Decoding cancer dormancy: integrative genomic, phenotypic and live-cell imaging analysis to reveal the hidden cancer cell reservoir

Metastases represent one of the hardest obstacles in cancer treatment, accounting for many cancer-related deaths. Understanding the mechanisms that drive disease progression is essential to improve patient outcomes and develop more effective therapeutic strategies. This phenomenon appears to be elicited by dormant cancer cells (DCCs), which can persist undetected for extended periods of time, entering a non-proliferative, hibernation-like state that confers resistance to conventional therapies and facilitates immune evasion. Owing to their status as a rare and energy-restricted population, combined with the limitations of current medical imaging, DCCs often evade early detection, hindering timely intervention and effective clinical management. Consequently, a critical need exists to develop high-resolution detection systems and identify specific DCC targetable biomarkers. Here, a comprehensive overview of the current understanding of DCCs is reported, with a focus on recent advancements in experimental strategies for their identification and tracking, as well as therapeutic approaches currently under clinical investigation aimed at targeting these elusive cells.