Cancer stem cells (CSCs), also known as tumor-initiating cells (TICs), contribute to tumorigenesis, cancer progression, metastasis, and therapeutic resistance. Their self-renewal, survival, and ability to evade treatment are strongly influenced by the tumor microenvironment and its associated signaling networks. This narrative review examines the biological characteristics of CSCs, their interactions with the tumor microenvironment, and the mechanisms underlying their proliferation, invasion, and resistance to anticancer therapies. Relevant literature was identified through searches of PubMed, Scopus, Web of Science, and Google Scholar using terms related to CSCs, the tumor microenvironment, drug resistance, and major signaling pathways, including Wnt, bone morphogenetic protein (BMP), Notch, and Hedgehog. Original research articles and review papers were considered, with no restrictions on the publication period, to integrate foundational knowledge with recent advances. The review discusses the role of CSC-associated signaling pathways and epithelial-mesenchymal transition in tumor progression and treatment resistance, as well as emerging therapeutic strategies targeting CSCs and their microenvironment. Understanding these mechanisms may provide valuable insights into the development of more effective therapeutic approaches for overcoming cancer recurrence and treatment resistance.
Type of Study:
Review |
Subject:
Cellular-Molecular Biology Received: 2026/02/11 | Revised: 2026/10/14 | Accepted: 2026/07/18 | Published: 2026/09/10
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