Resistance against conventional chemotherapeutic agents is one of the main reasons for tumor relapse and poor clinical outcomes in cancer patients. Various mechanisms are associated with drug resistance, including drug efflux, cell cycle, DNA repair and apoptosis. Doxorubicin (DOX) is a widely used first-line anti-cancer drug that functions as a DNA topoisomerase II inhibitor. However, DOX resistance has emerged as a large hurdle in efficient tumor therapy. Furthermore, despite its wide clinical application, DOX is a double-edged sword: it can damage normal tissues and affect the quality of patients’ lives during and after treatment. It is essential to clarify the molecular basis of DOX resistance to support the development of novel therapeutic modalities with fewer and/or lower-impact side effects in cancer patients. Long non-coding RNAs (lncRNAs) have critical roles in the drug resistance of various tumors. In this review, we summarize the state of knowledge on all the lncRNAs associated with DOX resistance. The majority are involved in promoting DOX resistance. This review paves the way to introducing an lncRNA panel marker for the prediction of the DOX response and clinical outcomes for cancer patients.

中文翻译：

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长链非编码 RNA 作为肿瘤细胞中多柔比星耐药性的关键调节因子

对常规化疗药物的耐药性是癌症患者肿瘤复发和临床预后不佳的主要原因之一。多种机制与耐药性有关，包括药物外排、细胞周期、DNA修复和细胞凋亡。多柔比星 (DOX) 是一种广泛使用的一线抗癌药物，可作为 DNA 拓扑异构酶 II 抑制剂。然而，DOX 耐药性已成为有效肿瘤治疗的一大障碍。此外，尽管 DOX 有广泛的临床应用，但它是一把双刃剑：它会损伤正常组织，影响患者在治疗期间和治疗后的生活质量。必须阐明 DOX 耐药性的分子基础，以支持开发对癌症患者产生较少和/或影响较小的副作用的新型治疗方式。长链非编码 RNA (lncRNA) 在各种肿瘤的耐药性中具有关键作用。在这篇综述中，我们总结了与 DOX 抗性相关的所有 lncRNA 的知识状况。大多数人参与促进 DOX 抗性。这篇综述为引入 lncRNA 面板标记物来预测癌症患者的 DOX 反应和临床结果铺平了道路。