Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations

Background: Mucinous adenocarcinoma (MAC) is a rare, aggressive subtype of adenocarcinoma, distinguished by excessive extracellular mucin production. This feature impairs drug penetration and contributes to poor chemotherapy response and chemoresistance. Genetic mutations (e.g., KRAS, BRAF, PI3K/AKT...

Full description

Saved in:
Bibliographic Details
Main Authors: Kaniga Pandi, Binoy Varghese Cheriyan, Vishali Ramesh, Sowparnika Murugavel, Jaya Surya Venkatesan
Format: Article
Language:English
Published: Creative Pharma Assent 2025-06-01
Series:Journal of Applied Pharmaceutical Research
Subjects:
Online Access:https://japtronline.com/index.php/joapr/article/view/1032
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850037478664175616
author Kaniga Pandi
Binoy Varghese Cheriyan
Vishali Ramesh
Sowparnika Murugavel
Jaya Surya Venkatesan
author_facet Kaniga Pandi
Binoy Varghese Cheriyan
Vishali Ramesh
Sowparnika Murugavel
Jaya Surya Venkatesan
author_sort Kaniga Pandi
collection DOAJ
description Background: Mucinous adenocarcinoma (MAC) is a rare, aggressive subtype of adenocarcinoma, distinguished by excessive extracellular mucin production. This feature impairs drug penetration and contributes to poor chemotherapy response and chemoresistance. Genetic mutations (e.g., KRAS, BRAF, PI3K/AKT), epithelial-to-mesenchymal transition (EMT), alterations in the tumor microenvironment, and mucin barriers contribute to this resistance. Objective: This narrative review aims to comprehensively summarize the molecular and microenvironmental mechanisms behind chemoresistance in MAC and highlight emerging therapeutic strategies to overcome it. Results: Chemoresistance in MAC arises from oncogenic signaling, immune evasion, hypoxia, and mucin-mediated drug exclusion. Promising approaches include mucolytic agents, small-molecule inhibitors, immune checkpoint inhibitors, RNA-based therapies, and nanoparticle-assisted drug delivery. Precision medicine, which utilizes genomic and transcriptomic profiling, is advancing individualized treatment; however, clinical translation remains limited. Conclusion: Resistance in MAC stems from both genetic and microenvironmental factors. Understanding these mechanisms is crucial for developing more effective, personalized therapies to improve patient outcomes. Future efforts should focus on validating novel therapies through clinical trials, discovering predictive biomarkers, and exploring tumor heterogeneity with multi-omics technologies. Integrating targeted therapies with advanced delivery systems may offer significant advances in treating chemoresistant MAC.
format Article
id doaj-art-1427dcbe8ded451b9d1af9b05362e488
institution DOAJ
issn 2348-0335
language English
publishDate 2025-06-01
publisher Creative Pharma Assent
record_format Article
series Journal of Applied Pharmaceutical Research
spelling doaj-art-1427dcbe8ded451b9d1af9b05362e4882025-08-20T02:56:51ZengCreative Pharma AssentJournal of Applied Pharmaceutical Research2348-03352025-06-01133769310.69857/joapr.v13i3.10321033Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterationsKaniga Pandi0Binoy Varghese Cheriyan1Vishali Ramesh2Sowparnika Murugavel3Jaya Surya Venkatesan4Department of Pharmaceutical Chemistry, Saveetha College of Pharmacy, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, IndiaDepartment of Pharmaceutical Chemistry, Saveetha College of Pharmacy, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, IndiaDepartment of Pharmaceutical Chemistry, Saveetha College of Pharmacy, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, IndiaDepartment of Pharmaceutical Chemistry, Saveetha College of Pharmacy, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, IndiaDepartment of Pharmaceutical Chemistry, Saveetha College of Pharmacy, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, IndiaBackground: Mucinous adenocarcinoma (MAC) is a rare, aggressive subtype of adenocarcinoma, distinguished by excessive extracellular mucin production. This feature impairs drug penetration and contributes to poor chemotherapy response and chemoresistance. Genetic mutations (e.g., KRAS, BRAF, PI3K/AKT), epithelial-to-mesenchymal transition (EMT), alterations in the tumor microenvironment, and mucin barriers contribute to this resistance. Objective: This narrative review aims to comprehensively summarize the molecular and microenvironmental mechanisms behind chemoresistance in MAC and highlight emerging therapeutic strategies to overcome it. Results: Chemoresistance in MAC arises from oncogenic signaling, immune evasion, hypoxia, and mucin-mediated drug exclusion. Promising approaches include mucolytic agents, small-molecule inhibitors, immune checkpoint inhibitors, RNA-based therapies, and nanoparticle-assisted drug delivery. Precision medicine, which utilizes genomic and transcriptomic profiling, is advancing individualized treatment; however, clinical translation remains limited. Conclusion: Resistance in MAC stems from both genetic and microenvironmental factors. Understanding these mechanisms is crucial for developing more effective, personalized therapies to improve patient outcomes. Future efforts should focus on validating novel therapies through clinical trials, discovering predictive biomarkers, and exploring tumor heterogeneity with multi-omics technologies. Integrating targeted therapies with advanced delivery systems may offer significant advances in treating chemoresistant MAC.https://japtronline.com/index.php/joapr/article/view/1032mucinous adenocarcinomachemoresistancetargeted therapytumor microenvironmentcancer stem cellsnanomedicine
spellingShingle Kaniga Pandi
Binoy Varghese Cheriyan
Vishali Ramesh
Sowparnika Murugavel
Jaya Surya Venkatesan
Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations
Journal of Applied Pharmaceutical Research
mucinous adenocarcinoma
chemoresistance
targeted therapy
tumor microenvironment
cancer stem cells
nanomedicine
title Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations
title_full Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations
title_fullStr Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations
title_full_unstemmed Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations
title_short Overcoming chemoresistance in mucinous adenocarcinoma: the impact of tumor microenvironment and genetic alterations
title_sort overcoming chemoresistance in mucinous adenocarcinoma the impact of tumor microenvironment and genetic alterations
topic mucinous adenocarcinoma
chemoresistance
targeted therapy
tumor microenvironment
cancer stem cells
nanomedicine
url https://japtronline.com/index.php/joapr/article/view/1032
work_keys_str_mv AT kanigapandi overcomingchemoresistanceinmucinousadenocarcinomatheimpactoftumormicroenvironmentandgeneticalterations
AT binoyvarghesecheriyan overcomingchemoresistanceinmucinousadenocarcinomatheimpactoftumormicroenvironmentandgeneticalterations
AT vishaliramesh overcomingchemoresistanceinmucinousadenocarcinomatheimpactoftumormicroenvironmentandgeneticalterations
AT sowparnikamurugavel overcomingchemoresistanceinmucinousadenocarcinomatheimpactoftumormicroenvironmentandgeneticalterations
AT jayasuryavenkatesan overcomingchemoresistanceinmucinousadenocarcinomatheimpactoftumormicroenvironmentandgeneticalterations