人类癌症中的耐药性 - 机制和含义
Drug resistance in human cancers - Mechanisms and implications
影响因子:5.10000
分区:医学3区 / 药学2区 医学：研究与实验3区
发表日期:2024 Sep 01
作者:
Sudikshaa Vijayakumar, Raveena Dhakshanamoorthy, Akshaya Baskaran, B Sabari Krishnan, Ravi Maddaly
摘要
癌症具有复杂的病因，除了社会经济的影响外，从医疗保健的角度产生了重大影响。从癌症治疗的临床试验与其他疾病获得的临床试验相比，癌症治疗的临床试验产生了最小的潜在承诺，可以理解癌症所带来的挑战的巨大性。手术，化学疗法和放疗仍然是癌症的主要治疗选择。在这些选择带来的挑战中，对化学治疗药物的抗药性可能是预后不良和治疗无效性的最重要贡献者。耐药性是几乎所有癌症类型的特性，包括癌，白血病，骨髓瘤，肉瘤和淋巴瘤。诱导耐药性的机制包括肿瘤微环境中的因素，负责药物代谢的基因突变，表面药物受体的变化和药物外排的增加。我们在这里全面提出了癌症中的耐药性及其机制。同样，除了耐药到定期使用的化学治疗药物外，我们还对新一代治疗剂（如单克隆抗体）提出了耐药性。最后，我们讨论了了解耐药性诱导和缓解诱导耐药性的潜在方法的实验方法。
Abstract
Cancers have complex etiology and pose a significant impact from the health care perspective apart from the socio-economic implications. The enormity of challenge posed by cancers can be understood from the fact that clinical trials for cancer therapy has yielded minimum potential promises compared to those obtained for other diseases. Surgery, chemotherapy and radiotherapy continue to be the mainstay therapeutic options for cancers. Among the challenges posed by these options, induced resistance to chemotherapeutic drugs is probably the most significant contributor for poor prognosis and ineffectiveness of the therapy. Drug resistance is a property exhibited by almost all cancer types including carcinomas, leukemias, myelomas, sarcomas and lymphomas. The mechanisms by which drug resistance is induced include the factors within the tumor microenvironment, mutations in the genes responsible for drug metabolism, changes in the surface drug receptors and increased drug efflux. We present here comprehensively the drug resistance in cancers along with their mechanisms. Also, apart from resistance to regularly used chemotherapeutic drugs, we present resistance induction to new generation therapeutic agents such as monoclonal antibodies. Finally, we have discussed the experimental approaches to understand the mechanisms underlying induction of drug resistance and potential ways to mitigate induced drug resistance.