CEDOC, Chronic Diseases Research Centre, NOVA Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal.
Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Lisbon, Portugal.
Adv Exp Med Biol. 2020;1219:297-310. doi: 10.1007/978-3-030-34025-4_15.
Despite all the progresses developed in prevention and new treatment approaches, cancer is the second leading cause of death worldwide, being chemoresistance a pivotal barrier in cancer management. Cancer cells present several mechanisms of drug resistance/tolerance and recently, growing evidence have been supporting a role of metabolism reprograming per se as a driver of chemoresistance. In fact, cancer cells display several adaptive mechanisms that allow the emergency of chemoresistance, revealing cancer as a disease that adapts and evolve along with the treatment. Therefore, clinical protocols that take into account the adaptive potential of cancer cells should be more effective than the current traditional standard protocols on the fighting against cancer.In here, some of the recent findings on the role of metabolism reprograming in cancer chemoresistance emergence will be discussed, as the potential evolutionary strategies that could unable these adaptations, hence allowing to prevent the emergency of treatment resistance, changing cancer outcome.
尽管在预防和新的治疗方法方面取得了所有进展,但癌症仍是全球第二大死亡原因,化疗耐药是癌症治疗中的一个关键障碍。癌细胞存在几种耐药/耐受机制,最近越来越多的证据支持代谢重编程本身作为化疗耐药的驱动因素。事实上,癌细胞表现出几种适应性机制,使化疗耐药得以出现,表明癌症是一种随着治疗而适应和进化的疾病。因此,考虑到癌细胞的适应潜力的临床方案应该比目前针对癌症的传统标准方案更有效。在这里,将讨论代谢重编程在癌症化疗耐药性出现中的作用的一些最新发现,以及可能使这些适应失效的潜在进化策略,从而防止治疗耐药性的出现,改变癌症的结果。