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Multilayered analysis of cisplatin resistance mechanisms in bladder cancer: from the cell membrane to organelles

cell-biology
genetics
genomics
surgery-and-surgical-specialties
urology

Abstract

Bladder cancer (BCa) is one of the most prevalent malignant tumors of the urinary system worldwide.Cisplatin, as a classic and widely used platinum-based drug, has long played a pivotal role in the treatment of various cancers.Cisplatin-based combination chemotherapy has become an essential therapeutic option for bladder cancer patients and has markedly improved clinical outcomes.However, its efficacy is frequently compromised by the development of acquired or secondary resistance, ultimately resulting in treatment failure and disease recurrence.To address this challenge, numerous studies in recent years have focused on elucidating the molecular basis of cisplatin resistance, aiming to uncover mechanisms at multiple levels.This review systematically summarizes the multilayered molecular mechanisms of cisplatin resistance in bladder cancer, covering the cell membrane, cytoplasm, nucleus, and organelles, with specific emphasis on epithelial-mesenchymal transition, cancer stem cell properties, DNA repair, apoptosis, autophagy, and critical signaling pathways.By integrating the analysis of different mechanisms, this review aims to provide novel theoretical foundations and insights for understanding resistance, advancing preclinical studies, and developing personalized therapeutic strategies.
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