Cancer drug resistance induced by EMT: novel therapeutic strategies

Arch Toxicol. 2021 Jul;95(7):2279-2297. doi: 10.1007/s00204-021-03063-7. Epub 2021 May 18.

Abstract

Over the last decade, important clinical benefits have been achieved in cancer patients by using drug-targeting strategies. Nevertheless, drug resistance is still a major problem in most cancer therapies. Epithelial-mesenchymal plasticity (EMP) and tumour microenvironment have been described as limiting factors for effective treatment in many cancer types. Moreover, epithelial-to-mesenchymal transition (EMT) has also been associated with therapy resistance in many different preclinical models, although limited evidence has been obtained from clinical studies and clinical samples. In this review, we particularly deepen into the mechanisms of which intermediate epithelial/mesenchymal (E/M) states and its interconnection to microenvironment influence therapy resistance. We also describe how the use of bioinformatics and pharmacogenomics will help to figure out the biological impact of the EMT on drug resistance and to develop novel pharmacological approaches in the future.

Keywords: Cancer; Epithelial plasticity; Therapy resistance; Tumour microenvironment.

Publication types

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

MeSH terms

  • Drug Resistance, Neoplasm
  • Epithelial-Mesenchymal Transition*
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / pathology
  • Tumor Microenvironment