Editorial: Unlocking cancer’s secrets: overcoming drug resistance in cancer stem cells

Despite remarkable advances in cancer diagnosis and treatment, therapeutic resistance remains one of the greatest challenges in modern oncology. Tumor recurrence, metastatic dissemination, and treatment failure continue to limit long-term patient survival across a broad range of malignancies. Increasing evidence indicates that these phenomena are driven not only by genetic alterations but also by dynamic cellular states characterized by stemness, plasticity, and adaptive responses to therapeutic pressure. Cancer stem cells (CSCs), together with other therapy-tolerant cell populations, have emerged as central mediators of these processes, sustaining tumor heterogeneity, promoting tumor evolution, and enabling survival under otherwise lethal conditions. CSCs are characterized by enhanced self-renewal capacity, activation of pro-survival signaling networks, metabolic adaptability, efficient DNA repair mechanisms, and dynamic interactions with the tumor microenvironment, all of which contribute to therapeutic resistance, tumor recurrence, and metastatic progression.