Mechanisms of Resistance

The common mechanisms of drug resistance in ovarian cancer include: (a) alteration of drug inactivation by agents such as glutathione S-transferase (GST), (b) enhanced DNA repair, (c) dysregulation of apoptotic pathways through activation of oncogenes or the loss of tumor suppressor gene functions, (d) p-glycoprotein (Pgp) multidrug resistance that leads to decreased drug accumulation, and (e) steroid xenobiotic receptor (SXR) that leads to enhanced drug metabolism. At this time, our understanding about the mechanism of drug resistance in ovarian cancer is incomplete and limited mostly to in vitro studies. Ongoing improvements in current technology have allowed development of in vivo studies to evaluate mechanisms of drug resistance in ovarian cancer. MDR has been one of the major limitations and is one of the ongoing challenges for the successful therapeutic treatment on recurrent and persistent ovarian cancer.

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