Molecular mechanisms of cisplatin resistance
Abstract
Platinum-based drugs, and in particular cis-diamminedichloroplatinum(II) (best known as cisplatin), are employed for the treatment of a wide array of solid malignancies, including testicular, ovarian, head and neck, colorectal, bladder and lung cancers. Cisplatin exerts anticancer effects via multiple mechanisms, yet its most prominent (and best understood) mode of action involves the generation of DNA lesions followed by the activation of the DNA damage response and the induction of mitochondrial apoptosis. Despite a consistent rate of initial responses, cisplatin treatment often results in the development of chemoresistance, leading to therapeutic failure. An intense research has been conducted during the past 30 years and several mechanisms that account for the cisplatin-resistant phenotype of tumor cells have been described. Here, we provide a systematic discussion of these mechanism by classifying them in alterations (1) that involve steps preceding the binding of cisplatin to DNA (pre-target resistance), (2) that directly relate to DNA-cisplatin adducts (on-target resistance), (3) concerning the lethal signaling pathway(s) elicited by cisplatin-mediated DNA damage (post-target resistance) and (4) affecting molecular circuitries that do not present obvious links with cisplatin-elicited signals (off-target resistance). As in some clinical settings cisplatin constitutes the major therapeutic option, the development of chemosensitization strategies constitute a goal with important clinical implications.
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Constant or prolonged cisplatin treatment often results in acquisition of resistance through selection bias of alternative cell survival pathways, leading to therapeutic failure and poor prognosis.
“Also, constant or prolonged cisplatin treatment often results in the acquisition of resistance through the selection bias of alternative cell survival pathways, leading to therapeutic failure and poor prognosis [9, 10].”
From Advances in platinum-based cancer therapy: overcoming platinum resistance through rational combinatorial strategies (2025) · cites this paper as [9]
Cells can prevent cisplatin from reaching and harming DNA by reducing drug uptake, increasing drug efflux, and inactivating the drug through covalent binding to glutathione or metalloproteins.
“Mechanistically, cells can prevent cisplatin from reaching and harming DNA by reducing drug uptake, increasing drug efflux, and inactivating the drug through covalent binding to glutathione or metalloproteins [9, 10].”
From Advances in platinum-based cancer therapy: overcoming platinum resistance through rational combinatorial strategies (2025) · cites this paper as [9]
Mitotic catastrophe is a major mechanism of action of anticancer chemotherapeutics, reflecting increased resistance of neoplastic cells to intrinsic apoptosis.
“However, mitotic catastrophe appears to constitute a major mechanism of action of anticancer chemotherapeutics, mostly reflecting the increased resistance of neoplastic cells to the induction of intrinsic apoptosis [1004–1009].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [1007]
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- Authors
- Galluzzi, L., Senovilla, L., Vitale, I., Michels, J., Martins, I., Kepp, O., Castedo, M., & Kroemer, G.
- Affiliations
- Inserm (FR)
- Université Paris-Sud (FR)
- Corresponding author
- Kroemer, G
- Venue
- Oncogene
- Published
- 2011-09-05
- Volume
- 31
- Issue
- 15
- Pages
- 1869-1883
- ISSN
- 0950-9232 (ISSN-L)
- 1476-5594
- OpenAlex
- W2141037581
- Cited by
- 2,760
- References
- 196
- Citations by year
- 2026: 154 · 2025: 187 · 2024: 244 · 2023: 220 · 2022: 247 · 2021: 308 · 2020: 252 · 2019: 213 · 2018: 169 · 2017: 167 · 2016: 159 · 2015: 160 · 2014: 145 · 2013: 89 · 2012: 44
- FWCI
- 7.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Oncogene (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Commission
- Ligue Contre le Cancer
- Fondation Bettencourt Schueller
- Labex Immuno-Oncology
- Topics
- Health Sciences › Medicine › Oncology › Metal complexes synthesis and properties
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › DNA Repair Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer therapeutics and mechanisms
- Keywords
- cisplatin resistance, chemoresistance, platinum anticancer drugs, DNA damage response, mitochondrial apoptosis, chemosensitization, DNA lesions
- MeSH terms
- Cisplatin, DNA Damage, DNA Repair, Humans, Signal Transduction, DNA Adducts, Drug Resistance, Neoplasm
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