{"entity":{"id":"b-resistance","kind":"bottleneck","name":"Acquired resistance to every therapy","aka":[],"tldr":"Nearly every targeted therapy stops working within months to a few years as the tumour adapts.","summary":"Every class of anticancer drug is followed by a catalogue of resistance mechanisms: on-target mutations (EGFR C797S, ESR1, BTK C481S, androgen receptor variants), bypass signalling (MET amplification, PI3K activation), lineage plasticity (adenocarcinoma to small-cell or neuroendocrine transformation), drug efflux, antigen loss after CAR-T or ADC therapy, and payload-specific resistance to topoisomerase inhibitors. Even the best first-line targeted therapies in lung cancer produce median progression-free survival of under two years. Because resistance biopsies are rare and mechanisms are heterogeneous between lesions, the choice of next-line therapy is often guesswork, and combination or sequencing strategies designed to pre-empt resistance are seldom tested prospectively. Degraders that remove the target, dual-payload conjugates, ctDNA-triggered switching, and upfront combinations are the emerging countermeasures.","asOf":"2026-09-08","links":[{"label":"Soria et al., Osimertinib in untreated EGFR-mutated NSCLC (FLAURA, NEJM 2018)","url":"https://doi.org/10.1056/NEJMoa1713137"},{"label":"Vasan, Baselga & Hyman, A view on drug resistance in cancer (Nature 2019)","url":"https://doi.org/10.1038/s41586-019-1730-1"}],"tags":[],"related":["idea-dual-payload-first","idea-payload-switching","idea-btk-degrader-frontline","idea-ctdna-switch-generalised","genie","idea-bio1-mandatory-progression-biopsy","idea-bio1-open-resistance-atlas","idea-bio1-upfront-bypass-combination","idea-bio1-pre-randomised-sequencing-trials","idea-bio1-antigen-mapping-at-progression","idea-bio1-dual-antigen-adc-escape","idea-bio1-adaptive-car-antigen-switch","idea-bio1-drug-holiday-resensitisation","idea-bio1-persister-ferroptosis","idea-bio1-epigenetic-persister-blockade","idea-bio1-mutagenesis-blockade-rev1","idea-bio1-stress-response-blockade","idea-bio1-senolytics-after-therapy","idea-bio1-persister-metabolic-vulnerability","idea-bio1-molecular-progression-add-on","idea-bio1-alternating-schedules","idea-bio1-resistance-mutation-vaccine","idea-bio1-mechanism-matched-access","idea-bio1-resistance-platform-trial","idea-bio1-slfn11-payload-guidance","idea-bio1-stromal-resistance-blockade","idea-bio1-real-world-resistance-surveillance","idea-bio1-approval-linked-progression-sampling","idea-bio1-drug-exposure-sanctuary-mapping","idea-bio1-immunopeptidome-timing","idea-moon-closed-loop-adaptive-therapy"],"cancers":["nsclc","breast-hr-positive","cll","prostate","melanoma","dlbcl"],"sections":[],"technologies":["protac-degrader","dual-payload-adc","bispecific-adc","liquid-biopsy","kinase-inhibitors","adc-payload-neutralizer"],"targets":[],"drugs":["osimertinib","camizestrant","pirtobrutinib","bgb-16673","amivantamab"],"companies":["astrazeneca","beone","nurix","sutro-biopharma","mersana","systimmune"],"institutions":["moffitt","mskcc"],"pathways":[],"terms":["resistance","c797s","esr1-mutation","castration-resistance","efflux-pump","met-amplification","histologic-transformation","endocrine-resistance","bcg-unresponsive","adc-sequencing"],"trials":["serena-6","mariposa","flaura2","bruin-cll-321","cadance-304"],"people":[],"bottlenecks":[],"keyPapers":["paper-vasan-nature"],"journals":[],"dependsOn":[],"notes":[],"stage":"biology","severity":"critical","metrics":[{"label":"Median progression-free survival with first-line osimertinib in EGFR-mutant NSCLC (FLAURA), the benchmark single-agent targeted therapy","value":"18.9 months","source":"Soria et al., NEJM 2018","url":"https://doi.org/10.1056/NEJMoa1713137"},{"label":"Median