Shariqa Aisha

Cancer treatment faces many hurdles and resistance is one among them. Anti-cancer treatment strategies are evolving due to innate and acquired resistance capacity, governed by genetic, epigenetic, proteomic, metabolic, or microenvironmental cues that ultimately enable selected cancer cells to survive and progress under unfavorable conditions. Although the mechanism of drug resistance is being widely studied to generate new target-based drugs with better potency than existing ones. However, due to the broader flexibility in acquired drug resistance, advanced therapeutic options with better efficacy need to be explored. Combination therapy is an alternative with a better success rate though the risk of amplified side effects is commonplace. Moreover, recent groundbreaking precision immune therapy is one of the ways to overcome drug resistance and has revolutionized anticancer therapy to a greater extent with the only limitation of being individual-specific and needs further attention. This review will focus on the challenges and strategies opted by cancer cells to withstand the current therapies at the molecular level and also highlights the emerging therapeutic options -like immunological, and stem cell-based options that may prove to have better potential to challenge the existing problem of therapy resistance. Video Abstract.

Baculoviral inhibitor of apoptosis repeat-containing 5 or BIRC5, member of the inhibitor of apoptosis (IAP), is a multitasking protein and among the top 100 deregulated genes in breast cancer patients. It negatively regulates apoptosis of tumor cells by inducing gene expression of anti-apoptotic proteins, promoting tumor cell proliferation, and modulates response to chemotherapeutics. The main objective of the study was to analyze the expression pattern, prognostic significance and functional role of BIRC5 in breast cancer (BC). In the present study, we utilized a bioinformatic approach, to analyze the expression pattern and prognostic significance of BIRC5 in BC and explore the interactions of BIRC5 in promoting breast tumorigenicity. BIRC5 mRNA levels were augmented in breast carcinoma & over-expression of BIRC5 was found associated with poor overall survival (OS) and relapse-free survival (RFS). The KEGG pathway and gene ontology analysis of BIRC5 indicate that BIRC5 is highly enriched in mitotic pathways and cancer pathways. The PPI and correlation analysis further revealed that BIRC5 showed high with oncogenic proteins. Moreover, BIRC5 showed high correlation with infiltration of myeloid derived suppressor cells (MDSCs) in the breast tumor stroma. Cumulatively, this study signifies that BIRC5 promotes tumor progression, & targeting BIRC5 in combination with conventional therapies will significantly enhance the response of BC patients to therapy.