Telomerase and drug resistance in cancer

Cell Mol Life Sci. 2017 Nov;74(22):4121-4132. doi: 10.1007/s00018-017-2573-2. Epub 2017 Jun 16.


It is well known that a decreased expression or inhibited activity of telomerase in cancer cells is accompanied by an increased sensitivity to some drugs (e.g., doxorubicin, cisplatin, or 5-fluorouracil). However, the mechanism of the resistance resulting from telomerase alteration remains elusive. There are theories claiming that it might be associated with telomere shortening, genome instability, hTERT translocation, mitochondria functioning modulation, or even alterations in ABC family gene expression. However, association of those mechanisms, i.e., drug resistance and telomerase alterations, is not fully understood yet. We review the current theories on the aspect of the role of telomerase in cancer cells resistance to therapy. We believe that revealing/unravelling this correlation might significantly contribute to an increased efficiency of cancer cells elimination, especially the most difficult ones, i.e., drug resistant.

Keywords: Cancer; Drug resistance; G-quadruplex stabilizers; Telomerase; Telomere shortening; Telomeres; hTERT expression.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP-Binding Cassette Transporters / metabolism*
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents / toxicity
  • Apoptosis / drug effects
  • DNA Damage / drug effects
  • Drug Resistance, Neoplasm / drug effects
  • G-Quadruplexes / drug effects
  • Humans
  • Neoplasms / drug therapy
  • Neoplasms / metabolism
  • Neoplasms / pathology*
  • Neoplastic Stem Cells / cytology
  • Neoplastic Stem Cells / enzymology
  • Neoplastic Stem Cells / metabolism
  • Poly(ADP-ribose) Polymerases / metabolism
  • Telomerase / metabolism*
  • Vault Ribonucleoprotein Particles / metabolism


  • ATP-Binding Cassette Transporters
  • Antineoplastic Agents
  • Vault Ribonucleoprotein Particles
  • Poly(ADP-ribose) Polymerases
  • vault poly(ADP-ribose) polymerase
  • Telomerase