Molecular and microenvironmental networks driving tumor dormancy: pathological mechanisms and emerging clinical strategies

Although standard therapies including surgery, radiotherapy, and chemotherapy have proven effective in the initial eradication of primary tumors, a substantial proportion of cancer patients remain at persistent threat of recurrence. Accumulating evidence identifies tumor dormancy as a pivotal driver of this clinical challenge. Dormant tumor cells can persist in a quiescent state for extended periods, during which they exhibit marked resistance to conventional therapies and may ultimately trigger disease relapse years after clinical remission. Consequently, deciphering the mechanisms governing tumor dormancy has become imperative for the development of novel therapeutic strategies aimed at preventing recurrence. Tumor dormancy arises from reciprocal interactions between tumor cells and their microenvironment, which collectively establishes a reservoir that fosters both drug tolerance and late relapse. This review systematically delineates the core molecular signatures, microenvironmental regulatory networks, and targeted intervention approaches relevant to dormant cancer cells, aiming to provide a theoretical foundation for the prevention of tumor recurrence.