Title:Failure of Chemotherapy in Hepatocellular Carcinoma Due to Impaired and Dysregulated Primary Liver Drug Metabolizing Enzymes and Drug Transport Proteins: What to Do?
VOLUME: 19 ISSUE: 10
Author(s):Salman Ul-Islam, Muhammad Bilal Ahmed, Adeeb Shehzad, Mazhar Ul-Islam and Young Sup Lee*
Affiliation:School of Life Sciences, College of Natural Sciences, Kyungpook National University, 41566, School of Life Sciences, College of Natural Sciences, Kyungpook National University, 41566, Department of Biomedical Engineering and Sciences, School of Mechanical and Manufacturing Engineering, National University of Sciences and Technology Islamabad, Department of Chemical Engineering, College of Engineering, Dhofar University, Salalah, School of Life Sciences, College of Natural Sciences, Kyungpook National University, 41566
Keywords:Hepatocellular carcinoma, Drug metabolism, CYP, Chemotherapy, Sorafenib, Drug resistance.
Abstract:Background: Most of the drugs are metabolized in the liver by the action of drug metabolizing enzymes.
In hepatocellular carcinoma (HCC), primary drug metabolizing enzymes are severely dysregulated, leading to failure
of chemotherapy. Sorafenib is the only standard systemic drug available, but it still presents certain limitations, and
much effort is required to understand who is responsive and who is refractory to the drug. Preventive and therapeutic
approaches other than systemic chemotherapy include vaccination, chemoprevention, liver transplantation, surgical
resection, and locoregional therapies.
Objectives: This review details the dysregulation of primary drug metabolizing enzymes and drug transport proteins
of the liver in HCC and their influence on chemotherapeutic drugs. Furthermore, it emphasizes the adoption of safe
alternative therapeutic strategies to chemotherapy.
Conclusion: The future of HCC treatment should emphasize on understanding of resistance mechanisms and the
finding of novel, safe, and efficacious therapeutic strategies, which will surely benefit patients affected by advanced
HCC.
