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.

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.

Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Adaptive Mechanisms in Cancer Cells02:53

Adaptive Mechanisms in Cancer Cells

Cancer cells accumulate genetic changes at an abnormally rapid rate due to the defects in the DNA repair mechanisms. From an evolutionary perspective, such genetic instability is advantageous for cancer development. Mutant cell lines accumulate a series of beneficial mutations that contribute to their progression into cancer.
Some of the advantages that cancer cells have on normal cells include - enhanced ability to divide without terminally differentiating, induce new blood vessel formation,...
Adaptive Mechanisms in Cancer Cells02:53

Adaptive Mechanisms in Cancer Cells

Cancer cells accumulate genetic changes at an abnormally rapid rate due to the defects in the DNA repair mechanisms. From an evolutionary perspective, such genetic instability is advantageous for cancer development. Mutant cell lines accumulate a series of beneficial mutations that contribute to their progression into cancer.
Some of the advantages that cancer cells have on normal cells include - enhanced ability to divide without terminally differentiating, induce new blood vessel formation,...
Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Cancer Stem Cells and Tumor Maintenance02:40

Cancer Stem Cells and Tumor Maintenance

Early diagnosis and treatment can often cure cancer. However, even with treatment, residual cells called cancer stem cells (CSC) might remain, often causing tumor recurrence. These cancer stem cells possess the potential for self-renewal and multi-lineage differentiation and are often responsible for the therapeutic resistance displayed in most cancers.
Cancer stem cells are thought to originate from tissue-specific normal stem cells or progenitor cells. The normal stem cells usually reside in...