Targeting autophagy to overcome drug resistance: further developments

J Hematol Oncol. 2020 Nov 25;13(1):159. doi: 10.1186/s13045-020-01000-2.

Abstract

Inhibiting cell survival and inducing cell death are the main approaches of tumor therapy. Autophagy plays an important role on intracellular metabolic homeostasis by eliminating dysfunctional or unnecessary proteins and damaged or aged cellular organelles to recycle their constituent metabolites that enable the maintenance of cell survival and genetic stability and even promotes the drug resistance, which severely limits the efficacy of chemotherapeutic drugs. Currently, targeting autophagy has a seemingly contradictory effect to suppress and promote tumor survival, which makes the effect of targeting autophagy on drug resistance more confusing and fuzzier. In the review, we summarize the regulation of autophagy by emerging ways, the action of targeting autophagy on drug resistance and some of the new therapeutic approaches to treat tumor drug resistance by interfering with autophagy-related pathways. The full-scale understanding of the tumor-associated signaling pathways and physiological functions of autophagy will hopefully open new possibilities for the treatment of tumor drug resistance and the improvement in clinical outcomes.

Keywords: Autophagy; Drug resistance; Histone deacetylase; MAPK; Metabolic stress; Therapeutic antibody; miRNA; p53.

Publication types

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

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Agents / therapeutic use
  • Autophagy / drug effects*
  • Beclin-1 / metabolism
  • Drug Resistance, Neoplasm / drug effects*
  • Humans
  • MAP Kinase Signaling System / drug effects
  • Molecular Targeted Therapy / methods
  • Neoplasms / drug therapy*
  • Neoplasms / metabolism
  • Signal Transduction / drug effects
  • TOR Serine-Threonine Kinases / metabolism
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Antineoplastic Agents
  • Beclin-1
  • Tumor Suppressor Protein p53
  • TOR Serine-Threonine Kinases