Insight into Autophagy and Drug Resistance in Gastric Cancer

Chemoresistance is a major obstacle in the treatment of gastric cancer and can contribute to poor treatment and prognosis in GC patients. Autophagy is a highly conserved degradation process, and its dysregulation is closely associated with various diseases. More and more people have realized the dual role of autophagy in the treatment resistance of GC. The activation of autophagy can enhance the chemotherapy sensitivity of GC cells, but in some cases, it increases the chemoresistance. The regulation of autophagy on GC drug resistance is reflected by its impact on cell apoptosis and metastasis. Multiple factors are involved in the regulation of autophagy in GC, among which, non-coding RNAs are one of the important regulatory factors. Natural or synthetic compounds targeting autophagy can help improve the sensitivity of GC cells to chemotherapy. The combined application of nanomaterials and autophagy regulators has shown great potential in the preclinical treatment of GC. This review summarizes the recent research about the molecular mechanisms of targeted autophagy therapy for drug resistance, the role of autophagy modulators in the treatment of GC, and the potential of developing small-molecule modulators and natural compounds as autophagy modulators for the treatment of GC.