Understanding prostate cancer stem cells: implications for therapy and treatment resistance

Abstract

Prostate cancer (PCa) is a highly heterogeneous and rapidly progressing malignancy with a complex etiology. The presence of cancer stem cells (CSCs) within prostate tumors contributes to treatment resistance, relapses, and metastasis. Understanding the molecular mechanisms and signaling pathways involved in CSC regulation is crucial for developing effective therapies. This article highlights the role of CSCs, particularly PCa stem cells (PCSCs), in PCa initiation and progression. It discusses the cellular heterogeneity of prostate tumors, the theories of clonal evolution and CSCs, and the resistance mechanisms exhibited by CSCs. In addition, the involvement of signaling pathways such as Hedgehog, PI3K/AKT, and mitogen-activated protein kinase/extracellular regulated kinases in PCSC regulation is explored. The need for new therapies targeting CSCs is emphasized, and potential treatment approaches, including immunotherapy and genetic engineering, are discussed. Despite the challenges posed by advanced therapies, targeting PCSCs holds promise for improving patient outcomes in advanced PCa. Further research on PCSC biology is warranted to advance our understanding and develop more effective therapeutic strategies.