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Updated: May 27, 2026

Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms
Published on: December 9, 2015
Resistance--the true face of biological defiance
Nia Emami-Shahri1, Thorsten Hagemann
1Barts Cancer Institute, John Vane Science Centre, London EC1M 6BQ, UK.
Abstract:
Biological therapeutics are widely used in chronic inflammatory and malignant disease. The underlying mechanisms of treatment failure for these drugs are poorly understood. Resistance to these biological agents and the further subdivision into intrinsic and acquired resistance are not clearly defined. In this review, we explore the current understanding of the mechanisms of action of several biological agents as well as the complex biological processes that underlie resistance. A better understanding of why biologicals fail might help to improve their single or combinational use and will ultimately help to alleviate disease burden more efficiently.
Insights
Biological therapies are crucial for chronic inflammatory and malignant diseases, but treatment failure is common. This review clarifies mechanisms of resistance to biological agents to improve treatment efficacy and reduce disease burden.
Area of Science:
- Immunology
- Pharmacology
- Oncology
Background:
- Biological therapeutics are mainstays in treating chronic inflammatory and malignant diseases.
- Treatment failure with biological agents is a significant clinical challenge.
- Mechanisms underlying resistance to biologicals, including intrinsic and acquired resistance, are not well-defined.
Purpose of the Study:
- To review the current understanding of biological agent mechanisms of action.
- To explore the complex biological processes contributing to treatment resistance.
- To provide insights into improving the efficacy of biological therapies.
Main Methods:
- Literature review of biological agents used in chronic inflammatory and malignant diseases.
- Analysis of mechanisms of action for key biological therapeutics.
- Synthesis of current knowledge on intrinsic and acquired resistance pathways.
Main Results:
- Biological agents target specific pathways in immune and cancer cells.
- Multiple intrinsic and acquired resistance mechanisms exist, often overlapping.
- Understanding resistance is key to optimizing therapeutic strategies.
Conclusions:
- Clarifying resistance mechanisms is essential for improving biological therapy outcomes.
- Enhanced understanding can guide the development of novel therapeutic combinations.
- More effective use of biologicals will ultimately reduce disease burden.
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