progression-free survival with sotorasib vs docetaxel in previously treated KRAS G12C NSCLC (CodeBreaK 200)","value":"5.6 vs 4.5 months","source":"de Langen et al., Lancet 2023","url":"https://doi.org/10.1016/S0140-6736(23)00221-0"}],"causes":["Tumours are heterogeneous, so a resistant subclone almost always pre-exists the drug.","Single-agent targeting of one node leaves parallel pathways available for bypass.","Resistance biopsies are uncommon outside academic centres, so mechanisms are inferred rather than measured.","Sequential single-agent development is commercially simpler than testing rational upfront combinations.","Lineage plasticity and epigenetic state changes are not captured by DNA sequencing and have few druggable handles."],"currentEfforts":["SERENA-6 established ctDNA-triggered switching to camizestrant on emergence of ESR1 mutation, before progression, as a viable strategy.","Combinations such as amivantamab plus lazertinib (MARIPOSA) and osimertinib plus chemotherapy (FLAURA2) attack EGFR resistance up front.","BTK degraders (BGB-16673) and non-covalent BTK inhibitors (pirtobrutinib) are designed to work after covalent-inhibitor resistance and to pre-empt it in first line.","Dual-payload and bispecific ADCs (Sutro Biopharma, Mersana, SystImmune's BL-B01D1) aim to prevent payload- or antigen-loss resistance.","AACR Project GENIE and cBioPortal make paired pre- and post-resistance sequencing data available for pooled analysis.","Evolutionary and adaptive therapy trials at Moffitt test dosing schedules that maintain drug-sensitive clones to suppress resistant ones."],"successLooksLike":"Resistance mechanisms are measured prospectively (tissue or blood) in every patient at progression, and first-line regimens are chosen to pre-empt the dominant resistance routes so that median progression-free survival on targeted therapy in lung and breast cancer more than doubles."},"route":"/bottlenecks/b-resistance/","neighbours":{"idea":[{"id":"idea-bio1-ctdna-clone-report","kind":"idea","name":"A clone report from blood at every treatment cycle","route":"/ideas/idea-bio1-ctdna-clone-report/"},{"id":"idea-bio1-mechanism-matched-access","kind":"idea","name":"A fast route to the matched drug when it is licensed for another cancer","route":"/ideas/idea-bio1-mechanism-matched-access/"},{"id":"idea-tnbc-adc-sequencing-trial","kind":"idea","name":"A randomised trial of antibody-drug conjugate sequence in metastatic triple-negative breast cancer","route":"/ideas/idea-tnbc-adc-sequencing-trial/"},{"id":"idea-bio1-resistance-platform-trial","kind":"idea","name":"A standing platform trial that assigns treatment by how the tumour escaped","route":"/ideas/idea-bio1-resistance-platform-trial/"},{"id":"idea-moon-synthetic-lethality-map-every-driver","kind":"idea","name":"A synthetic lethality map for every cancer driver in every tissue context","route":"/ideas/idea-moon-synthetic-lethality-map-every-driver/"},{"id":"idea-bio1-molecular-progression-add-on","kind":"idea","name":"Add a drug when the blood test turns, without stopping the one that works","route":"/ideas/idea-bio1-molecular-progression-add-on/"},{"id":"idea-bio1-upfront-bypass-combination","kind":"idea","name":"Add the second drug on day one when the escape route is predictable","route":"/ideas/idea-bio1-upfront-bypass-combination/"},{"id":"idea-bio1-collateral-sensitivity-atlas","kind":"idea","name":"An open atlas of collateral sensitivity for every approved targeted drug","route":"/ideas/idea-bio1-collateral-sensitivity-atlas/"},{"id":"idea-moon-closed-loop-adaptive-therapy","kind":"idea","name":"Autonomous closed-loop adaptive therapy driven by blood tests and evolutionary models","route":"/ideas/idea-moon-closed-loop-adaptive-therapy/"},{"id":"idea-bio1-outlier-lesion-biopsy","kind":"idea","name":"Biopsy