Colorectal cancer cell dormancy: An insight into pathways

Abstract

Cancer cell dormancy (CCD) in colorectal cancer (CRC) poses a significant challenge to effective treatment. In CRC, CCD contributes to tumour recurrence, drug resistance, and amplifying the disease's burden. The molecular mechanisms governing CCD and strategies for eliminating dormant cancer cells remain largely unexplored. Therefore, understanding the molecular mechanisms governing dormancy is crucial for improving patient outcomes and developing targeted therapies. This editorial highlights the complex interplay of signalling pathways and factors involved in colorectal CCD, emphasizing the roles of Hippo/YAP, pluripotent transcription factors such as NANOG, HIF-1α signalling, and Notch signalling pathways. Additionally, ERK/p38α/β/MAPK pathways, AKT signalling pathway, and Extracellular Matrix Metalloproteinase Inducer, along with some potential less explored pathways such as STAT/p53 switch and canonical and non-canonical Wnt and SMAD signalling, are also involved in promoting colorectal CCD. Highlighting their clinical significance, these findings may offer the potential for identifying key dormancy regulator pathways, improving treatment strategies, surmounting drug resistance, and advancing personalized medicine approaches. Moreover, insights into dormancy mechanisms could lead to the development of predictive biomarkers for identifying patients at risk of recurrence and the tailoring of targeted therapies based on individual dormancy profiles. It is essential to conduct further research into these pathways and their modulation to fully comprehend CRC dormancy mechanisms and enhance patient outcomes.

Keywords: Colorectal cancer; Colorectal cancer cell dormancy; Cancer cell dormancy; Pathways in colorectal cancer dormancy

Core Tip: Colorectal cancer (CRC) cell dormancy drives therapeutic resistance, recurrence, and metastasis. Key molecular pathways involved in CRC dormancy include Hippo/YAP, NANOG, HIF-1α, Notch, ERK/MAPK, AKT, Wnt, and SMAD. Dysregulation of these pathways promotes dormancy. After re-entering active tumor state following dormancy, these cancer cells become more aggressive and metastasize quickly. The mechanisms behind CRC dormancy are largely unexplored. This editorial summarizes these pathways and their interactions, highlighting the identification of predictive biomarkers crucial for developing targeted therapies, overcoming drug resistance, and enhancing personalized treatments and patient outcomes.