Drug tolerant persister cell plasticity in cancer: a revolutionary strategy for more effective anticancer therapies

• Published in: Signal transduction and targeted therapy Vol. 9; no. 1; pp. 209 - 24
• Main Authors: He, Jun, Qiu, Zejing, Fan, Jingjing, Xie, Xiaohong, Sheng, Qinsong, Sui, Xinbing
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14.08.2024; Nature Publishing Group
• Subjects: 631/67/1059; 631/67/2327; 631/67/580; Antineoplastic Agents - pharmacology; Antineoplastic Agents - therapeutic use; Antineoplastic drugs; Cancer Research; Cancer therapies; Cell Biology; Cell Plasticity - drug effects; Cell Plasticity - genetics; Cell proliferation; Drug resistance; Drug Resistance, Neoplasm - drug effects; Drug Resistance, Neoplasm - genetics; Humans; Internal Medicine; Medicine; Medicine & Public Health; Natural products; Neoplasms - drug therapy; Neoplasms - genetics; Neoplasms - pathology; Oncology; Pathology; Patients; Phenotypes; Review; Review Article
• ISSN: 2059-3635; 2095-9907; 2059-3635
• DOI: 10.1038/s41392-024-01891-4

Non-genetic mechanisms have recently emerged as important drivers of anticancer drug resistance. Among these, the drug tolerant persister (DTP) cell phenotype is attracting more and more attention and giving a predominant non-genetic role in cancer therapy resistance. The DTP phenotype is characterized by a quiescent or slow-cell-cycle reversible state of the cancer cell subpopulation and inert specialization to stimuli, which tolerates anticancer drug exposure to some extent through the interaction of multiple underlying mechanisms and recovering growth and proliferation after drug withdrawal, ultimately leading to treatment resistance and cancer recurrence. Therefore, targeting DTP cells is anticipated to provide new treatment opportunities for cancer patients, although our current knowledge of these DTP cells in treatment resistance remains limited. In this review, we provide a comprehensive overview of the formation characteristics and underlying drug tolerant mechanisms of DTP cells, investigate the potential drugs for DTP (including preclinical drugs, novel use for old drugs, and natural products) based on different medicine models, and discuss the necessity and feasibility of anti-DTP therapy, related application forms, and future issues that will need to be addressed to advance this emerging field towards clinical applications. Nonetheless, understanding the novel functions of DTP cells may enable us to develop new more effective anticancer therapy and improve clinical outcomes for cancer patients.