Abstract
Malignant tumors are life-threatening, and chemotherapy is one of the common treatment methods. However, there are often many factors that contribute to the failure of chemotherapy. The multidrug resistance of cancer cells during chemotherapy has been reported, since tumor cells’ sensitivity decreases over time. To overcome these problems, extensive studies have been conducted to reverse drug resistance in tumor cells. Elemene, an extract of the natural drug Curcuma wenyujin, has been found to reverse drug resistance and sensitize cancer cells to chemotherapy. Mechanisms by which elemene reverses tumor resistance include inhibiting the efflux of ATP binding cassette subfamily B member 1(ABCB1) transporter, reducing the transmission of exosomes, inducing apoptosis and autophagy, regulating the expression of key genes and proteins in various signaling pathways, blocking the cell cycle, inhibiting stemness, epithelial–mesenchymal transition, and so on. In this paper, the mechanisms of elemene’s reversal of drug resistance are comprehensively reviewed.
Highlights
Cancer is a fatal disease and a global public health problem due to its high mortality rate [1]
The resistance of chemotherapy to anticancer drugs has become a major problem in oncology, leading to the failure of anti-tumor therapy mainly due to drug efflux and metabolism, tumor cell heterogeneity, genetic or epigenetic changes in cancer cells induced by tumor microenvironment stress, etc
The results showed that the pretreatment of mice with elemene, DOX, and their combination revealed that the expression level of CDK8 gene in the serum of mice pretreated with DOX was higher than that of the model group, and the expression level of the CDK8 gene in tumor tissues of mice in the combination group was lower than that in the DOX group but higher than in the elemene group
Summary
Cancer is a fatal disease and a global public health problem due to its high mortality rate [1]. In a meta-analysis, elemene injectable emulsion was used as an adjuvant treatment to platinum-based chemotherapy in patients with stage III/IV non-small cell lung cancer, and 15 randomized clinical trials (RCTs) recruiting. We found no significant difference in gastrointestinal reactions, fever, or bone marrow suppression between the two groups [20] These data suggest that β-elemene has a synergistic effect in the treatment of malignant diseases in combination with chemotherapy, and improves the prognosis. Β-elemene has anti-tumor effects, including playing a role in a variety of signal transduction pathways [24], inducing tumor cell apoptosis, blocking the tumor cell cycle, and reversing chemotherapy drug resistance [25]. The mechanisms of elemene’s reversal of drug resistance are reviewed to provide ideas and references for subsequent research and clinical strategy in elemene’s reversal of drug resistance
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