Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge

Triple-negative (TNBC) is the most lethal subtype of breast cancer owing to high heterogeneity, aggressive nature, and lack of treatment options. Chemotherapy remains the standard of care for TNBC treatment, but unfortunately, patients frequently develop resistance. Accordingly, in recent years, tre...

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Main Authors: Milica Nedeljković, Ana Damjanović
Format: Article
Language:English
Published: MDPI AG 2019-08-01
Series:Cells
Subjects:
Online Access:https://www.mdpi.com/2073-4409/8/9/957
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author Milica Nedeljković
Ana Damjanović
author_facet Milica Nedeljković
Ana Damjanović
author_sort Milica Nedeljković
collection DOAJ
description Triple-negative (TNBC) is the most lethal subtype of breast cancer owing to high heterogeneity, aggressive nature, and lack of treatment options. Chemotherapy remains the standard of care for TNBC treatment, but unfortunately, patients frequently develop resistance. Accordingly, in recent years, tremendous effort has been made into elucidating the mechanisms of TNBC chemoresistance with the goal of identifying new molecular targets. It has become evident that the development of TNBC chemoresistance is multifaceted and based on the elaborate interplay of the tumor microenvironment, drug efflux, cancer stem cells, and bulk tumor cells. Alterations of multiple signaling pathways govern these interactions. Moreover, TNBC’s high heterogeneity, highlighted in the existence of several molecular signatures, presents a significant obstacle to successful treatment. In the present, in-depth review, we explore the contribution of key mechanisms to TNBC chemoresistance as well as emerging strategies to overcome them. We discuss novel anti-tumor agents that target the components of these mechanisms and pay special attention to their current clinical development while emphasizing the challenges still ahead of successful TNBC management. The evidence presented in this review outlines the role of crucial pathways in TNBC survival following chemotherapy treatment and highlights the importance of using combinatorial drug strategies and incorporating biomarkers in clinical studies.
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spelling doaj.art-17e25d73a21d4b7a93af755a75deaf9e2023-09-03T09:52:43ZengMDPI AGCells2073-44092019-08-018995710.3390/cells8090957cells8090957Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the ChallengeMilica Nedeljković0Ana Damjanović1Institute of Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, SerbiaInstitute of Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, SerbiaTriple-negative (TNBC) is the most lethal subtype of breast cancer owing to high heterogeneity, aggressive nature, and lack of treatment options. Chemotherapy remains the standard of care for TNBC treatment, but unfortunately, patients frequently develop resistance. Accordingly, in recent years, tremendous effort has been made into elucidating the mechanisms of TNBC chemoresistance with the goal of identifying new molecular targets. It has become evident that the development of TNBC chemoresistance is multifaceted and based on the elaborate interplay of the tumor microenvironment, drug efflux, cancer stem cells, and bulk tumor cells. Alterations of multiple signaling pathways govern these interactions. Moreover, TNBC’s high heterogeneity, highlighted in the existence of several molecular signatures, presents a significant obstacle to successful treatment. In the present, in-depth review, we explore the contribution of key mechanisms to TNBC chemoresistance as well as emerging strategies to overcome them. We discuss novel anti-tumor agents that target the components of these mechanisms and pay special attention to their current clinical development while emphasizing the challenges still ahead of successful TNBC management. The evidence presented in this review outlines the role of crucial pathways in TNBC survival following chemotherapy treatment and highlights the importance of using combinatorial drug strategies and incorporating biomarkers in clinical studies.https://www.mdpi.com/2073-4409/8/9/957triple-negative breast cancerchemoresistanceABC transporterscancer stem cellssignaling pathwayshypoxiaapoptosisreceptor tyrosine kinasesmicroRNAmolecular subtypes
spellingShingle Milica Nedeljković
Ana Damjanović
Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge
Cells
triple-negative breast cancer
chemoresistance
ABC transporters
cancer stem cells
signaling pathways
hypoxia
apoptosis
receptor tyrosine kinases
microRNA
molecular subtypes
title Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge
title_full Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge
title_fullStr Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge
title_full_unstemmed Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge
title_short Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge
title_sort mechanisms of chemotherapy resistance in triple negative breast cancer how we can rise to the challenge
topic triple-negative breast cancer
chemoresistance
ABC transporters
cancer stem cells
signaling pathways
hypoxia
apoptosis
receptor tyrosine kinases
microRNA
molecular subtypes
url https://www.mdpi.com/2073-4409/8/9/957
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