Suresh Raagini, Ali Shadan, Ahmad Aamir, Philip Philip A, Sarkar Fazlul H
Department of Pathology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
Adv Exp Med Biol. 2016;890:57-74. doi: 10.1007/978-3-319-24932-2_4.
Lung cancer is the leading cause of cancer-related deaths worldwide with a 5-year overall survival rate of less than 20 %. Considering the treatments currently available, this statistics is shocking. A possible explanation for the disconnect between sophisticated treatments and the survival rate can be related to the post-treatment enrichment of Cancer Stem Cells (CSCs), which is one of a sub-set of drug resistant tumor cells with abilities of self-renewal, cancer initiation, and further maintenance of tumors. Lung CSCs have been associated with resistance to radiation and chemotherapeutic treatments. CSCs have also been implicated in tumor recurrence because CSCs are not typically killed after conventional therapy. Investigation of CSCs in determining their role in tumor recurrence and drug-resistance relied heavily on the use of specific markers present in CSCs, including CD133, ALDH, ABCG2, and Nanog. Yet another cell type that is also associated with increased resistance to treatment is epithelial-to-mesenchymal transition (EMT) phenotypic cells. Through the processes of EMT, epithelial cells lose their epithelial phenotype and gain mesenchymal properties, rendering EMT phenotypic cells acquire drug-resistance. In this chapter, we will further discuss the role of microRNAs (miRNAs) especially because miRNA-based therapies are becoming attractive target with respect to therapeutic resistance and CSCs. Finally, the potential role of the natural agents and synthetic derivatives of natural compounds with anti-cancer activity, e.g. curcumin, CDF, and BR-DIM is highlighted in overcoming therapeutic resistance, suggesting that the above mentioned agents could be important for better treatment of lung cancer in combination therapy.
肺癌是全球癌症相关死亡的主要原因,其5年总生存率低于20%。考虑到目前可用的治疗方法,这一统计数据令人震惊。对于先进治疗方法与生存率之间脱节的一种可能解释可能与癌症干细胞(CSCs)的治疗后富集有关,癌症干细胞是具有自我更新、启动癌症及进一步维持肿瘤能力的耐药肿瘤细胞亚群之一。肺CSCs与对放疗和化疗的耐药性有关。CSCs也与肿瘤复发有关,因为CSCs在传统治疗后通常不会被杀死。在确定CSCs在肿瘤复发和耐药性中的作用时,对CSCs的研究严重依赖于CSCs中存在的特定标志物的使用,包括CD133、醛脱氢酶(ALDH)、ATP结合盒转运蛋白G2(ABCG2)和Nanog。另一种也与治疗耐药性增加相关的细胞类型是上皮-间质转化(EMT)表型细胞。通过EMT过程,上皮细胞失去其上皮表型并获得间质特性,使EMT表型细胞获得耐药性。在本章中,我们将进一步讨论微小RNA(miRNAs)的作用,特别是因为基于miRNA的疗法在治疗耐药性和CSCs方面正成为有吸引力的靶点。最后,强调了具有抗癌活性的天然药物和天然化合物的合成衍生物(如姜黄素、CDF和BR-DIM)在克服治疗耐药性方面的潜在作用,这表明上述药物在联合治疗中对更好地治疗肺癌可能很重要。