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. Author manuscript; available in PMC: 2018 Feb 19.
Published in final edited form as: Biochim Biophys Acta. 2016 Oct 15;1866(2):276–289. doi: 10.1016/j.bbcan.2016.10.003

Figure 2. Multiple Cancer Stem Cell Subsets Confer Tumor Sustenance during Remission and Provoke Treatment-Refractory Recurrence.

Figure 2

Depicted is the typical clinical course of various malignancies with an overall timeline that covers decades. CSC-poor primary tumors show a favorable response to the initial therapeutic intervention and the patients enter clinical remission or MRD. However, heterogeneous CSC fractions persist which eventually causes treatment-refractory recurrence rich in CSCs and tumor heterogeneity. Conceptually, the cytoreduced setting of remission/MRD is very well-suited to initiate targeted anti-CSC therapy, but the heterogeneity of the surviving cells poses considerable therapeutic challenges. Finding vulnerabilities common to most CSC populations is therefore of critical importance to enable broad eradication of these cells and prevent life-threatening recurrence. CSC, cancer stem cell; MRD, minimal residual disease.