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Surmounting cancer drug resistance: New insights from the perspective of N6-methyladenosine RNA modification

期刊

DRUG RESISTANCE UPDATES
卷 53, 期 -, 页码 -

出版社

CHURCHILL LIVINGSTONE
DOI: 10.1016/j.drup.2020.100720

关键词

Cancer; Chemotherapy; RNA modification; m(6)A RNA modification; Drug resistance; Surmounting chemoresistance

资金

  1. National Natural Science Foundation of China [81821002, 81790251, 81672381, 81872901]
  2. Guangdong Basic and Applied Basic Research Foundation [2019B030302012]

向作者/读者索取更多资源

Despite the development of targeted therapy, drug resistance remains a primary hindrance to curative treatment of various cancers. Among several novel approaches to overcome drug resistance, modulating N-6-methyl adenosine (m(6)A) RNA modification was found to be an important strategy in various types of cancer cells. Considered as one of the most common epigenetic RNA modifications, m(6)A regulates multiple biological processes including cellular proliferation, metabolism, and metastasis through modulation of RNA splicing, degradation, and translation, leading to anticancer drug resistance. This regulatory network is orchestrated mainly by several m(6)A regulators, including writers, readers, and erasers. It is encouraging that several small molecules targeting m(6)A regulators have shown great potential in overcoming drug resistance in different cancer cell types, two of which entacapone and meclofenamate, are currently undergoing evaluation. However, the m(6)A modification participates in complex biological processes and its functions are context-dependent, which has challenged the clinical application of targeting the m(6)A modification in cancer therapy. In this review, we discuss the molecular mechanisms underlying the m(6)A modification in regulating anticancer drug resistance through modulation of drug-target interaction and drug-mediated cell death signaling. Alteration of the m(6)A modification interferes with drug efficacy through modulation of the expression of multidrug efflux transporters (e.g., ABCG2, ABCC9, ABCC10), drug metabolizing enzymes (e.g., CYP2C8), and drug targets (e.g., p53 R273 H). Furthermore, alterations of the m(6)A modification may protect cells from drug-mediated cell death by regulating DNA damage repair (e.g., p53, BRCA1, Pol kappa, UBE2B, and ERCC1), downstream adaptive response (e.g., critical regulators of apoptosis, autophagy, pro-survival signaling, and oncogenic bypass signaling), cell stemness, and tumor microenvironment (e.g., ITGA(6), ITGB3, and PD-1). We particularly highlight recent advances in therapeutic strategies targeting the m(6)A modification with the aim to surmount chemoresistance. The comprehensive understanding of the role of the m(6)A modification integrated with combined therapeutic strategies, should facilitate the development of future therapeutic strategies to circumvent or surmount drug resistance, thus enhancing therapeutic efficacy.

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