Please use this identifier to cite or link to this item: https://doi.org/10.2174/156800906777723967
Title: Reversal of resistance to oxazaphosphorines
Authors: Zhang, J.
Tian, Q.
Zhu, Y.-Z.
Xu, A.-L.
Zhou, S.-F. 
Keywords: Cyclophosphamide
Ifosfamide
Oxazaphosphorine
Pharmacogenetics
Resistance
Reversing agents
Issue Date: 2006
Citation: Zhang, J., Tian, Q., Zhu, Y.-Z., Xu, A.-L., Zhou, S.-F. (2006). Reversal of resistance to oxazaphosphorines. Current Cancer Drug Targets 6 (5) : 385-407. ScholarBank@NUS Repository. https://doi.org/10.2174/156800906777723967
Abstract: The oxazaphosphorines including cyclophosphamide (CPA), ifosfamide (IFO) and trofosfamide are one important group of alkylating agents. However, resistance is the major hindrance for success of oxazaphosphorine chemotherapy. The mechanism of resistance to oxazaphosphorines is not fully identified, but recently some novel insights into these aspects have been generated by using sensitive analytical techniques and powerful pharmacogenetic techniques. Potential mechanisms for oxazaphosphorine resistance include decreased activation by cytochrome P450s (e.g. CYP3A4, CYP2C9 and CYP2B6), increased deactivation of the agents by deactivating enzymes such as aldehyde dehydrogenases (ALDHs), increased cellular thiol level, increased DNA repair capacity, and altered cellular apoptotic response to DNA repair, e.g. deficient apoptosis due to lack of cellular mechanisms to result in cell death following DNA damage. In addition, decreased cellular accumulation of cytotoxic species of oxazaphosphorines may also play a role in the resistance. This review highlights the pharmacology of oxazaphosphorine anticancer drugs and possible agents that reverse the resistance to these agents. Possible agents that can overcome oxazaphosphorine resistance include inducers of CYPs, modulators of GSTs and ALDHs, modulators of DNA repair process, antisense oligonucleotides against genes encoding various enzymes and signalling proteins, and novel gene delivery systems. Most of these agents have been investigated in preclinical studies and promising results have been observed. To date, several types of these agents are being evaluated in Phase III trials in cancer patients. Further studies are needed to identify the molecular targets associated with resistance to oxazaphosphorines. © 2006 Bentham Science Publishers Ltd.
Source Title: Current Cancer Drug Targets
URI: http://scholarbank.nus.edu.sg/handle/10635/106701
ISSN: 15680096
DOI: 10.2174/156800906777723967
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