Understanding and targeting resistance mechanisms in NSCLC
Julia Rotow1,2, Trever G Bivona1,2,3
1Department of Medicine, Division of Hematology and Oncology, University of California San Francisco, 505 Parnassus Avenue, Box 1270, San Francisco, California 94143, USA.
Targeted therapies for non-small-cell lung cancer (NSCLC) show promise but face resistance. Understanding on-target and off-target resistance mechanisms, including tumor microenvironment interactions, is key to improving patient outcomes.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- Non-small-cell lung cancer (NSCLC) has a growing list of identified oncogenic driver mutations.
- Targeted therapies inhibiting these mutations offer improved patient outcomes.
- Therapeutic resistance remains a major challenge in advanced-stage NSCLC.
Purpose of the Study:
- To review mechanisms of resistance to targeted therapies in NSCLC.
- To explore on-target and off-target resistance pathways.
- To discuss the role of the tumor microenvironment in therapeutic resistance.
Main Methods:
- Literature review of targeted therapies and resistance mechanisms in NSCLC.
- Analysis of common resistance themes across different NSCLC subtypes.
- Examination of interactions between targeted therapies and the tumor microenvironment.
Main Results:
- Resistance occurs through on-target alterations in the oncogene or off-target alterations in downstream/parallel pathways.
- Tumor microenvironment interactions significantly contribute to therapeutic resistance.
- Common resistance mechanisms are observed across NSCLC subtypes with EGFR, ALK, ROS1, and BRAF alterations.
Conclusions:
- Understanding resistance mechanisms is crucial for developing effective NSCLC treatments.
- Combination therapy approaches may overcome resistance and tumor heterogeneity.
- Further research into resistance pathways can inform novel therapeutic strategies for NSCLC.
More Related Videos
08:46Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms
Published on: December 9, 2015
08:52Profiling Sensitivity to Targeted Therapies in EGFR-Mutant NSCLC Patient-Derived Organoids
Published on: November 22, 2021
Related Concept Videos
Treatment Resistant Cancers
Adaptive Mechanisms in Cancer Cells
Some of the advantages that cancer cells have on normal cells include - enhanced ability to divide without terminally differentiating, induce new blood vessel formation,...
Targeted Cancer Therapies
There are several types of targeted therapies against...
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase
Cytotoxic T Cells-mediated Immune Response
Immunological surveillance is the ability of immune cells to monitor and eliminate infected cells with intracellular pathogens, neoplastically transformed cells, and cells with non-self antigens. Cytotoxic T cells and NK...
Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
