Abstract:
Chemotherapeutic drugs target a physiological differentiating feature of cancer cells as they
tend to actively proliferate more than normal cells. They have well-known side-effects resulting from
the death of highly proliferative normal cells in the gut and immune system. Cancer treatment has
changed dramatically over the years owing to rapid advances in oncology research. Developments
in cancer therapies, namely surgery, radiotherapy, cytotoxic chemotherapy and selective treatment
methods due to better understanding of tumor characteristics, have significantly increased cancer
survival. However, many chemotherapeutic regimes still fail, with 90% of the drug failures in
metastatic cancer treatment due to chemoresistance, as cancer cells eventually develop resistance to
chemotherapeutic drugs. Chemoresistance is caused through genetic mutations in various proteins
involved in cellular mechanisms such as cell cycle, apoptosis and cell adhesion, and targeting those
mechanisms could improve outcomes of cancer therapy. Recent developments in cancer treatment
are focused on combination therapy, whereby cells are sensitized to chemotherapeutic agents using
inhibitors of target pathways inducing chemoresistance thus, hopefully, overcoming the problems of
drug resistance. In this review, we discuss the role of cell cycle, apoptosis and cell adhesion in cancer
chemoresistance mechanisms, possible drugs to target these pathways and, thus, novel therapeutic
approaches for cancer treatment