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Cancer mass comprises heterogeneous population. The majority of cancer population is vulnerable to chemotherapeutic agents and radiotherapy whilst the small population, cancer stem cells, having specific capacity of growth advantages results in multidrug resistance and survival from conventional therapies. Therefore, cancer stem cells should be targeted in cancer treatment to cure malignant disease. Characterisation and identification should be extensively studied to specifically and accurately identify these population. Additional, identification of cancer stem cells should universally indicate these population of all cancer types. Multidrug resistance of cancer stem cells to conventional therapies results from not only one mechanism but it can possibly cause from severe drug resistance mechanisms such as key signalling pathways (Wnt signaling pathway, Hedgehog pathway and Notch signaling pathway), ABC transporters effluxing chemotherapeutic agents out of cells and microenvironment niche helping cancer stem cells to survive and resist to treatment. Hence, the principal drug resistance mechanism of cancer stem cells should be intensively studied to effectively target these population resulting in cure treatment of malignant diseases. Additionally, drug resistance mechanisms require further studies to develop and improve treatment of cancer. Hopefully, malignant diseases are curable in the future.
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