Promising Strategies for Overcoming BRAF Inhibitor Resistance Based on Known Resistance Mechanisms

Anticancer Agents Med Chem. 2020;20(12):1415-1430. doi: 10.2174/1871520620666200422073622.

Abstract

Background: Almost 50% of metastatic melanomas harbor BRAF mutations. Since 2011, BRAF inhibitors have exhibited striking clinical benefits in BRAF-mutant melanoma patients. Unfortunately, their therapeutic effects are often temporary. The resistance mechanisms vary and can be broadly classified as MAPK reactivation-dependent and -independent. Elucidation of these resistance mechanisms provides new insights into strategies for overcoming resistance. Indeed, several alternative treatment strategies, including changes in the mode of administration, combinations of BRAF and MEK inhibitors, and immunotherapy have been verified as beneficial to BRAF inhibitor-resistant melanoma patients.

Prospect: In this review, we discuss promising strategies for overcoming drug resistance and highlighting the prospects for discovering strategies to counteract BRAF inhibitor resistance.

Keywords: BRAF; MAPK; Melanoma; immunotherapy; inhibitors; mechanisms of resistance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / pharmacology*
  • Drug Resistance, Neoplasm / drug effects*
  • Humans
  • Immunotherapy
  • Melanoma / metabolism
  • Melanoma / therapy*
  • Melanoma, Cutaneous Malignant
  • Protein Kinase Inhibitors / chemistry
  • Protein Kinase Inhibitors / pharmacology*
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*
  • Proto-Oncogene Proteins B-raf / metabolism
  • Skin Neoplasms / metabolism
  • Skin Neoplasms / therapy*

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf