Targeting hedgehog-driven mechanisms of drug-resistant cancers

Due to the cellular plasticity that is inherent to cancer, the acquisition of resistance to therapy remains one of the biggest obstacles to patient care. In many patients, the surviving cancer cell subpopulation goes on to proliferate or metastasize, often as the result of dramatically altered cell signaling and transcriptional pathways. A notable example is the Hedgehog (Hh) signaling pathway, which is a driver of several cancer subtypes and aberrantly activated in a wide range of malignancies in response to therapy. This review will summarize the field's current understanding of the many roles played by Hh signaling in drug resistance and will include topics such as non-canonical activation of Gli proteins, amplification of genes which promote tolerance to chemotherapy, the use of hedgehog-targeted drugs and tool compounds, and remaining gaps in our knowledge of the transcriptional mechanisms at play.

Automated summary

Resisting therapy remains a major challenge in cancer treatment due to cellular plasticity. The Hedgehog (Hh) signaling pathway plays a significant role in drug resistance and is aberrantly activated in various malignancies. This review summarizes the current understanding of Hh signaling in drug resistance, including non-canonical activation of Gli proteins, gene amplification promoting chemotherapy tolerance, and the use of Hh-targeted drugs.