Table 6 Mechanisms of drug resistance in NSC and strategies to overcome resistance
Mechanism | Proposed strategy to overcame resistance | Examples |
|---|---|---|
NSC quiescence | Antibody-based killing of NSC | CD20, CD33, CD52, |
Mobilization of the immune system against NSC | Vaccination [314], | |
IL-2 + histamine [315] | ||
NSC mobilization into the cell cycle | Cytokine-priming [316] | |
CTLA-4 inhibition | Ipilimumab [317] | |
PD1 inhibition | Nivolumab [318] | |
NSC-niche interactions | NSC mobilization out of the niche | Plerixafor [159] |
Redirection of NSC into the niche | Gliptins (CML [84]) | |
Targeting of niche cells | Revlimid [319] | |
Targeting of Niche modulating-cytokines (for example, VEGF) or | Avastin [320] | |
Cytokine (for example, VEGF) synthesis | Rapamycin [295] | |
Blocking the efflux pumps | CSA | |
Expression of anti-apoptotic proteins | Blocking BCL-2 family members | Obatoclax [323] |
Blocking heat shock proteins (Hsp) | Hsp70, Hsp90 [324] |