Cancer plasticity and histological transformation as adaptive resistance mechanisms in precision oncology.

The advent of precision oncology has brought substantial advancements in cancer therapy, yet it has been accompanied by equally complex resistance mechanisms. Among these mechanisms, histological transformations can compromise the effectiveness of targeted therapies, resulting in a loss of clinical benefit following initial success. Understanding these evolutionary processes is crucial for developing the next generation of cancer treatments that can effectively combat resistance. This review examines histological transformation as a key mechanism of resistance to anticancer therapies, driven by various forms of tumor plasticity, and explores into the underlying processes and mechanisms that drive these changes. We also discuss how precision oncology and an appreciation of cancer plasticity can be leveraged to overcome histological transformation and lead to improved patient outcomes.