Overcoming Resistance to Targeted Therapies in Cancer

Semin Oncol. 2015 Dec;42(6):896-908. doi: 10.1053/j.seminoncol.2015.09.028. Epub 2015 Sep 25.

Abstract

The recent discovery of oncogenic drivers and subsequent development of novel targeted strategies has significantly added to the therapeutic armamentarium of anti-cancer therapies. Targeting BCR-ABL in chronic myeloid leukemia (CML) or HER2 in breast cancer has led to practice-changing clinical benefits, while promising therapeutic responses have been achieved by precision medicine approaches in EGFR mutant lung cancer, colorectal cancer and BRAF mutant melanoma. However, although initial therapeutic responses to targeted therapies can be substantial, many patients will develop disease progression within 6-12 months. An increasing application of powerful omics-based approaches and improving preclinical models have enabled the rapid identification of secondary resistance mechanisms. Herein, we discuss how this knowledge has translated into rational, novel treatment strategies for relapsed patients in genomically selected cancer populations.

Publication types

  • Review

MeSH terms

  • Anaplastic Lymphoma Kinase
  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Agents / therapeutic use
  • Colorectal Neoplasms / drug therapy
  • Drug Resistance, Neoplasm / drug effects*
  • ErbB Receptors / genetics
  • ErbB Receptors / metabolism
  • Fusion Proteins, bcr-abl / metabolism
  • Humans
  • Immunotherapy / methods
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
  • Lung Neoplasms / drug therapy
  • Melanoma / drug therapy
  • Molecular Targeted Therapy / methods*
  • Protein Kinase Inhibitors / pharmacology
  • Proto-Oncogene Proteins B-raf / genetics
  • Proto-Oncogene Proteins B-raf / metabolism
  • Receptor Protein-Tyrosine Kinases / genetics
  • Receptor, ErbB-2 / metabolism
  • Tumor Microenvironment

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Anaplastic Lymphoma Kinase
  • EGFR protein, human
  • ERBB2 protein, human
  • ErbB Receptors
  • Receptor Protein-Tyrosine Kinases
  • Receptor, ErbB-2
  • Fusion Proteins, bcr-abl
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf