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Updated: May 11, 2026

Radiosensitivity of Cancer Stem Cells in Lung Cancer Cell Lines
Published on: August 21, 2019
Basic mechanisms of therapeutic resistance to radiation and chemotherapy in lung cancer
Henning Willers1, Christopher G Azzoli, Wil L Santivasi
1Department of Radiation Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Abstract:
In recent years, there have been multiple breakthroughs in our understanding of lung cancer biology. Despite significant advances in molecular targeted therapies, DNA-damaging cytotoxic therapies will remain the mainstay of lung cancer management for the near future. Similar to the concept of personalized targeted therapies, there is mounting evidence that perturbations in DNA repair pathways are common in lung cancers, altering the resistance of the affected tumors to many chemotherapeutics as well as radiation. Defects in DNA repair may be due to a multitude of mechanisms including gene mutations, epigenetic events, and alterations in signal transduction pathways such as epidermal growth factor receptor and phosphoinositide 3-kinase/AKT. Functional biomarkers that assess the subcellular localization of central repair proteins in response to DNA damage may prove useful for individualization of cytotoxic therapies including poly(adenosine diphosphate-ribose) polymerase inhibitors. A better mechanistic understanding of cellular sensitivity and resistance to DNA damaging agents should facilitate the development of novel, individualized treatment approaches. Absolute resistance to radiation therapy, however, does not exist. To some extent, radiation therapy will always have to remain unselective and indiscriminant to eradicate persistent, drug-resistant tumor stem cell pools.
Insights
DNA repair defects in lung cancer influence treatment resistance. Understanding these defects can help personalize cytotoxic therapies and improve patient outcomes for better lung cancer management.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Lung cancer treatment relies heavily on DNA-damaging cytotoxic therapies.
- Despite targeted therapy advances, DNA repair pathway alterations are frequent in lung cancers.
- These alterations impact tumor resistance to chemotherapy and radiation.
Purpose of the Study:
- To explore the role of DNA repair pathway perturbations in lung cancer.
- To investigate how these defects influence treatment resistance.
- To highlight the potential for individualized cytotoxic therapy approaches.
Main Methods:
- Review of recent breakthroughs in lung cancer biology and DNA repair mechanisms.
- Analysis of genetic mutations, epigenetic events, and signaling pathway alterations (e.g., EGFR, PI3K/AKT).
- Discussion of functional biomarkers for assessing DNA repair protein localization.
Main Results:
- Perturbations in DNA repair pathways are common in lung cancers.
- These defects contribute to resistance against chemotherapeutics and radiation.
- Functional biomarkers assessing DNA repair protein localization show promise for therapy individualization.
Conclusions:
- Understanding DNA repair mechanisms is crucial for developing individualized lung cancer treatments.
- Targeting DNA repair pathways, including with poly(adenosine diphosphate-ribose) polymerase inhibitors, offers potential.
- While absolute resistance doesn't exist, strategies are needed to overcome persistent, drug-resistant tumor stem cells.
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