Dr. Prabhakar Kore Basic Science Research Center, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi- 590010, Karnataka, India.
Anticancer Agents Med Chem. 2021;21(6):668-678. doi: 10.2174/1871520620666200908104835.
This review focuses on the conventional treatment, signaling pathways and various reasons for drug resistance with an understanding of novel methods that can lead to effective therapies. Ovarian cancer is amongst the most common gynecological and lethal cancers in women affecting different age groups (20-60). The survival rate is limited to 5 years due to diagnosis in subsequent stages with a reoccurrence of tumor and resistance to chemotherapeutic therapy. The recent clinical trials use the combinatorial treatment of carboplatin and paclitaxel on ovarian cancer after the cytoreduction of the tumor. Predominantly, patients are responsive initially to therapy and later develop metastases due to drug resistance. Chemotherapy also leads to drug resistance causing enormous variations at the cellular level. Multifaceted mechanisms like drug resistance are associated with a number of genes and signaling pathways that process the proliferation of cells. Reasons for resistance include epithelial-mesenchyme, DNA repair activation, autophagy, drug efflux, pathway activation, and so on. Determining the routes on the molecular mechanism that target chemoresistance pathways are necessary for controlling the treatment and understanding efficient drug targets can open light on improving therapeutic outcomes. The most common drug used for ovarian cancer is Cisplatin that activates various chemoresistance pathways, ultimately causing drug resistance. There have been substantial improvements in understanding the mechanisms of cisplatin resistance or chemo sensitizing cisplatin for effective treatment. Therefore, using therapies that involve a combination of phytochemical or novel drug delivery system would be a novel treatment for cancer. Phytochemicals are plant-derived compounds that exhibit anti-cancer, anti-oxidative, anti-inflammatory properties and reduce side effects exerted by chemotherapeutics.
本篇综述聚焦于传统治疗方法、信号通路以及耐药的各种原因，并探讨了可能导致有效治疗方法的新方法。卵巢癌是女性中最常见的妇科和致命癌症之一，影响不同年龄段（20-60 岁）的人群。由于诊断为晚期，且肿瘤复发和对化疗的耐药性，生存率限制在 5 年以内。最近的临床试验使用卡铂和紫杉醇联合治疗卵巢癌，在肿瘤细胞减灭术后进行。最初，大多数患者对治疗有反应，但后来由于耐药性而发生转移。化疗也会导致耐药性，从而在细胞水平上产生巨大的变化。多种耐药机制与许多基因和信号通路有关，这些基因和信号通路处理细胞的增殖。耐药的原因包括上皮-间充质转化、DNA 修复激活、自噬、药物外排、通路激活等。确定靶向化疗耐药途径的分子机制途径对于控制治疗和了解有效的药物靶点是必要的，这可以为改善治疗结果提供启示。用于卵巢癌的最常见药物是顺铂，它会激活多种化疗耐药途径，最终导致耐药性。人们对顺铂耐药机制或使顺铂化疗增敏以进行有效治疗的机制有了更深入的理解。因此，使用包含植物化学物质或新型药物输送系统的联合疗法将是癌症的一种新治疗方法。植物化学物质是具有抗癌、抗氧化、抗炎特性的植物衍生化合物，可以减少化疗药物的副作用。
