Abstract
Standard treatment for colorectal cancer includes surgery, radiotherapy, and chemotherapy. Conventional chemotherapeutic agents used in colorectal cancer such as 5-fluorouracil, capecitabine which is oral form of 5-fluorouracil, irinotecan, and oxaliplatin. One of the major challenges in chemotherapy considered as drug resistance. Drug resistance occurs in many different mechanisms such as alteration in tumor microenvironment, growth kinetics, genetic variations, and tumor heterogeneity. These cytotoxic agents are used in combination form to overcome drug resistance on colorectal cancer. They can also be used in combination with cytotoxic agents as bevacizumab and cetuximab. Combination therapy depends on tumor burden, type, stage, and molecular characteristics. It is crucial to choose the combination therapy to be applied by taking these factors into consideration. In this review, current drug resistance mechanisms were discussed and then mechanisms of conventional chemotherapy related resistance were explained.
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