Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
Nanhai Translational Innovation Center of Precision Immunology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Foshan, 528200, China.
Sci China Life Sci. 2024 Jan;67(1):19-40. doi: 10.1007/s11427-022-2340-4. Epub 2023 Sep 15.
A potential reason for the failure of tumor therapies is treatment resistance. Resistance to chemotherapy, radiotherapy, and immunotherapy continues to be a major obstacle in clinic, resulting in tumor recurrence and metastasis. The major mechanisms of therapy resistance are inhibitions of cell deaths, like apoptosis and necrosis, through drug inactivation and excretion, repair of DNA damage, tumor heterogeneity, or changes in tumor microenvironment, etc. Recent studies have shown that ferroptosis play a major role in therapies resistance by inducing phospholipid peroxidation and iron-dependent cell death. Some ferroptosis inducers in combination with clinical treatment techniques have been used to enhance the effect in tumor therapy. Notably, versatile ferroptosis nanoinducers exhibit an extensive range of functions in reversing therapy resistance, including directly triggering ferroptosis and feedback regulation. Herein, we provide a detailed description of the design, mechanism, and therapeutic application of ferroptosis-mediated synergistic tumor therapeutics. We also discuss the prospect and challenge of nanomedicine in tumor therapy resistance by regulating ferroptosis and combination therapy.
肿瘤治疗失败的一个潜在原因是治疗耐药性。化疗、放疗和免疫治疗的耐药性仍然是临床的主要障碍,导致肿瘤复发和转移。治疗耐药性的主要机制包括通过药物失活和排泄、DNA 损伤修复、肿瘤异质性或肿瘤微环境改变等来抑制细胞死亡,如细胞凋亡和坏死。最近的研究表明,铁死亡通过诱导磷脂过氧化和铁依赖性细胞死亡在治疗耐药性中起主要作用。一些铁死亡诱导剂与临床治疗技术联合使用,以增强肿瘤治疗效果。值得注意的是,多功能铁死亡纳米诱导剂在逆转治疗耐药性方面表现出广泛的功能,包括直接触发铁死亡和反馈调节。本文详细描述了铁死亡介导的协同肿瘤治疗的设计、机制和治疗应用。我们还讨论了通过调节铁死亡和联合治疗,纳米医学在肿瘤治疗耐药性方面的前景和挑战。