Mechanisms of treatment resistance in cancer

Abstract

Dr. Priya Hays discusses the mechanisms of treatment resistance in cancer, highlighting their significance for developing better treatment strategies and improving outcomes. When it was discovered in the clinic that both classes of therapies – targeted therapies and cancer immunotherapies – met with responders in the clinic and clinical efficacy, drug-related resistance soon emerged. The mechanisms of resistance for each class of therapy are distinguished by differing molecular pathways and tumor heterogeneity. There are two categories of resistance: innate resistance occurs when cancer cells are non responsive to a therapy before treatment begins, while acquired resistance develops after an initial period of sensitivity. Both forms limit the effectiveness of cancer drugs and immunotherapies. Innate resistance is built into cancer biology through pre-existing mechanisms, including genetic instability and immune evasion. When T cells cannot recognize cancer cells due to a lack of antigens or altered antigen presentation machinery, immune detection of tumor cell death is prevented.