Abstract

Prostate cancer (PC) constitutes an alarming health issue as it remains one of the most diagnosed cancers and a leading cause of cancer-related deaths among men worldwide. Despite the advances that have been made to manage PC, the disease often develops resistance and progresses to the metastatic castration-resistant prostate cancer (mCRPC) state. This failure has been mainly attributed to the high levels of heterogeneity and the presence of a subpopulation of cancer stem cells (CSCs) within the tumor bulk. Prostate cancer stem cells (PCSCs) possess unique characteristics allowing them to self-renew and differentiate into multiple lineages of cells. Compelling evidence implicates CSCs in cancer progression, dissemination, and resistance to standardized therapies, including chemotherapy, androgen deprivation therapy (ADT), and radiotherapy. This is governed by several defective mechanisms and regulatory pathways that aim to sustain the stemness properties of PCSCs and support their resistant phenotype. Hence, it is primordial to target this highly resistant subpopulation of cells which is adding a high level of complexity to cancer treatment. Herein, we describe the stem cell markers used for the identification and isolation of PCSCs. We highlight also the main signaling pathways and regulatory mechanisms governing the stemness properties of PCSCs. Prominently, we emphasize the modes of resistance employed by PCSCs to escape the different treatment modalities and contribute to therapy failure and PC disease recurrence.

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