Personalized and Precision Medicine Journal
Where Innovations Meets Personalized and Precision Medicine

The Evolving Landscape of Drug Resistance: From Mechanisms to Therapeutic Strategies

Document Type : Review Article

Authors

Yousef Roosta 1
Neda Abedi 2

1 Department of Internal Medicine, Faculty of Medicine, University of Medical Sciences, Urmia, Iran

2 Department of Microbiology, North Branch of Azad University, Tehran, Iran.

https://doi.org/10.22034/pmj.2025.2054050.1055
Abstract
Drug resistance is a major obstacle in the effective treatment of cancer, severely impacting patient outcomes and complicating therapeutic strategies. The development of resistance is multifactorial, involving a combination of genetic and epigenetic changes within cancer cells, alterations in drug metabolism, increased DNA repair mechanisms, overexpression of drug efflux pumps, and complex interactions with the tumor microenvironment. These factors work synergistically to render traditional chemotherapy and targeted therapies less effective over time.
Recent advances in molecular biology, particularly next-generation sequencing and the CRISPR-Cas9 gene-editing tool, have significantly enhanced our understanding of the underlying mechanisms driving resistance. These technologies have enabled researchers to identify novel genetic mutations and signaling pathways that cancer cells exploit to evade treatment, offering new potential targets for therapeutic intervention. Additionally, the dynamic role of the tumor microenvironment, including immune cells, stromal cells, and extracellular matrix components, has emerged as a key factor influencing drug resistance, further complicating treatment strategies.
To address these challenges, several innovative therapeutic approaches are being explored. Combination therapies, which involve the use of multiple drugs targeting different pathways simultaneously, hold promise in overcoming resistance by attacking cancer cells from multiple fronts. Immunotherapy, which harnesses the body's immune system to target cancer cells, is also showing significant potential in resistant cancers. Furthermore, nanomedicine, which uses nanoparticles to deliver drugs directly to tumors, may improve drug efficacy and minimize resistance.
Despite these advancements, much remains to be done. Ongoing research focused on identifying reliable biomarkers, developing personalized medicine approaches, and understanding the intricate relationship between cancer cells and their microenvironment is essential. This review aims to provide a comprehensive overview of the current state of knowledge regarding drug resistance in cancer, emerging therapeutic strategies, and future research directions in this critical field.

Keywords

Drug resistance
Cancer therapy
Immunotherapy
Nanomedicine
Personalized medicine

Subjects

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Personalized and Precision Medicine Journal
Volume 10, Issue 36 - Serial Number 36
Original article
Winter 2025
Pages 1-11

  • Receive Date 02 December 2024
  • Revise Date 30 January 2024
  • Accept Date 25 February 2025

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