Treatment resistance in pancreatic and biliary tract cancer: molecular and clinical pharmacology perspectives.

Autor:	Toledo B; Department of Health Sciences, University of Jaén, Jaén, Spain.; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center (VUmc), Amsterdam, The Netherlands., Deiana C; Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Scianò F; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center (VUmc), Amsterdam, The Netherlands.; Lumobiotics GmbH, Karlsruhe, Germany., Brandi G; Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Marchal JA; Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain.; Instituto de Investigación Sanitaria ibs. GRANADA, Hospitales Universitarios de Granada-Universidad de Granada, Granada, Spain.; Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain.; Excellence Research Unit 'Modeling Nature' (MNat), University of Granada, Granada, Spain., Perán M; Department of Health Sciences, University of Jaén, Jaén, Spain.; Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain.; Excellence Research Unit 'Modeling Nature' (MNat), University of Granada, Granada, Spain., Giovannetti E; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center (VUmc), Amsterdam, The Netherlands.; Cancer Pharmacology Lab, Fondazione Pisana per la Scienza, Pisa, Italy.; Cancer Pharmacology Lab, Associazione Italiana per la Ricerca sul Cancro (AIRC) Start-Up Unit, Fondazione Pisana per la Scienza, University of Pisa, Pisa, Italy.
Jazyk:	angličtina
Zdroj:	Expert review of clinical pharmacology [Expert Rev Clin Pharmacol] 2024 Apr; Vol. 17 (4), pp. 323-347. Date of Electronic Publication: 2024 Mar 15.
DOI:	10.1080/17512433.2024.2319340
Abstrakt:	Introduction: Treatment resistance poses a significant obstacle in oncology, especially in biliary tract cancer (BTC) and pancreatic cancer (PC). Current therapeutic options include chemotherapy, targeted therapy, and immunotherapy. Resistance to these treatments may arise due to diverse molecular mechanisms, such as genetic and epigenetic modifications, altered drug metabolism and efflux, and changes in the tumor microenvironment. Identifying and overcoming these mechanisms is a major focus of research: strategies being explored include combination therapies, modulation of the tumor microenvironment, and personalized approaches. Areas Covered: We provide a current overview and discussion of the most relevant mechanisms of resistance to chemotherapy, target therapy, and immunotherapy in both BTC and PC. Furthermore, we compare the different strategies that are being implemented to overcome these obstacles. Expert Opinion: So far there is no unified theory on drug resistance and progress is limited. To overcome this issue, individualized patient approaches, possibly through liquid biopsies or single-cell transcriptome studies, are suggested, along with the potential use of artificial intelligence, to guide effective treatment strategies. Furthermore, we provide insights into what we consider the most promising areas of research, and we speculate on the future of managing treatment resistance to improve patient outcomes.
Databáze:	MEDLINE
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