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. 2023 Apr 29;6(2):257–272. doi: 10.20517/cdr.2022.136

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© The Author(s) 2023.

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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5-FU Resistance develops from processes that increase thymidylate synthase (TS) activity in cancer cells. Increased TS activity can result from multiple processes including gene amplification, increased transcription, TSER*3R polymorphism, increased TS nuclear localization, and decreased TS protein degradation, which are indicated by red arrows. Increased TS activity renders cells 5-FU-resistant because FdUMP levels are insufficient to inhibit all the TS available. 5-FU: 5-Fluorouracil; FdUMP: 5-Fluoro-2’-deoxyuridine-5’-O-monophosphate; FOXM1: forkhead box M1.