Targeting dormant cancer cells: ferroptosis as a precision therapeutic strategy

Abstract Dormant cancer cells are a significant source of cancer recurrence and metastasis and exhibit robust resistance to conventional therapies. Therefore, the exploration of novel therapeutic strategies to eliminate these cells has become a hot topic in cancer research. Ferroptosis, a newly identified form of regulated cell death, has garnered considerable attention in the field of cancer therapy in recent years. As a novel form of regulated cell death, the core mechanism of ferroptosis lies in the accumulation of intracellular iron and the induction of lipid peroxidation. Oxidative stress, the transforming growth factor-β (TGF-β) signaling pathway, autophagy, and lipid metabolism play dual roles in the survival of dormant cancer cells and the process of ferroptosis, influencing the response of dormant cancer cells to ferroptosis. These complex molecular mechanisms form a regulatory network between ferroptosis and dormant cancer cells, which holds significant implications for the development of future anti-tumor therapeutic strategies. This review synthesizes current evidence on targeting ferroptosis to eliminate dormant cancer cells, positions ferroptosis as a precision modality against dormant cancer cells, and discusses its therapeutic promise as a conceptual framework for developing next-generation anti-tumor strategies. Graphical abstract