Cancer stem cells (CSCs) are a minor subset of chemotherapy-resistant and radiotherapy-resistant tumor cells that can undergo unlimited self-renewal and generate tumor mass. CSC-targeted therapies are more effective therapeutic approaches for cancer. Various targeting strategies are implemented to eliminate CSCs by targeting CSCs surface markers and the quiescence of CSCs, regulating stem cell- specific signaling pathways such as Notch, Wnt and hedgehog, inhibiting drug-efflux pumps, induction of differentiation in CSCs by epigenetic regulation or epithelial-mesenchymal transition induction, modulating the tumor microenvironment and disturbing niche. MicroRNAs, dendritic cell vaccination using CSC antigens, induction of apoptosis, modulators of autophagy, inhibitors of glycolysis metabolism or oxidative phosphorylation using drugs or natural products such as CAPE (Caffeic Acid Phenyl Ester) and vitamin C have also been developed as anti-CSC therapy. Some of these anti-CSCs targeted strategis are under evaluation in preclinical and clinical studies. The combination therapy of CSCs-targeting agents and conventional anticancer drugs may be an effective strategy for eradication of different types of cancers.

Keywords