A view on drug resistance in cancer Review
| Authors: | Vasan, N.; Baselga, J.; Hyman, D. M. |
| Review Title: | A view on drug resistance in cancer |
| Abstract: | The problem of resistance to therapy in cancer is multifaceted. Here we take a reductionist approach to define and separate the key determinants of drug resistance, which include tumour burden and growth kinetics; tumour heterogeneity; physical barriers; the immune system and the microenvironment; undruggable cancer drivers; and the many consequences of applying therapeutic pressures. We propose four general solutions to drug resistance that are based on earlier detection of tumours permitting cancer interception; adaptive monitoring during therapy; the addition of novel drugs and improved pharmacological principles that result in deeper responses; and the identification of cancer cell dependencies by high-throughput synthetic lethality screens, integration of clinico-genomic data and computational modelling. These different approaches could eventually be synthesized for each tumour at any decision point and used to inform the choice of therapy. © 2019, Springer Nature Limited. |
| Keywords: | cancer chemotherapy; gene mutation; review; cancer growth; antineoplastic agent; tumor volume; cancer screening; high throughput screening; drug resistance; cancer resistance; oncogene; tumor suppressor gene; early diagnosis; cancer cell; clinical decision making; drug monitoring; computer model; tumor microenvironment; tumor immunology; physical parameters; human; priority journal; malignant neoplasm |
| Journal Title: | Nature |
| Volume: | 575 |
| Issue: | 7782 |
| ISSN: | 0028-0836 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2019-11-14 |
| Start Page: | 299 |
| End Page: | 309 |
| Language: | English |
| DOI: | 10.1038/s41586-019-1730-1 |
| PUBMED: | 31723286 |
| PROVIDER: | scopus |
| PMCID: | PMC8008476 |
| DOI/URL: | |
| Notes: | Review -- Source: Scopus |
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