Xu Jiaqi, Zhang Ji, Chen Wubing, Ni Xiangrong
The Second Clinical Medical School, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Front Oncol. 2024 May 28;14:1388700. doi: 10.3389/fonc.2024.1388700. eCollection 2024.
Malignant gliomas are one of the most common and lethal brain tumors with poor prognosis. Most patients with glioblastoma (GBM) die within 2 years of diagnosis, even after receiving standard treatments including surgery combined with concomitant radiotherapy and chemotherapy. Temozolomide (TMZ) is the first-line chemotherapeutic agent for gliomas, but the frequent acquisition of chemoresistance generally leads to its treatment failure. Thus, it's urgent to investigate the strategies for overcoming glioma chemoresistance. Currently, many studies have elucidated that cancer chemoresistance is not only associated with the high expression of drug-resistance genes in glioma cells but also can be induced by the alterations of the tumor microenvironment (TME). Numerous studies have explored the use of antifibrosis drugs to sensitize chemotherapy in solid tumors, and surprisingly, these preclinical and clinical attempts have exhibited promising efficacy in treating certain types of cancer. However, it remains unclear how tumor-associated fibrotic alterations in the glioma microenvironment (GME) mediate chemoresistance. Furthermore, the possible mechanisms behind this phenomenon are yet to be determined. In this review, we have summarized the molecular mechanisms by which tumor-associated fibrotic reactions drive glioma transformation from a chemosensitive to a chemoresistant state. Additionally, we have outlined antitumor drugs with antifibrosis functions, suggesting that antifibrosis strategies may be effective in overcoming glioma chemoresistance through TME normalization.
恶性胶质瘤是最常见且致命的脑肿瘤之一,预后较差。大多数胶质母细胞瘤(GBM)患者在确诊后2年内死亡,即使接受了包括手术联合同步放化疗在内的标准治疗。替莫唑胺(TMZ)是胶质瘤的一线化疗药物,但频繁出现的化疗耐药通常导致治疗失败。因此,迫切需要研究克服胶质瘤化疗耐药的策略。目前,许多研究已阐明癌症化疗耐药不仅与胶质瘤细胞中耐药基因的高表达有关,还可由肿瘤微环境(TME)的改变诱导产生。众多研究探索了使用抗纤维化药物使实体瘤化疗增敏,令人惊讶的是,这些临床前和临床尝试在治疗某些类型癌症方面已显示出有前景的疗效。然而,尚不清楚胶质瘤微环境(GME)中肿瘤相关的纤维化改变如何介导化疗耐药。此外,这一现象背后的可能机制仍有待确定。在本综述中,我们总结了肿瘤相关纤维化反应驱动胶质瘤从化疗敏感状态转变为化疗耐药状态的分子机制。此外,我们概述了具有抗纤维化功能的抗肿瘤药物,表明抗纤维化策略可能通过使TME正常化有效克服胶质瘤化疗耐药。
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