Cancer Stem Cells as Dynamic Attractor States: Systems Biology of Tumor Plasticity and Therapy Resistance.

The cancer stem cell (CSC) paradigm has evolved from a rigid hierarchical model to a systems-level perspective in which stemness is a reversible and context-dependent phenotype. Evidence from lineage tracing and single-cell/spatial multiomics indicates that tumor cells occupy continuously evolving phenotypic states governed by complex gene regulatory networks. Within this landscape, CSCs can be interpreted as metastable attractors maintained through coupled signaling, epigenetic, metabolic, transcriptional, and microenvironmental interactions. Tumor heterogeneity and therapeutic resistance emerge through phenotypic reprogramming, regulatory network rewiring, and niche-dependent stabilization under environmental and therapeutic stress. This reframes resistance as an emergent property of tumor ecosystems, underscoring the limitations of targeting static CSC populations or single pathways. Therefore, durable therapeutic control will require network-oriented interventions capable of reshaping attractor topology and disrupting stemness-supportive microenvironments.