the one lesion that is growing while the others shrink","route":"/ideas/idea-bio1-outlier-lesion-biopsy/"},{"id":"idea-bio1-epigenetic-persister-blockade","kind":"idea","name":"Block the chemical switch that lets cells hide from treatment","route":"/ideas/idea-bio1-epigenetic-persister-blockade/"},{"id":"idea-bio1-stromal-resistance-blockade","kind":"idea","name":"Block the survival signals the tumour's neighbours provide","route":"/ideas/idea-bio1-stromal-resistance-blockade/"},{"id":"idea-btk-degrader-frontline","kind":"idea","name":"BTK degraders to pre-empt resistance in frontline CLL","route":"/ideas/idea-btk-degrader-frontline/"},{"id":"idea-bio2-antigen-presentation-triage","kind":"idea","name":"Check whether a tumour can still show itself to the immune system","route":"/ideas/idea-bio2-antigen-presentation-triage/"},{"id":"idea-bio1-senolytics-after-therapy","kind":"idea","name":"Clear the zombie cells left behind by chemotherapy and radiotherapy","route":"/ideas/idea-bio1-senolytics-after-therapy/"},{"id":"idea-tr2-resistance-mechanism-baskets","kind":"idea","name":"Combination baskets defined by resistance mechanism rather than by cancer type","route":"/ideas/idea-tr2-resistance-mechanism-baskets/"},{"id":"idea-bio1-ctdna-adaptive-tki","kind":"idea","name":"ctDNA-guided dose holidays for lung cancer targeted therapy","route":"/ideas/idea-bio1-ctdna-adaptive-tki/"},{"id":"idea-bio1-stress-response-blockade","kind":"idea","name":"Cut off the emergency programme cancer cells use to survive treatment","route":"/ideas/idea-bio1-stress-response-blockade/"},{"id":"idea-bio1-evolutionary-double-bind","kind":"idea","name":"Design drug pairs where resisting one makes you vulnerable to the other","route":"/ideas/idea-bio1-evolutionary-double-bind/"},{"id":"idea-bio1-arv7-degrader","kind":"idea","name":"Destroy the truncated androgen receptor that hormone drugs cannot touch","route":"/ideas/idea-bio1-arv7-degrader/"},{"id":"idea-bio1-cfrna-plasticity-tracking","kind":"idea","name":"Detect tumours changing cell type from RNA in the blood","route":"/ideas/idea-bio1-cfrna-plasticity-tracking/"},{"id":"idea-dual-payload-first","kind":"idea","name":"Dual-payload ADCs in first line to prevent resistance","route":"/ideas/idea-dual-payload-first/"},{"id":"idea-bio1-reverse-translation-resistance-models","kind":"idea","name":"Every resistance mechanism found in a patient must be rebuilt in the laboratory","route":"/ideas/idea-bio1-reverse-translation-resistance-models/"},{"id":"idea-tr1-adaptive-therapy-randomised-phase-2","kind":"idea","name":"Evolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trials","route":"/ideas/idea-tr1-adaptive-therapy-randomised-phase-2/"},{"id":"idea-bio1-drug-exposure-sanctuary-mapping","kind":"idea","name":"Find the parts of a tumour the drug never reaches","route":"/ideas/idea-bio1-drug-exposure-sanctuary-mapping/"},{"id":"idea-bio1-evolution-forecasting","kind":"idea","name":"Forecast the next resistance mutation like the weather","route":"/ideas/idea-bio1-evolution-forecasting/"},{"id":"idea-bio1-mandatory-progression-biopsy","kind":"idea","name":"Fund a biopsy at progression, every time, as standard care","route":"/ideas/idea-bio1-mandatory-progression-biopsy/"},{"id":"idea-bio1-ctc-derived-explants","kind":"idea","name":"Grow models from tumour cells in the blood when a biopsy is impossible","route":"/ideas/idea-bio1-ctc-derived-explants/"},{"id":"idea-bio1-persister-ferroptosis","kind":"idea","name":"Kill the sleeping survivor cells with iron-dependent cell death","route":"/ideas/idea-bio1-persister-ferroptosis/"},{"id":"idea-bio1-baseline-ultradeep-resistant-clones","kind":"idea","name":"Look for the