The Role of Autophagy in the Mechanisms of Tumor Cell Chemoresistance Induced by Anthracycline Antibiotic Use

Autophagy is not just a way to get rid of damaged, mutated, or genetically unstable cells, but it also increases the chances that tumor cells can overcome the effects of chemotherapy-induced damage. Anthracyclines have a cytoprotective effect of autophagy in most cancer cell lines. The blocking of autophagy in this case makes tumor cells more sensitive to therapy. Cytoprotective autophagy activation can cause chemoresistance, and if it is overstimulated, it can cause energy depletion and autophagic death. In some cases, cytotoxic autophagy develops under the action of anthracyclines and blocking it increases cell survival. On the contrary, activation of cytotoxic autophagy triggers the process of “self-eating”. Modulating autophagy can be a dual-edged sword for tumor cells, leading to both death and survival.