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Persister cell plasticity in tumour drug resistance
Paul C McDonald1, Shoukat Dedhar2
1Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada.
Abstract:
The emergence of therapeutic resistance remains a formidable barrier to durable responses by cancer patients and is a major cause of cancer-related deaths. It is increasingly recognized that non-genetic mechanisms of acquired resistance are important in many cancers. These mechanisms of resistance rely on inherent cellular plasticity where cancer cells can switch between multiple phenotypic states without genetic alterations, providing a dynamic, reversible resistance landscape. Such mechanisms underlie the generation of drug-tolerant persister (DTP) cells, a subpopulation of tumour cells that contributes to heterogeneity within tumours and that supports therapeutic resistance. In this review, we provide an overview of the major features of DTP cells, focusing on phenotypic and metabolic plasticity as two key drivers of tolerance and persistence. We discuss the link between DTP cell plasticity and the potential vulnerability of these cells to ferroptosis. We also discuss the relationship between DTP cells and cells that survive the induction of apoptosis, a process termed anastasis, and discuss the properties of such cells in the context of increased metastatic potential and sensitivity to cell death mechanisms such as ferroptosis.
Insights
Therapeutic resistance in cancer is often driven by non-genetic, plastic changes in drug-tolerant persister (DTP) cells. Understanding DTP cell plasticity and vulnerability to ferroptosis is key to overcoming treatment failure.
Area of Science:
- Oncology
- Cancer Biology
- Cellular Plasticity
Background:
- Therapeutic resistance is a major cause of cancer mortality.
- Non-genetic mechanisms, particularly cellular plasticity, drive acquired resistance.
- Drug-tolerant persister (DTP) cells emerge due to this plasticity, contributing to tumor heterogeneity and treatment failure.
Purpose of the Study:
- To review the key features of DTP cells.
- To highlight phenotypic and metabolic plasticity as drivers of DTP cell tolerance and persistence.
- To explore the connection between DTP cell plasticity and ferroptosis vulnerability.
Main Methods:
- Literature review focusing on DTP cells.
- Analysis of phenotypic and metabolic plasticity in cancer resistance.
- Examination of the relationship between DTP cells, anastasis, and ferroptosis.
Main Results:
- DTP cells exhibit significant phenotypic and metabolic plasticity.
- This plasticity contributes to reversible therapeutic resistance.
- DTP cells may be vulnerable to ferroptosis, a cell death pathway.
Conclusions:
- Cellular plasticity is a critical factor in the emergence of DTP cells and therapeutic resistance.
- Targeting DTP cell plasticity and exploiting ferroptosis presents a potential strategy to overcome treatment resistance.
- Further research into DTP cells, anastasis, and ferroptosis is warranted for improved cancer therapies.
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