resistant sub-population before the first dose","route":"/ideas/idea-bio1-baseline-ultradeep-resistant-clones/"},{"id":"idea-bio1-approval-linked-progression-sampling","kind":"idea","name":"Make post-progression sampling a condition of accelerated approval","route":"/ideas/idea-bio1-approval-linked-progression-sampling/"},{"id":"idea-lung-resistance-directed-sequencing-at-every-progression","kind":"idea","name":"Make resistance a diagnosis: sequence at every progression and choose the next line from what the tumour became","route":"/ideas/idea-lung-resistance-directed-sequencing-at-every-progression/"},{"id":"idea-ctdna-switch-generalised","kind":"idea","name":"Molecular-progression switching beyond ESR1","route":"/ideas/idea-ctdna-switch-generalised/"},{"id":"idea-bio1-open-resistance-atlas","kind":"idea","name":"One open atlas of how tumours escape every drug","route":"/ideas/idea-bio1-open-resistance-atlas/"},{"id":"idea-bio1-drug-holiday-resensitisation","kind":"idea","name":"Pause a failed drug so the tumour becomes sensitive to it again","route":"/ideas/idea-bio1-drug-holiday-resensitisation/"},{"id":"idea-payload-switching","kind":"idea","name":"Payload-class switching as the rule for ADC sequencing","route":"/ideas/idea-payload-switching/"},{"id":"idea-bio1-adaptive-car-antigen-switch","kind":"idea","name":"Plan the second CAR-T target before the first one is lost","route":"/ideas/idea-bio1-adaptive-car-antigen-switch/"},{"id":"idea-bio1-pre-randomised-sequencing-trials","kind":"idea","name":"Randomise the next line of treatment before the first one fails","route":"/ideas/idea-bio1-pre-randomised-sequencing-trials/"},{"id":"idea-prostate-randomise-the-sequence-not-only-the-drugs","kind":"idea","name":"Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer","route":"/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/"},{"id":"idea-pdac-ras-inhibitor-combinations-and-sequencing","kind":"idea","name":"RAS inhibitor combinations and sequence: pan-RAS plus G12D-selective, plus chemotherapy, and what to give after progression","route":"/ideas/idea-pdac-ras-inhibitor-combinations-and-sequencing/"},{"id":"idea-bio1-antigen-mapping-at-progression","kind":"idea","name":"Re-map the tumour's surface proteins before choosing the next antibody drug","route":"/ideas/idea-bio1-antigen-mapping-at-progression/"},{"id":"idea-bio1-rebiopsy-before-switch","kind":"idea","name":"Re-test the metastasis, not the old primary, before every change of treatment","route":"/ideas/idea-bio1-rebiopsy-before-switch/"},{"id":"idea-bio1-alternating-schedules","kind":"idea","name":"Rotate between drugs on a fixed schedule instead of waiting for failure","route":"/ideas/idea-bio1-alternating-schedules/"},{"id":"idea-tr2-smart-sequencing-adc","kind":"idea","name":"Sequential multiple-assignment randomised trials to find the best order of ADCs","route":"/ideas/idea-tr2-smart-sequencing-adc/"},{"id":"idea-bio1-apobec-inhibitor-adjunct","kind":"idea","name":"Slow the tumour's mutation engine with APOBEC inhibitors during targeted therapy","route":"/ideas/idea-bio1-apobec-inhibitor-adjunct/"},{"id":"idea-tr1-smart-designs-for-adaptive-strategies","kind":"idea","name":"SMART designs to test treatment strategies, not just single drugs","route":"/ideas/idea-tr1-smart-designs-for-adaptive-strategies/"},{"id":"idea-bio1-persister-metabolic-vulnerability","kind":"idea","name":"Starve the survivors: target the energy pathway drug-tolerant cells switch to","route":"/ideas/idea-bio1-persister-metabolic-vulnerability/"},{"id":"idea-bio1-first-strike-second-strike","kind":"idea","name":"Switch drugs at maximum response, not at relapse","route":"/ideas/idea-bio1-first-strike-second-strike/"},{"id":"idea-prostate-bipolar-androgen-therapy-phase-3-on-pfs2","kind":"idea","name":"Take