基于摄取药物的乳腺癌治疗中的化疗耐药性。

Drug uptake-based chemoresistance in breast cancer treatment.

机构信息

Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, E-08195 Sant Cugat del Vallès, Spain.

Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, E-08195 Sant Cugat del Vallès, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, E-28029 Madrid, Spain.

出版信息

Biochem Pharmacol. 2020 Jul;177:113959. doi: 10.1016/j.bcp.2020.113959. Epub 2020 Apr 7.

Abstract

Breast cancer is the most prevalent type of tumor and the second leading cause of death due to cancer among women. Although screening methods, diagnosis and therapeutic options have improved in the last decade, chemoresistance remains an important challenge. There is evidence relating breast cancer resistance with signaling pathways involving hormone and growth receptors, survival, apoptosis and the activation of efflux pumps. However, the resistance mechanisms linked to drug uptake are poorly understood, despite it often being observed that the drug content is lower in resistant cancer cells and that the entry of the drug into these cells is a limiting process for the subsequent therapeutic effect.In this review, we provide an overview of drug uptake-based resistance mechanisms developed by cancer cells in the four main types of chemotherapy used in breast cancer: anthracyclines, taxanes, oxazaphosphorines and platinum-based drugs. The contribution of tumor microenvironment to reduced drug-uptake and multidrug resistance is also analyzed. As a developing field, nanomedicine-based approaches provide promising opportunities to improve drug specific targeting, cell interaction and uptake into cancer cells. The endocytic-mediated pathways attributed to the different types of nanoformulations as well as the contribution of nanotherapeutics to overcoming chemoresistance affecting drug uptake in breast cancer will be described. New approaches focusing on drug uptake mechanisms could improve breast cancer chemotherapy, obtaining better dose-response outcomes and reducing toxic side effects.

摘要

乳腺癌是最常见的肿瘤类型,也是女性癌症死亡的第二大主要原因。尽管在过去十年中,筛查方法、诊断和治疗选择有所改善,但化疗耐药仍然是一个重要的挑战。有证据表明,乳腺癌耐药与涉及激素和生长受体、存活、凋亡和外排泵激活的信号通路有关。然而,尽管经常观察到耐药癌细胞中的药物含量较低,并且药物进入这些细胞是随后治疗效果的限制过程,但与药物摄取相关的耐药机制仍了解甚少。在这篇综述中,我们概述了乳腺癌中四种主要化疗药物(蒽环类药物、紫杉烷类药物、唑烷磷类药物和铂类药物)中癌细胞发展的基于药物摄取的耐药机制。还分析了肿瘤微环境对减少药物摄取和多药耐药性的贡献。作为一个新兴领域,基于纳米医学的方法为改善药物特异性靶向、细胞相互作用和进入癌细胞提供了有前途的机会。将描述归因于不同类型的纳米制剂的内吞介导途径以及纳米疗法对克服影响乳腺癌药物摄取的化疗耐药性的贡献。专注于药物摄取机制的新方法可以改善乳腺癌化疗,获得更好的剂量反应结果并减少毒性副作用。

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