About this Research Topic
In recent years, technical advances in chemotherapy and radiotherapy have helped substantially improve the treatment outcome and quality of life of cancer patients. Nevertheless, successful cancer therapy remains a major challenge, particularly in tumors that are resistant to chemotherapy or radiation therapy.
There are two general causes of failure of antineoplastic therapy: Inherent genetic characteristics that induce resistance in cancer cells and acquired resistance after drug exposure and radiation exposure. Characteristics of chemo-and radiation-resistant cells include altered membrane transporter expressions and functions, enhanced DNA repair activity, apoptotic pathway defects, alteration of target molecules, and protein and pathway mechanisms such as enzymatic deactivation.
Inherent gene-associated drug and radiation resistance is largely rooted in cancer cell heterogeneity. For this type of resistance, we may be able to detect variants through gene sequencing, flow cytometry, and microarray to determine their mechanisms of resistance, and guide physicians in choosing the right approach for their individual patients. While variants identified for leukemia and lung cancer have improved our ability to predict prognoses and provide personalized medical care, there remain other types of cancer such as hepatic carcinomas and pancreatic cancer where many new advances could be made.
Many cancer patients who are treated with chemotherapy and/or radiotherapy eventually become resistant, and acquired resistance accounts for the majority of cases. One of the most well-understood mechanisms of chemo-resistance is the overexpression of ABC transporters. The next step is discovering how to deliver the ABC transporter inhibitor combination treatment into tumors without also affecting normal cells in the body such as epithelial cells in the GI tract and endothelial cells in the blood-brain barrier. Another cause of drug resistance and radio-resistance is the cancer cell’s ability to enhance DNA repair activity through poly ADP-ribose polymerase (PARP). Fortunately, PARP inhibitors such as niraparib and recaparib were FDA-approved and demonstrated a partial or complete response to platinum-based therapy in the treatment of recurrent epithelial ovarian cancer and primary peritoneal cancer. However, the very nature of acquired resistance means that these tumors may develop new mutations and new methods of resistance after long periods of treatment. Therefore, new drug development and novel strategies are needed to overcome their resistance and stay one step ahead.
In this current Research Topic, we aim to cover novel research trends for cancer treatment related to chemo-radiation-resistance. We welcome the submission of Original Research, Review, and Mini-Review articles covering, but not limited to, the following topics:
1. Mechanisms of chemo-radiation-resistance related to target mutations, tumor microenvironment, undiscovered genes and signaling pathways in cancers.
2. Biomarkers of chemo-radiation-resistance in cancer patients, as well as in vitro and in vivo models.
3. Imaging in diagnosis, therapeutic effect evaluation or prognostic prediction of tumor chemo-radiation-resistance.
4. Clinical insights in the context of research on tumor chemo-radiation-resistance.
5. Strategies that can overcome chemo-radiation-resistance.
6. Strategies that can improve patient care during chemo- and/or radiation-therapy.
Keywords: Drug resistance, radiation resistance, immunological resistance, cancer treatment
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