high-dose testosterone to phase 3, with progression-free survival through the second line as the primary endpoint","route":"/ideas/idea-prostate-bipolar-androgen-therapy-phase-3-on-pfs2/"},{"id":"idea-tr2-alternating-vs-concurrent","kind":"idea","name":"Test alternating drug schedules against giving both drugs at once","route":"/ideas/idea-tr2-alternating-vs-concurrent/"},{"id":"idea-tr1-intermittent-dosing-to-delay-resistance","kind":"idea","name":"Test intermittent dosing of targeted drugs to delay resistance, with honest priors","route":"/ideas/idea-tr1-intermittent-dosing-to-delay-resistance/"},{"id":"idea-bio1-immunopeptidome-timing","kind":"idea","name":"Time immunotherapy to the moment targeted drugs make tumours visible","route":"/ideas/idea-bio1-immunopeptidome-timing/"},{"id":"idea-bio1-real-world-resistance-surveillance","kind":"idea","name":"Treat resistance like an infectious disease and run national surveillance","route":"/ideas/idea-bio1-real-world-resistance-surveillance/"},{"id":"idea-bio1-mutagenesis-blockade-rev1","kind":"idea","name":"Turn off the error-prone repair that manufactures resistance mutations","route":"/ideas/idea-bio1-mutagenesis-blockade-rev1/"},{"id":"idea-bio1-dual-antigen-adc-escape","kind":"idea","name":"Two-target antibody drugs to close the antigen escape route","route":"/ideas/idea-bio1-dual-antigen-adc-escape/"},{"id":"idea-bio1-slfn11-payload-guidance","kind":"idea","name":"Use SLFN11 status to decide which antibody-drug payload to give next","route":"/ideas/idea-bio1-slfn11-payload-guidance/"},{"id":"idea-bio1-resistance-mutation-vaccine","kind":"idea","name":"Vaccinate against the resistance mutation before it takes over","route":"/ideas/idea-bio1-resistance-mutation-vaccine/"},{"id":"idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine","kind":"idea","name":"Watch for the cancer changing cell type before the biopsy says neuroendocrine, and act on it","route":"/ideas/idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine/"},{"id":"idea-bio1-wrn-msi-programme","kind":"idea","name":"WRN inhibitors: a second synthetic-lethal win for mismatch-repair cancers","route":"/ideas/idea-bio1-wrn-msi-programme/"}],"collection":[{"id":"genie","kind":"collection","name":"AACR Project GENIE","route":"/collections/genie/"}],"cancer":[{"id":"cll","kind":"cancer","name":"Chronic lymphocytic leukaemia","route":"/cancers/cll/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"adc-payload-neutralizer","kind":"technology","name":"ADC payload neutralisers","route":"/technologies/adc-payload-neutralizer/"},{"id":"bispecific-adc","kind":"technology","name":"Bispecific ADC","route":"/technologies/bispecific-adc/"},{"id":"dual-payload-adc","kind":"technology","name":"Dual-payload ADC","route":"/technologies/dual-payload-adc/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"protac-degrader","kind":"technology","name":"PROTACs & molecular glues (targeted protein degradation)","route":"/technologies/protac-degrader/"},{"id":"kinase-inhibitors","kind":"technology","name":"Small-molecule kinase inhibitors","route":"/technologies/kinase-inhibitors/"}],"drug":[{"id":"amivantamab","kind":"drug","name":"Amivantamab","route":"/drugs/amivantamab/"},{"id":"bgb-16673","kind":"drug","name":"BGB-16673","route":"/drugs/bgb-16673/"},{"id":"camizestrant","kind":"drug","name":"Camizestrant","route":"/drugs/camizestrant/"},{"id":"osimertinib","kind":"drug","name":"Osimertinib","route":"/drugs/osimertinib/"},{"id":"pirtobrutinib","kind":"drug","name":"Pirtobrutinib","route":"/drugs/pirtobrutinib/"}],"company":[{"id":"astrazeneca","kind":"company","name":"AstraZeneca","route":"/companies/astrazeneca/"},{"id":"beone","kind":"company","name":"BeOne