Fernandez-Muñoz Karen Vanessa, Sánchez-Barrera Cuauhtémoc Ángel, Meraz-Ríos Marco, Reyes Jose Luis, Pérez-Yépez Eloy Andrés, Ortiz-Melo Maria Teresa, Terrazas Luis I, Mendoza-Rodriguez Monica Graciela
Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico.
Departamento de Biomedicina Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Avenida Instituto Politécnico Nacional 2508, Ciudad de México 07360, Mexico.
Biomolecules. 2025 Feb 24;15(3):326. doi: 10.3390/biom15030326.
Colorectal cancer (CRC) is one of the deadliest neoplasia. Intrinsic or acquired resistance is the main cause of failure of therapy regimens that leads to relapse and death in CRC patients. The widely used chemotherapeutic agent 5-fluorouracil (5-FU) remains the mainstay for therapeutic combinations. Unfortunately, chemotherapeutic resistance and side effects are frequent events that compromise the success of these therapies; the dysregulation of enzymes that regulate 5-FU metabolism increases the expression and activity of efflux pumps. Additional tumor cell adaptations such as epithelial-mesenchymal transition (EMT), autophagy shaping of the tumor microenvironment, and inflammation contribute to chemoresistance. Finding new strategies and alternatives to enhance conventional chemotherapies has become necessary. Recently, the study of natural compounds has been gaining strength as an alternative to chemotherapeutics in different cancers. Curcumin, trimethylglycine, resveratrol, artemisinin, and some helminth-derived molecules, among others, are some natural compounds studied in the context of CRC. This review discusses the main benefits, mechanisms, advances, and dark side of conventional chemotherapeutics currently evaluated in CRC treatment. We also analyzed the landscape of alternative non-conventional compounds and their underlying mechanisms of action, which could, in the short term, provide fundamental knowledge to harness their anti-tumor effects and allow them to be used as alternative adjuvant therapies.
结直肠癌(CRC)是最致命的肿瘤之一。内在或获得性耐药是导致CRC患者复发和死亡的治疗方案失败的主要原因。广泛使用的化疗药物5-氟尿嘧啶(5-FU)仍然是治疗组合的主要药物。不幸的是,化疗耐药和副作用是常见事件,会影响这些治疗的成功率;调节5-FU代谢的酶失调会增加外排泵的表达和活性。其他肿瘤细胞适应性变化,如上皮-间质转化(EMT)、肿瘤微环境的自噬塑造和炎症,也会导致化疗耐药。因此,寻找新的策略和替代方法来增强传统化疗变得十分必要。最近,天然化合物的研究作为不同癌症化疗替代方法的力度不断加大。姜黄素、甜菜碱、白藜芦醇、青蒿素以及一些源自蠕虫的分子等,都是在CRC背景下研究的天然化合物。本综述讨论了目前在CRC治疗中评估的传统化疗药物的主要益处、作用机制、进展和不足之处。我们还分析了替代的非传统化合物的情况及其潜在作用机制,这些机制短期内可能提供基础知识,以利用它们的抗肿瘤作用,并使其可用作替代辅助疗法。