Resistance to chemotherapeutic antimetabolites: A function of salvage pathway involvement and cellular response to DNA damage

被引:89
作者
Kinsella, AR [1 ]
Smith, D [1 ]
Pickard, M [1 ]
机构
[1] CLATTERBRIDGE CTR ONCOL,WIRRAL L63 4JY,MERSEYSIDE,ENGLAND
关键词
methotrexate; 5-fluorouracil; N-phosphonacetyl-L aspartate; p53; salvage pathways;
D O I
10.1038/bjc.1997.164
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The inherent or acquired (induced) resistance of certain tumours to cytotoxic drug therapy is a major clinical problem. There are many categories of cytotoxic agent: the antimetabolites, e.g. methotrexate (MTX), N-phosphonacetyl-L-aspartate (PALA), 5-fluorouracil (5-FU), 6-mercaptopurine (6-TG), hydroxyurea (HU) and 1-beta-D-arabinofuranosylcytosine (AraC); the alkylating agents, e.g, the nitrogen mustards and nitrosoureas; the antibiotics, e.g. doxorubicin and mitomycin C; the plant alkaloids, e.g. vincristine and vinblastine; and miscellaneous compounds, such as cisplatin. There are also many mechanisms of drug resistance elucidated principally from in vitro studies. These include mutation of target genes, amplification of target and mutated genes, differences in repair capacity, altered drug transport and differences in nucleoside and nucleobase salvage pathways (Fox et al, 1991). The aim of the present review is to evaluate in detail the mechanisms of response of both normal and tumour cells to three chemotherapeutic antimetabolites, MTX, PALA and 5-FU, which are routinely used in the clinic either alone or in combination to treat some of the commonest solid tumours, e.g, breast, colon, gastric and head and neck. The normal and tumour cell response to these agents will be discussed in relation to the operation of the known alternative 'salvage pathways' of DNA synthesis and current theories of DNA damage response.
引用
收藏
页码:935 / 945
页数:11
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