Medicines (formerly BeiGene)","route":"/companies/beone/"},{"id":"mersana","kind":"company","name":"Mersana Therapeutics","route":"/companies/mersana/"},{"id":"nurix","kind":"company","name":"Nurix Therapeutics","route":"/companies/nurix/"},{"id":"sutro-biopharma","kind":"company","name":"Sutro Biopharma","route":"/companies/sutro-biopharma/"},{"id":"systimmune","kind":"company","name":"SystImmune / Sichuan Biokin","route":"/companies/systimmune/"}],"institution":[{"id":"arpa-h","kind":"institution","name":"Advanced Research Projects Agency for Health","route":"/institutions/arpa-h/"},{"id":"candiolo","kind":"institution","name":"Istituto di Candiolo IRCCS (FPO)","route":"/institutions/candiolo/"},{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","route":"/institutions/mskcc/"},{"id":"moffitt","kind":"institution","name":"Moffitt Cancer Center","route":"/institutions/moffitt/"},{"id":"mark-foundation","kind":"institution","name":"The Mark Foundation for Cancer Research","route":"/institutions/mark-foundation/"}],"term":[{"id":"adc-sequencing","kind":"term","name":"ADC sequencing","route":"/terms/adc-sequencing/"},{"id":"bcg-unresponsive","kind":"term","name":"BCG-unresponsive","route":"/terms/bcg-unresponsive/"},{"id":"bipolar-androgen-therapy","kind":"term","name":"Bipolar androgen therapy (BAT)","route":"/terms/bipolar-androgen-therapy/"},{"id":"castration-resistance","kind":"term","name":"Castration-resistant prostate cancer (CRPC)","route":"/terms/castration-resistance/"},{"id":"efflux-pump","kind":"term","name":"Drug efflux pumps (ABC transporters)","route":"/terms/efflux-pump/"},{"id":"resistance","kind":"term","name":"Drug resistance (primary and acquired)","route":"/terms/resistance/"},{"id":"c797s","kind":"term","name":"EGFR C797S","route":"/terms/c797s/"},{"id":"endocrine-resistance","kind":"term","name":"Endocrine resistance","route":"/terms/endocrine-resistance/"},{"id":"esr1-mutation","kind":"term","name":"ESR1 mutation","route":"/terms/esr1-mutation/"},{"id":"genome-wide-loss-of-heterozygosity","kind":"term","name":"Genome-wide loss of heterozygosity (gLOH)","route":"/terms/genome-wide-loss-of-heterozygosity/"},{"id":"histologic-transformation","kind":"term","name":"Histologic transformation","route":"/terms/histologic-transformation/"},{"id":"met-amplification","kind":"term","name":"MET amplification (bypass resistance)","route":"/terms/met-amplification/"},{"id":"neuroendocrine-differentiation","kind":"term","name":"Neuroendocrine differentiation in prostate cancer","route":"/terms/neuroendocrine-differentiation/"},{"id":"radiographic-progression-free-survival","kind":"term","name":"Radiographic progression-free survival (rPFS)","route":"/terms/radiographic-progression-free-survival/"}],"trial":[{"id":"bruin-cll-321","kind":"trial","name":"BRUIN CLL-321","route":"/trials/bruin-cll-321/"},{"id":"cadance-304","kind":"trial","name":"CaDAnCe-304","route":"/trials/cadance-304/"},{"id":"flaura2","kind":"trial","name":"FLAURA2","route":"/trials/flaura2/"},{"id":"mariposa","kind":"trial","name":"MARIPOSA","route":"/trials/mariposa/"},{"id":"serena-6","kind":"trial","name":"SERENA-6","route":"/trials/serena-6/"}],"paper":[{"id":"paper-vasan-nature","kind":"paper","name":"A view on drug resistance in cancer","route":"/key-papers/paper-vasan-nature/"},{"id":"paper-abiraterone-acetate-prostate-n-engl-j-med-2013","kind":"paper","name":"Abiraterone in metastatic prostate cancer without previous chemotherapy","route":"/key-papers/paper-abiraterone-acetate-prostate-n-engl-j-med-2013/"},{"id":"paper-admiral-gilteritinib-flt3-nejm-2019","kind":"paper","name":"ADMIRAL: gilteritinib pills versus chemotherapy for relapsed FLT3-mutated acute myeloid 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