Abstract: Tumor microenvironment (TME) plays a particularly important role in the pathogenesis and drug resistance of lung cancer. This article provides a framework that allows us to view lung cancer through the lens of cancer stem cells (CSCs) and angiogenesis, with the aim of enhancing both clinical and laboratory insights. It critically examines the bidirectional interactions between CSCs and other components of the TME, highlighting their combined contributions to tumor aggressiveness and angiogenic processes. We discuss the mechanisms by which CSCs influence angiogenesis, including the release of growth factors and cytokines, while also emphasizing how angiogenic factors, in turn, modulate CSC behavior and help maintain a microenvironment that supports tumor growth. Potential biomarkers and therapeutic targets— such as CD133, ALDH1, and VEGF—are explored as valuable not only for disease management but also for the development of targeted therapies for lung cancer. This article ultimately provides a foundation for researchers to further investigate these interconnected processes and for clinicians to consider therapeutic strategies when managing patients with lung cancer. Given the multifaceted nature of lung cancer biology and the numerous molecules involved, we advocate for a panel-centered approach in both research and clinical management, while underscoring the importance of carefully considering toxicity risks and variability in molecular expression.
Tchawe et al. (Mon,) studied this question.