Holistic anti-tumor resistance mechanism of YBX1 and its potential as a chemoresistance target in pancreatic ductal adenocarcinoma

The overall survival rate of pancreatic ductal adenocarcinoma (PDAC) is the worst among all cancers, which is mainly due to the fact that most patients are in the late tumor stage when diagnosed, lacking effective treatment options. Although targeted therapy has shown some prospects in PDAC, its efficacy is limited to patients with specific gene mutation or target gene expression. A large number of patients have no other treatment options except chemotherapy. However, the high drug resistance rate of chemotherapy for PDAC severely limits the improvement of curative effect. Therefore, determining the key factors that lead to drug resistance in PDAC is crucial to improve the prognosis of patients. Multifunctional oncoprotein Y-box binding protein 1 (YBX1) may be one of such potential targets. Studies have confirmed that YBX1 is associated with the inherent behavior of a variety of cancers, such as proliferation, invasion, metastasis, and cancer cell stemness. Herein, we integrated and analyzed the resistance mechanism of YBX1 in anti-tumor therapy, and discussed its potential as a therapeutic target to reverse the chemotherapy resistance of PDAC.