MECHANISMS OF DRUG RESISTANCE IN CANCER CHEMOTHERAPY: AN OBSERVATIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN NORTH INDIA
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Keywords
Cancer chemotherapy; Drug resistance; Efflux mechanisms; Apoptosis; Tumor stage; North India
Abstract
Background:Drug resistance remains a major limitation in the effectiveness of cancer chemotherapy, leading to treatment failure and disease progression. Understanding the underlying mechanisms is essential for improving therapeutic outcomes, particularly in resource-limited settings.
Objectives:To evaluate the mechanisms of drug resistance in cancer chemotherapy and analyze their association with clinical and demographic factors among patients in a tertiary care hospital in North India.
Methods:A hospital-based observational analytical study was conducted from June 2021 to October 2021 among 40 patients with histopathologically confirmed malignancies receiving chemotherapy. Data were collected using a semi-structured proforma, including demographic details, clinical profile, and treatment characteristics. Drug resistance was assessed based on clinical response criteria. Mechanisms of resistance were identified through available laboratory and clinical records. Statistical analysis was performed using SPSS version 22.0, with p<0.05 considered significant.
Results:The prevalence of drug resistance was 55%. A statistically significant association was observed between advanced stage of cancer and drug resistance (p<0.05), with the highest resistance seen in Stage IV patients. No significant association was found with age, gender, or type of cancer. Drug efflux mechanisms were the most common (40.9%), followed by altered drug targets (18.2%) and apoptosis evasion (18.2%). Multiple mechanisms were observed in a minority of cases.
Conclusion:Drug resistance is highly prevalent among cancer patients undergoing chemotherapy, particularly in advanced stages of disease. The predominance of efflux-mediated resistance highlights the need for targeted therapeutic strategies. Early detection, personalized treatment approaches, and improved diagnostic infrastructure are crucial for overcoming chemoresistance and enhancing patient outcomes.
References
2. Longley DB, Johnston PG. Molecular mechanisms of drug resistance. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland. 2005 Jan;205(2):275-92.
3. Holohan C, Van Schaeybroeck S, Longley DB, Johnston PG. Cancer drug resistance: an evolving paradigm. Nature Reviews Cancer. 2013 Oct;13(10):714-26.
4. Robey RW, Pluchino KM, Hall MD, Fojo AT, Bates SE, Gottesman MM. Revisiting the role of ABC transporters in multidrug-resistant cancer. Nature Reviews Cancer. 2018 Jul;18(7):452-64.
5. Gottesman MM. Mechanisms of cancer drug resistance. Annual review of medicine. 2002 Feb;53(1):615-27.
6. Sharma SV, Lee DY, Li B, Quinlan MP, Takahashi F, Maheswaran S, McDermott U, Azizian N, Zou L, Fischbach MA, Wong KK. A chromatin-mediated reversible drug-tolerant state in cancer cell subpopulations. Cell. 2010 Apr 2;141(1):69-80.
7. Vasan N, Baselga J, Hyman DM. A view on drug resistance in cancer. Nature. 2019 Nov 14;575(7782):299-309.
8. Meads MB, Gatenby RA, Dalton WS. Environment-mediated drug resistance: a major contributor to minimal residual disease. Nature reviews cancer. 2009 Sep;9(9):665-74.
9. Alfarouk KO, Stock CM, Taylor S, Walsh M, Muddathir AK, Verduzco D, Bashir AH, Mohammed OY, Elhassan GO, Harguindey S, Reshkin SJ. Resistance to cancer chemotherapy: failure in drug response from ADME to P-gp. Cancer cell international. 2015 Jul 15;15(1):71.
10. Mallath MK, Taylor DG, Badwe RA, Rath GK, Shanta V, Pramesh CS, Digumarti R, Sebastian P, Borthakur BB, Kalwar A, Kapoor S. The growing burden of cancer in India: epidemiology and social context. The lancet oncology. 2014 May 1;15(6):e205-12.
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Dr. Kunal Siddharth Sonawane
Assistant Professor, Department of Pharmacology, RAMA Medical College Hospital & Research Centre, Kanpur, Uttar Pradesh, India.
Dr. Deshmukh Amol Chandrakant
Assistant Professor, Department of Pharmacology, RAMA Medical College Hospital & Research Centre, Kanpur, Uttar Pradesh, India. (
Dr. Chakrapani Kumar
Assistant Professor, Department of Pharmacology, Netaji Subhas Medical College & Hospital, Bihta, Patna, Bihar, India. (
