Despite the development of various therapeutic approaches, recurrence and metastasis remain major problems for patients with advanced cancer. Recent studies have shown that cancer stem cells (CSCs) play an important role in cancer aggressiveness. In cancer tissues, a small number of CSCs are able to self-renew and differentiate into heterogeneous cancer cells. CSCs usually remain in the resting phase of the cell cycle and possess efficient drug efflux pathways. Thus, they are resistant to chemoradiotherapy and surviving CSCs contribute to recurrence. During cancer metastasis, CSCs undergo epithelial-mesenchymal transition (EMT), thereby acquiring mesenchymal features, migrating to adjacent stromal tissues, and invading blood or lymph vessels. Recent studies showed that EMT-inducible factors also enhance or induce CSC-like features in cancer cells. These findings suggest that EMT is closely correlated with cancer recurrence and metastasis. Inhibition of nestin, a CSC marker, reduces the aggressiveness of several types of cancer. Suppression of the mesenchymal variant of fibroblast growth factor (FGFR)-2, FGFR-2 IIIc, and regulation of the EMT using epithelial splicing regulatory protein 1 (ESRP1) are effective in the treatment of immunodeficient mice with pancreatic cancer. The roles of CSCs and EMT in cancer and possible therapies are discussed in this review.Key words: cancer stem cell, epithelial-mesenchymal transition, epithelial splicing regulatory protein 1/ESRP1, fibroblast growth factor receptor-2/FGFR-2, nestinIn Japan and the United States, the average 5-year survival rates of major cancers, including gastric, colorectal, lung, breast, cervical, ovarian, and prostate cancer, as well as leukemia, are around 55 %, and this number has shown only a 2 % improvement in the last 5 years.1 Additionally, cancers with poor prognosis, including advanced malignant melanoma, glioblastoma, and pancreatic cancer, present 5-year survival rates lower than 10 %. CSCs present characteristic features such as expression of CSC markers, which are proteins specific of or highly expressed in CSCs. We recently reported that targeting nestin, a CSC marker, may be a novel therapeutic option for pancreatic cancer, glioblastoma, malignant melanoma, and lung cancer treatment. [6][7][8][9][10][11] Alternative splicing in some proteins is regulated