Biological determinants of radioresistance and their remediation in pancreatic cancer

Parthasarathy Seshacharyulu, Michael J. Baine, Joshua J. Souchek, Melanie Menning, Sukhwinder Kaur, Ying Yan, Michel M. Ouellette, Maneesh Jain, Chi Lin, Surinder K. Batra

Research output: Contribution to journalReview articlepeer-review

68 Scopus citations


Despite recent advances in radiotherapy, a majority of patients diagnosed with pancreatic cancer (PC) do not achieve objective responses due to the existence of intrinsic and acquired radioresistance. Identification of molecular mechanisms that compromise the efficacy of radiation therapy and targeting these pathways is paramount for improving radiation response in PC patients. In this review, we have summarized molecular mechanisms associated with the radio-resistant phenotype of PC. Briefly, we discuss the reversible and irreversible biological consequences of radiotherapy, such as DNA damage and DNA repair, mechanisms of cancer cell survival and radiation-induced apoptosis following radiotherapy. We further describe various small molecule inhibitors and molecular targeting agents currently being tested in preclinical and clinical studies as potential radiosensitizers for PC. Notably, we draw attention towards the confounding effects of cancer stem cells, immune system, and the tumor microenvironment in the context of PC radioresistance and radiosensitization. Finally, we discuss the need for examining selective radioprotectors in light of the emerging evidence on radiation toxicity to non-target tissue associated with PC radiotherapy.

Original languageEnglish (US)
Pages (from-to)69-92
Number of pages24
JournalBiochimica et Biophysica Acta - Reviews on Cancer
Issue number1
StatePublished - Aug 1 2017

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research


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