Evidence mapPaperPMID 42467388Full record

ReviewMolecular biomedicine2026

Cancer stem cells and drug resistance in cancer: molecular mechanisms and therapeutic targets.

Hayam Hamdy, Youzhou Li, Chen Li, Zhuoxuan Li, Xin Liu, Ensong Sun, Doaa Safwat, Junling Shen, Hui Li, Jianwei Sun

Abstract readReview
In one paragraph

Review in Molecular biomedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hayam Hamdy *Yunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Youzhou Li *Yunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Chen Li *Department of Scientific Research, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, PekingKunming, China.
Zhuoxuan Li *Yunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Xin LiuYunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Ensong SunYunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Doaa SafwatDepartment of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, New Valley University, New Valley, Egypt.
Junling ShenYunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China. jlshen@ynu.edu.cn.
Hui LiYunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China. lihuidoc@126.com.
Jianwei SunYunnan Key Laboratory of Cell Metabolism and Diseases, State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China. jwsun@ynu.edu.cn.ORCID http://orcid.org/0000-0002-3045-2724

Funding

Applied Basic Research Key Project of Yunnan 2024YNLCYXZX0084National Natural Science Foundation of China 32260167National Natural Science Foundation of China 82273460Open Research Program of NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China First People's Hospital of Yunnan Province 2024XBYSKF003Yunnan Applied Basic Research Projects 202401AS070133Yunnan Applied Basic Research Projects XDYC-YLWS-2023-0056Yunnan Applied Basic Research Projects YDYXJJ2025-0007
6 · The paper itself

Abstract

Cancer therapy has advanced substantially through targeted therapies and immunotherapy; however, durable clinical responses remain limited by the development of drug resistance. Increasing evidence identifies cancer stem cells (CSCs) as central drivers of therapeutic failure, tumor recurrence, metastasis, and minimal residual disease. CSCs possess self-renewal and differentiation capacities together with remarkable adaptability under therapeutic stress, enabling long-term tumor maintenance and regeneration. CSC-mediated resistance arises through coordinated intrinsic and extrinsic mechanisms. Intrinsically, CSCs employ multiple survival programs, including cellular quiescence, enhanced DNA damage response and repair, ATP-binding cassette transporter-mediated drug efflux, apoptosis evasion, and metabolic reprogramming. Extrinsically, these mechanisms are reinforced through dynamic interactions with the tumor microenvironment (TME), particularly hypoxic and perivascular niches that support stemness and therapeutic tolerance. Importantly, CSCs are increasingly recognized as dynamic cellular states rather than fixed populations and exhibit marked plasticity through reversible transitions between stem-like and non-stem states, frequently mediated by epithelial-mesenchymal transition (EMT). This plasticity promotes intratumoral heterogeneity and replenishes resistant cell populations. In this review, we provide a comprehensive synthesis of the molecular and microenvironmental mechanisms underlying CSC-driven drug resistance and critically discuss emerging therapeutic strategies targeting CSC plasticity, niche interactions, metabolic adaptation, and immune evasion. Collectively, these insights support the development of integrated multi-target therapeutic approaches to improve long-term clinical outcomes.

Indexed as

Drug Resistance, NeoplasmNeoplasmsNeoplastic Stem CellsAnimalsAntineoplastic AgentsEpithelial-Mesenchymal TransitionHumansMetabolic ReprogrammingMolecular Targeted TherapyTumor MicroenvironmentAntineoplastic AgentsCancer stem cellsDrug resistanceEpithelial-mesenchymal transitionImmunotherapyMetabolic reprogrammingTumor microenvironment

Identifiers

PMID42467388
PMCPMC13379561

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.