Figure 2.

Different mechanisms inducing therapeutic resistance in lung cancer: Therapeutic resistance against chemotherapy, radiotherapy, targeted therapy, and immunotherapy in lung cancer is caused by different types of mechanism. For instance, tumor heterogeneity, alteration in drug influx and efflux, compartmentalization, epigenetic changes, hypoxia, or reduced autophagy stimulate chemoresistance in lung cancer. Radioresistance is found to happen by epithelial and mesenchymal transition, DNA damage, dysregulated miRNA, and changes in various signaling pathways. Mutations in EGFR or KRAS genes and targets as well as alterations in drug sensitivity lead to mutations at T790M that cause primary and acquired resistance for targeted therapy. Mutations in cancer driver genes, immunosuppressive TME, modified epigenetics, and high bioenergetic are mainly responsible for triggering immunoresistance in lung cancer (created with BioRender.com (accessed on 15 September 2022).