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The Role of Cancer Stem Cells in Disease Progression and Therapy Resistance

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A small subpopulation of tumour cells, known as cancer stem cells (CSCs),is the main culprit of tumour growth. They are capable of self-renewal, tumourinitiation, expansion, metastasis, therapy resistance and cancer relapse. Factorsassociated with malignant properties of CSCs include decreased apoptotic insults,enhanced activity of drug efflux pumps and capacity to induce DNA repair, expressionof detoxification enzymes and ability to become quiescent, i.e. phenotypic andgenotypic plasticity of CSC, etc. These extraordinary capabilities of CSCs contribute totherapeutic resistance and cancer recurrence. Moreover, multiple factors including acomplex network of tumour stroma, epidermal microenvironment and different subcompartmentswithin the tumour stimulate CSCs plasticity-mediated tumourprogression. These factors along with the metabolic flexibility of CSCs help them tobecome more aggressive, subsequently leading to tumour progression. Therefore, inthis chapter, we describe how CSCs are associated with the initiation and progressionof cancer. We also discuss the role of CSCs in therapy resistance with detailedmolecular mechanisms, all of which could help us in developing promising strategies tobenefit cancer treatment.

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