Cancer stem cell plasticity drives therapy resistance in colorectal cancer

Figure 1 Biology of colorectal cancer stem cells. Normal intestinal epithelium contains leucine-rich G repeat-containing protein-coupled receptor 5+ intestinal stem cells that maintain epithelial homeostasis through self-renewal and differentiation. During colorectal tumorigenesis, a subset of tumor cells acquires cancer stem cell (CSC) characteristics, including self-renewal, differentiation capacity, and tumor-initiating potential. CSCs exhibit remarkable phenotypic plasticity, allowing bidirectional interconversion between CSCs and non-CSCs through dedifferentiation and reprogramming. Under chemotherapy, radiotherapy, or targeted therapy, resistant CSC populations are preferentially enriched, contributing to tumor recurrence, metastasis, and treatment failure. CSC: Cancer stem cell; LGR5: Leucine-rich G repeat-containing protein-coupled receptor 5.