Abstract
Breast cancer is the most common malignant tumor in females worldwide. Chemotherapy is the standard breast cancer treatment; however, chemoresistance is often seen in patients with metastatic breast cancer. Owing to high heterogeneity, the mechanisms of breast cancer chemoresistance and metastasis have not been fully investigated. The possible molecular mechanisms of chemoresistance in breast cancer include efflux transporters, signaling pathways, non-coding RNAs, and cancer stem cells. However, to overcome this hurdle, the use of novel clinical strategies such as drug carriers, immunotherapy, and autophagy regulation, are being investigated. The goal of this review is to summarize the current data about the molecular mechanisms of breast cancer chemoresistance and the novel clinical strategies; thus, providing a useful clinical tool to explore optimal treatment for breast cancer.
Highlights
Breast cancer (BRCA) is the most common malignancy and the most frequent cause of cancerrelated deaths among women worldwide [1]
We focus on the subset of ATP binding cassette (ABC) transporters that were first reported as multidrug efflux pumps, including ABCB1 [P-glycoprotein/P-gp/MDR1), ABCG2 (BRCA Resistance Protein/BCRP), and ABCC1 (multidrug resistance protein 1(MRP1)] [5, 6]
With the rapid development of molecular biology, great progress has been achieved in breast cancer treatment; some groups of BRCA, such as triple-negative breast cancer (TNBC), display significant problems of chemoresistance and metastasis
Summary
Breast cancer (BRCA) is the most common malignancy and the most frequent cause of cancerrelated deaths among women worldwide [1]. BRCA is a complex heterogeneous disease classified into three basic types based on the presence or absence of molecular biomarkers for estrogen or progesterone receptors and human epidermal growth factor 2 (ERBB2; formerly HER2). These molecular biomarkers are hormone receptor positive/ERBB2 negative (HR+/ERBB2-; 70% of patients), ERBB2 positive (ERBB2+; 15%-20%), and triple-negative (tumors lacking all 3 standard molecular markers; 15%) [2, 3]. BRCA is curable in 70%-80% of patients in early stage, non-metastatic disease.
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