State Key Laboratory of Biotherapy and Cancer Center and Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
State Key Laboratory of Biotherapy and Cancer Center and Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Biochim Biophys Acta Rev Cancer. 2023 May;1878(3):188866. doi: 10.1016/j.bbcan.2023.188866. Epub 2023 Feb 24.
Despite some advances in targeted therapeutics of human cancers, curative cancer treatment still remains a tremendous challenge due to the occurrence of drug resistance. A variety of underlying resistance mechanisms to targeted cancer drugs have recently revealed that the dual-target therapeutic strategy would be an attractive avenue. Compared to drug combination strategies, one agent simultaneously modulating two druggable targets generally shows fewer adverse reactions and lower toxicity. As a consequence, the dual-target small molecule has been extensively explored to overcome drug resistance in cancer therapy. Thus, in this review, we focus on summarizing drug resistance mechanisms of cancer cells, such as enhanced drug efflux, deregulated cell death, DNA damage repair, and epigenetic alterations. Based upon the resistance mechanisms, we further discuss the current therapeutic strategies of dual-target small molecules to overcome drug resistance, which will shed new light on exploiting more intricate mechanisms and relevant dual-target drugs for future cancer therapeutics.
尽管人类癌症的靶向治疗取得了一些进展,但由于耐药性的发生,治愈癌症的治疗仍然是一个巨大的挑战。最近发现了多种针对靶向癌症药物的潜在耐药机制,表明双靶治疗策略将是一个有吸引力的途径。与药物联合策略相比,同时调节两个可用药靶的单一药物通常表现出更少的不良反应和更低的毒性。因此,双靶小分子已被广泛探索用于克服癌症治疗中的耐药性。因此,在这篇综述中,我们重点总结癌细胞的耐药机制,如增强的药物外排、细胞死亡失调、DNA 损伤修复和表观遗传改变。基于这些耐药机制,我们进一步讨论了克服耐药性的双靶小分子的当前治疗策略,这将为开发更多复杂的机制和相关的双靶药物以用于未来的癌症治疗提供新的思路。