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Role and mechanism of autophagy-regulating factors in tumorigenesis and drug resistance

Journal

ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY
Volume 17, Issue 3, Pages 193-208

Publisher

WILEY
DOI: 10.1111/ajco.13449

Keywords

Autophagy-related genes; autophagy; drug resistance; hydroxychloroquine; tumorigenesis

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Autophagy is regulated by multiple genes and plays a crucial role in tumorigenesis and drug resistance. Disrupted autophagy is associated with various malignancies, affecting cell growth and treatment response. Therapeutic approaches targeting autophagy may provide new strategies for cancer drug development and overcoming drug resistance.
A hallmark feature of tumorigenesis is uncontrolled cell division. Autophagy is regulated by more than 30 genes and it is one of several mechanisms by which cells maintain homeostasis. Autophagy promotes cancer progression and drug resistance. Several genes play important roles in autophagy-induced tumorigenesis and drug resistance includingBeclin-1, MIF, HMGB1, p53, PTEN, p62, RAC3, SRC3, NF-2, MEG3, LAPTM4B, mTOR, BRAFandc-MYC. These genes alter cell growth, cellular microenvironment and cell division. Mechanisms involved in tumorigenesis and drug resistance include microdeletions, genetic mutations, loss of heterozygosity, hypermethylation, microsatellite instability and translational modifications at a molecular level. Disrupted or altered autophagy has been reported in hematological malignancies like lymphoma, leukemia and myeloma as well as multiple solid organ tumors like colorectal, hepatocellular, gall bladder, pancreatic, gastric and cholangiocarcinoma among many other malignancies. In addition, defects in autophagy also play a role in drug resistance in cancers like osteosarcoma, ovarian and lung carcinomas following treatment with drugs such as doxorubicin, paclitaxel, cisplatin, gemcitabine and etoposide. Therapeutic approaches that modulate autophagy are a novel future direction for cancer drug development that may help to prevent issues with disease progression and overcome drug resistance.

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