A view on drug resistance in cancer

Neil Vasan, José Baselga and David M. Hyman ()
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Neil Vasan: Memorial Sloan Kettering Cancer Center
José Baselga: Memorial Sloan Kettering Cancer Center
David M. Hyman: Memorial Sloan Kettering Cancer Center

Nature, 2019, vol. 575, issue 7782, 299-309

Abstract: Abstract The problem of resistance to therapy in cancer is multifaceted. Here we take a reductionist approach to define and separate the key determinants of drug resistance, which include tumour burden and growth kinetics; tumour heterogeneity; physical barriers; the immune system and the microenvironment; undruggable cancer drivers; and the many consequences of applying therapeutic pressures. We propose four general solutions to drug resistance that are based on earlier detection of tumours permitting cancer interception; adaptive monitoring during therapy; the addition of novel drugs and improved pharmacological principles that result in deeper responses; and the identification of cancer cell dependencies by high-throughput synthetic lethality screens, integration of clinico-genomic data and computational modelling. These different approaches could eventually be synthesized for each tumour at any decision point and used to inform the choice of therapy.

Date: 2019
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Citations: View citations in EconPapers (17)

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Persistent link: https://EconPapers.repec.org/RePEc:nat:nature:v:575:y:2019:i:7782:d:10.1038_s41586-019-1730-1

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DOI: 10.1038/s41586-019-1730-1

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