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Updated: Sep 22, 2025

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Resistance to anti-tubulin agents: From vinca alkaloids to epothilones

Werner Krause1

  • 1Formerly Bayer AG, Project Management, Berlin 13353, Germany.

Cancer Drug Resistance (Alhambra, Calif.)
|May 18, 2022
PubMed

Insights

Mechanisms of resistance to cancer drugs like vinca alkaloids, taxanes, and epothilones are reviewed. Understanding these resistance mechanisms, including efflux pumps and target modification, is key for effective chemotherapy.

Area of Science:

  • Oncology
  • Pharmacology
  • Cell Biology

Background:

  • Chemotherapy resistance is a significant challenge in cancer treatment.
  • Vinca alkaloids, taxanes, and epothilones are crucial anticancer drugs targeting microtubules.
  • Understanding resistance mechanisms is vital for improving therapeutic outcomes.

Purpose of the Study:

  • To review the mechanisms of action and resistance for microtubule-targeting agents.
  • To explore various resistance pathways, including efflux pumps, target modification, and other cellular processes.
  • To discuss the role of biomarkers in predicting treatment response.

Main Methods:

  • Literature review of scientific articles on chemotherapy resistance.
  • Analysis of mechanisms of action for vinca alkaloids, taxanes, and epothilones.
  • Examination of molecular and cellular factors contributing to drug resistance.

Main Results:

  • Overexpression of efflux pumps and microtubule target modifications are primary resistance mechanisms.
  • Drug efflux, tubulin isotype changes, and protein attachments alter drug efficacy.
  • Other resistance factors include drug detoxification, apoptosis blockade, and cancer stem cells.
  • Drug resistance can paradoxically lead to sensitization in specific contexts.

Conclusions:

  • Multiple resistance mechanisms contribute to chemotherapy failure.
  • Biomarkers are essential for predicting patient response and guiding therapy.
  • Targeting resistance pathways offers potential for novel therapeutic strategies.
Keywords:
Microtubulesbiomarkerscancer stem cellsmechanisms of resistancemetabolismpharmacokineticstumor heterogeneity

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