The Great Escape: The Power of Cancer Stem Cells to Evade Programmed Cell Death

SIMPLE SUMMARY: Several current therapies fail to eradicate tumors due to the ability of cancer stem cells (CSCs) to escape different programmed cell deaths. In fact, apoptosis, autophagy, and necroptosis are deregulated in CSCs. Over the years, it has emerged that CSCs play a key role in tumor formation, progression, and recurrence. Thus, developing CSC-selective and programmed death-inducing therapeutic approaches appears of primary importance. In this review, we focus on signaling pathways involved in CSCs’ escape-death ability and the variety of CSC-targeting agents developed in recent years. ABSTRACT: Cancer is one of the primary causes of death worldwide. Tumour malignancy is related to tumor heterogeneity, which has been suggested to be due to a small subpopulation of tumor cells named cancer stem cells (CSCs). CSCs exert a key role in metastasis development, tumor recurrence, and also epithelial–mesenchymal transition, apoptotic resistance, self-renewal, tumorigenesis, differentiation, and drug resistance. Several current therapies fail to eradicate tumors due to the ability of CSCs to escape different programmed cell deaths. Thus, developing CSC-selective and programmed death-inducing therapeutic approaches appears to be of primary importance. In this review, we discuss the main programmed cell death occurring in cancer and the promising CSC-targeting agents developed in recent years. Even if the reported studies are encouraging, further investigations are necessary to establish a combination of agents able to eradicate CSCs or inhibit their growth and proliferation.