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Our earlier report revealed very marked heterogeneity between resistant tumours in key IHC biomarkers.12 Of note, ER expression was maintained or enhanced in the majority of tumours and was felt to be consistent with a potential for oestrogen signalling in the face of AI to be a driver of resistance, a mechanism that is supported in only a minority of ER + resistant tumours in the current study.
DNA sequencing revealed the acquisition of ALK G1269A as the potential driver of resistance.
In fact, urban poverty is a huge and largely unappreciated driver of resistance.
Attention has turned to sub-optimal use of antimicrobials as a driver of resistance.
Dame Sally Davies answers: In the UK we believe that the major driver of resistance is prescribing for humans.
Through genetic screens, we unexpectedly find that mutant HRAS, which is rarely found in CRC, is a stronger driver of resistance than mutant KRAS.
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To identify potential drivers of resistance in Pat208, we looked for genes showing mutations concurrent with loss of heterozygosity (LOH) that were present at high cancer cell fractions only during progressive disease but not while the patient was responding.
Therefore, a better understanding of the molecular drivers of resistance could enable the identification of effective drug combinations to improve clinical efficacy.
First, recent local [ 31] and national [ 32] campaigns to promote appropriate antibacterial prescribing may have exerted a downward pressure on resistance rates as this factor is one of the most important drivers of resistance in community-acquired infections [ 33].
These longer dwell times may be the main drivers of resistance in individuals whose time to resistance is long compared to the average transition rate between states (e.g., due to a higher immune pressure p).
Asian countries, users of large amounts of antimicrobial agents and important drivers of resistance until recently, will change paradigms and introduce modern infection control concepts and public health policies that will decrease overuse of antimicrobial agents.
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