Molecular modulation of autophagy: New venture to target resistant cancer stem cells

Figure 3 The divergent role of autophagy in cancer stem cells and cancer cells. Cancer stem cells (CSCs) drive the initiation and progression of cancer in multiple tumors. CSCs are reliant on their niches to sustain their self-renewal capacity and plasticity. Hypoxia induced autophagy, provides metabolic plasticity to CSCs. The role of autophagy in hypoxia is to modulate the metabolic remodeling of cancer cells, in particular CSCs. Additionally, autophagy and hypoxia have been implicated in immunosurveillance of CSCs during glucose limitation by increasing the expression of programmed death ligand 1 which results to tumor-infiltrating lymphocytes exhaustion. In addition, autophagy supports tumor dormancy, metastasis and invasion resulting to the treatment of resistant CSCs. CSC: Cancer stem cell; CC: Cancer cell; ER: Endothelial reticulum; TIL: Tumor-infiltrating lymphocytes; TME: Tumor microenvironment.