CSCs mediated drug resistance. Some of them are currently under clinical evaluation in different cancer types. A better understanding of CSC biology, as well as more accurate study design, may maximize the therapeutic effects of these agents. In this respect, it is important to establish: (i) which molecules should be targeted; (ii) what drug combinations may be suitable; (iii) which patient settings will CSC targeting offer the highest clinical benefit; and (iv) how to integrate therapeutic approaches targeting CSCs with standard cancer therapy.
authors.affiliation: a Dipartimento di Medicina Clinica e Chirurgia , Università di Napoli Federico II , Napoli , Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Rosa
authors.affiliation: a Dipartimento di Medicina Clinica e Chirurgia , Università di Napoli Federico II , Napoli , Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: D'Amato
authors.affiliation: a Dipartimento di Medicina Clinica e Chirurgia , Università di Napoli Federico II , Napoli , Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: De Placido
authors.affiliation: a Dipartimento di Medicina Clinica e Chirurgia , Università di Napoli Federico II , Napoli , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianco
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D019008:Drug Resistance, Neoplasm; D006801:Humans; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014411:Neoplastic Stem Cells / Q000378:metabolism*; D012107:Research Design
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer stem cells; EMT; immune evasion; resistance; stemness