Abstract
Ovarian cancer is the most lethal gynecological malignancy and the high morbidity and mortality are due in large part to relapse with chemotherapy-resistant disease. Cancer stem cells are purported to be a small population of undifferentiated cells endowed with features of normal stem cells that permit them to evade chemotherapy, persist indefinitely, and regenerate a heterogeneous tumor. The high rate of recurrence after an apparent complete remission suggests this elusive population plays an important role in ovarian cancer progression after initial chemotherapy. Research over the last two decades has uncovered a wealth of information about the biology of ovarian cancer stem cells, their potential origins, the markers and phenotypes associated with them, and challenges to targeting them. Heterogeneity within the cancer stem cell population adds more complexity, as does understanding components of the microenvironment that support stem cell phenotypes. New research focused on combination therapies that include standard chemotherapy in conjunction with CSC-targeted agents, epigenetic modifiers, or immunotherapies, shows great promise for overcoming ovarian cancer chemotherapy resistance.
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