Cancer Stem Cell Quiescence and Plasticity as Major Challenges in Cancer Therapy

Figure 4

Mechanisms inducing CSC phenotypes. The CSC phenotype of cancer cells is influenced by cues related to the tumor microenvironment. These include remodeling of the extracellular matrix and signaling through factors secreted by endothelial, immune system cells and stromal fibroblasts. Signaling related to EMT (epithelial to mesenchymal transition) may also induce a CSC phenotype. Low oxygen (hypoxia) and acidic conditions nearby the CSC niche may induce and/or enhance the CSC phenotype of cells. Radiotherapy and chemotherapy have been shown to induce dedifferentiation of cancer cells and acquisition of a CSC phenotype. Figure was constructed in part with objects from Servier Medical Art documents under license from Creative Commons Attribution 3.0 France (http://creativecommons.org/licenses/by/3.0/fr/legalcode).