The biological characteristic and therapeutic prospect of bladder cancer stem cells

Bladder cancer (BC), arising from bladder epithelial cells, is the most prevalent malignant tumor of the urinary system. Its main pathological variants include transitional cell carcinoma (TCC), squamous cell carcinoma, and adenocarcinoma, with TCC further divided into non-muscle-invasive BC (NMIBC) and muscle-invasive BC (MIBC). NMIBC accounts for 70% of all BC cases and is characterized by a favorable prognosis yet a high recurrence rate (31 – 78%). Conversely, MIBC accounts for the remainder of BC cases, characterized by high heterogeneity and poor prognosis. Current treatment methods for BC predominantly encompass surgical resection, radiotherapy, chemotherapy, and immunotherapy. However, these methods lack specificity, exhibit limited clinical efficacy, and often yield unsatisfactory treatment outcomes, predisposing BC to recurrence. On the other hand, BC stem cells (BCSCs) are a subset of cells within heterogeneous BC, possessing robust abilities in self-renewal, differentiation, tumorigenicity, metastasis, and drug resistance. They play a pivotal role in the initiation, progression, metastasis, and relapse of BC, rendering them ideal targets for targeted therapy. Research efforts in this field are currently focused on investigating the evolutionary origins, biomarkers, mechanism governing stemness maintenance, drug resistance, metastasis, metabolic reprogramming, immune evasion, and targeted therapies related to BCSCs. This article provides a comprehensive review of the latest advancements in the biological characteristics and therapeutic prospects of BCSCs.