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Chemoresistance in Cancer Stem Cells and Strategies to Overcome Resistance

Margaret Lois Thomas, Krysta Mila Coyle, Mohammad Sultan, Ahmad Vaghar-Kashani and Paola Marcato

In cancers, there exists a subpopulation of cells which are referred to as cancer stem cells (CSCs) or tumorinitiating cells that have enhanced tumor-initiating capacity and metastatic potential, and drive tumor progression.Since the initial identification of acute myeloid leukemia CSCs in 1997, CSCs have been found in many types ofcancer and have intrinsic resistance to the current chemotherapeutic strategies. With increased levels of detoxifyingenzymes, enhanced DNA repair abilities, impressive efflux capacity, and a slower cell-cycle; CSCs present aformidable obstacle against effective chemotherapy. Several methods of specifically targeting CSCs have beendeveloped in recent years, and these compounds have potential as adjuvant therapies. The following is a review ofthe mechanisms responsible for chemoresistance in CSCs, with an emphasis on potential strategies to overcomethis resistance .