Abstract
Cancer is an important contributor to mortality worldwide. Breast cancer is the most common solid tumor in women. Despite numerous drug combinations and regimens, all patients with advanced breast cancer, similarly to other solid tumors, inevitably develop resistance to treatment. Identified mechanisms of resistance could be classified into intra- and extracellular mechanisms. Intracellular mechanisms include drug metabolism and efflux, target modulations and damage restoration. Extracellular mechanisms might be attributed to the crosstalk between tumor cells and environmental factors. However, current knowledge concerning resistance mechanisms cannot completely explain the phenomenon of multi-drug resistance, which occurs in the vast majority of patients treated with chemotherapy. In this opinion article, we investigate the role of these factors in the development of drug-resistance.
Highlights
Cancer is an important contributor to mortality worldwide
Drug therapy is an important part of primary treatment for loco-regional breast cancer, and is a cornerstone of treatment in advanced disease[1]
For breast cancer, elimination of tumor cells can be achieved by surgical excision or radical radiotherapy
Summary
Cancer is an important contributor to mortality worldwide. Breast cancer is the most common solid tumor in women. This approach, though it is experimentally verified, is not able to explain the resistance to multiple agents, which is not dependent on the mechanism of drug anticancer cation, and is either present at the beginning of treatment or formed during subsequent lines of therapy in all patients. Due to various resistance mechanisms, described in detail below, drug therapy by itself rarely cures cancer, even in the case of such chemosensitive tumors as breast cancer.
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