Hepatocellular carcinoma and multidrug resistance: Past, present and new challenges for therapy improvement

作     者：María L Cuestas José R Oubia Verónica L Mathet 

作者机构：Institutode Investigaciones en Microbiología y Parasitología Médica(IMPaMUBA-CONICET)Facultad de Medicina Universidad de Buenos Aires-Consejo Nacional de Investigaciones Científicas y TécnicasParaguay 2155Buenos AiresArgentina 

出 版 物：《World Journal of Pharmacology》 (世界药理学杂志)

年 卷 期：2015年第4卷第1期

页      面：96-116页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Hepatocellular carcinoma Therapy Multidrug resistance Drug delivery systems Liver targeting 

摘      要：Hepatocellular carcinoma(HCC) is the most frequent form of liver cancer and the third most common cause of cancer-related death in the world. The main risk factor worldwide for this type of malignancy is chronic hepatitis caused by hepatitis B virus and hepatitis C virus infections. Advances in early detection and treatmenthave improved life expectancy of patients with HCC. However, this disorder remains as a disease with poor prognosis. In fact, epidemiological studies have revealed that there is an 8-mo median survival rate in patients, approximately 20% of whom survive one year while only 5% remain alive after three years. Additionally, HCC is particularly difficult to treat because of its high recurrence rate, and its resistance to conventional chemotherapy is due, among other mechanisms, to several members of the ATP-Binding Cassette protein family involved in drug transport being overexpressed. Fortunately, there is evidence that these patients may benefit from alternative molecular-targeted therapies. This manuscript intends to provide further insight into the etiology and molecular mechanisms related to HCC development and the latest therapeutic approaches to treat this malignancy. The development of effective delivery systems of antitumor drugs able to target the liver parenchyma is also assessed. Finally, the prospects in the development of more efficient drug therapies to overcome multidrug resistance are also examined.