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Resistance to cisplatin.

S Akiyama1, Z S Chen, T Sumizawa

  • 1Department of Cancer Chemotherapy, Faculty of Medicine, Kagoshima University, Japan. akiyamas@khosp2.kufm.kagoshima-u.ac.jp

Anti-Cancer Drug Design
|July 16, 1999
PubMed
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Cisplatin resistance in cancer is a significant challenge, often caused by reduced drug accumulation. While various mechanisms exist, no single intervention fully overcomes this resistance, highlighting the complexity of platinum-based chemotherapy.

Area of Science:

  • Oncology
  • Pharmacology
  • Molecular Biology

Background:

  • Cisplatin is a crucial DNA-damaging chemotherapy agent.
  • Resistance to cisplatin limits its clinical efficacy in cancer treatment.
  • Understanding resistance mechanisms is vital for improving chemotherapy outcomes.

Purpose of the Study:

  • To review and summarize the known mechanisms of cisplatin resistance.
  • To highlight the commonality of reduced cisplatin accumulation as a resistance factor.
  • To discuss strategies for overcoming cisplatin resistance.

Main Methods:

  • Literature review of studies investigating cisplatin resistance mechanisms.
  • Analysis of frequently cited factors contributing to resistance.
  • Evaluation of agents that modulate cisplatin sensitivity.

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Main Results:

  • Reduced cellular accumulation is the most frequent cisplatin resistance mechanism.
  • Other mechanisms include elevated glutathione (GSH), metallothionein, and enhanced DNA repair.
  • Organic anion transporters, such as the canalicular multispecific organic anion transporter, are implicated in cisplatin efflux.
  • Inhibitors of DNA repair, GSH depletion, and agents increasing cisplatin accumulation can enhance sensitivity.
  • No single agent completely reverses cisplatin resistance, indicating multifactorial resistance.

Conclusions:

  • Cisplatin resistance is complex and multifactorial.
  • Reduced drug accumulation is a primary mechanism.
  • Targeting multiple resistance pathways may be necessary for effective treatment.
  • In vitro selection can lead to cells with multiple resistance mechanisms simultaneously.