Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2016; 8(9): 673-681
Published online Sep 15, 2016. doi: 10.4251/wjgo.v8.i9.673
Molecular mechanisms of chemoresistance in gastric cancer
Wen-Jia Shi, Jin-Bo Gao
Wen-Jia Shi, Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Jin-Bo Gao, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Shi WJ and Gao JB contributed equally to this work.
Supported by National Natural Science Foundation of China, No. 81572411.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Jin-Bo Gao, Associate Professor, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China. gaojinbo@163.com
Telephone: +86-27-85351619 Fax: +86-27-85351619
Received: March 27, 2016
Peer-review started: March 28, 2016
First decision: May 23, 2016
Revised: June 7, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: September 15, 2016
Abstract

Gastric cancer is the fourth most common cancer and the second leading cause of cancer deaths worldwide. Chemotherapy is one of the major treatments for gastric cancer, but drug resistance limits the effectiveness of chemotherapy, which results in treatment failure. Resistance to chemotherapy can be present intrinsically before the administration of chemotherapy or it can develop during chemotherapy. The mechanisms of chemotherapy resistance in gastric cancer are complex and multifactorial. A variety of factors have been demonstrated to be involved in chemoresistance, including the reduced intracellular concentrations of drugs, alterations in drug targets, the dysregulation of cell survival and death signaling pathways, and interactions between cancer cells and the tumor microenvironment. This review focuses on the molecular mechanisms of chemoresistance in gastric cancer and on recent studies that have sought to overcome the underlying mechanisms of chemoresistance.

Keywords: Drug resistance, Gastric cancer, Chemotherapy

Core tip: Although chemotherapy remains one of the primary therapeutic modalities used in the treatment of gastric cancer, chemoresistance limits the effectiveness of chemotherapy and results in treatment failure. The elucidation of the mechanisms of drug resistance will be very helpful for the prediction of sensitivity to chemotherapy and the reversal of drug resistance to improve therapeutic efficacy. The mechanisms of drug resistance have been broadly investigated in recent years. In this review, we summarize the molecular mechanisms of chemoresistance in gastric cancer and discuss the progress in the reversal of drug resistance.