Fig. 1

Mechanisms involved in therapeutic resistance in cancer. Increased drug efflux and decreased drug influx lead to reduced accumulation of anticancer drugs in tumor cells. Additionally, blocking apoptosis, promoting DNA damage repair and enhancing autophagy also help tumor cells easily survive under treatment stress. Moreover, tumor cells preferentially consume glucose, producing lactic acid and ATP through glycolysis, contributing to cell rapid proliferation and resistance to therapy. Finally, a disordered tumor microenvironment (TME), promotion of epithelial-mesenchymal transition (EMT) and augmented cancer stem cell (CSC) properties will also restrict the therapeutic efficacy of cancer