Chemoresistance: The hidden barrier in cancer treatment

Despite significant advances in cancer diagnosis and therapy, the global burden of cancer continues to escalate, characterized by increasing incidence and mortality rates. A problem for successful treatment is chemoresistance, which undermines the effectiveness of traditional and targeted treatments. This review synthesizes emerging therapeutic strategies, including targeted agents, combinatorial regimens, and advances in precision medicine, with a focus on improving clinical outcomes. Integrating the latest understanding from molecular biology, genomics, and pharmacology emphasizes new paths to overcoming resistance. Particular attention is focused on the roles played by exosomes, metabolic reprogramming, and the tumour microenvironment in facilitating drug resistance, as well as promising approaches to counteract these mechanisms and improve therapeutic responsiveness.