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World J Clin Oncol. Oct 10, 2014; 5(4): 588-594
Published online Oct 10, 2014. doi: 10.5306/wjco.v5.i4.588
Apoptosis block as a barrier to effective therapy in non small cell lung cancer
Ian Paul, J Mark Jones
Ian Paul, J Mark Jones, Department of Cardiothoracic Surgery, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, United Kingdom
Author contributions: Paul I conceived and constructed the manuscript; Jones JM edited and critically reviewed the manuscript.
Correspondence to: J Mark Jones, MD, FRCSEd(CTh), Department of Cardiothoracic Surgery, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, United Kingdom. mark.jones@belfasttrust.hscni.net
Telephone: +44-28-90636544 Fax: +44-28-90312907
Received: January 10, 2014
Revised: February 28, 2014
Accepted: June 10, 2014
Published online: October 10, 2014
Processing time: 203 Days and 9.2 Hours
Abstract

Lung cancer, is the most common cause of cancer death in men and second only to breast cancer in women. Currently, the first line therapy of choice is platinum-based combination chemotherapy. A therapeutic plateau has been reached with the prognosis for patients with advanced non-small cell lung cancer (NSCLC) remaining poor. New biomarkers of prognosis as well as new therapies focusing on molecular targets are emerging helping to identify patients who are likely to benefit from therapy. Despite this, drug resistance remains the major cause for treatment failure. In this article we review the role of apoptosis in mediating drug resistance in NSCLC. Better understanding of this fundamental biological process may provide a rationale for overcoming the current therapeutic plateau.

Keywords: Apoptosis; Lung cancer; Adjuvant therapy; Mitochondria; BAX; BAK; BCL2

Core tip: A therapeutic plateau has been reached with the treatment of non-small cell lung cancers with platinum-based combination chemotherapy. New biomarkers of prognosis as well as new therapies focusing on molecular targets are emerging helping to identify patients who are likely to benefit from therapy. These are as yet only available to the minority of patients. Drug resistance remains the major cause for treatment failure. Apoptosis block as a mechanism for drug resistance and potential routes to overcome this will be reviewed.