Tumor resistance to antimetabolites

1. The inherent or acquired resistance of certain tumors to cytotoxic drug therapy is a major clinical problem. 2. Resistance to the chemotherapeutic antimetabolites (e.g., methotrexate, 5-fluorouracil, tomudex and gemcitabine) is no exception. 3. Mechanisms of resistance include mutations, amplification of target genes, altered drug transport, differences in nucleoside and nucleobase salvage pathways, DNA damage-response pathways and cell cycle control pathways.