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The cancer cell membrane phospholipid bilayer is a dynamic structure that undergoes significant biochemical and biophysical changes during oncogenesis. These changes include the externalization of phosphatidylserine (PS) to the outer leaflet and an increase in sialic acid content, resulting in a more negative surface charge compared to normal cells (Riedl et al., 2011, 'The surface of cancer cells as a target for anticancer peptides'). This altered landscape provides a basis for selective therapeutic targeting using cationic anticancer peptides (ACPs) and lipid-analog drugs like alkylphosphocholines (Gaspar et al., 2013, 'Anticancer peptides: a promising alternative to conventional chemo-therapy'). These agents typically exert their effects by disrupting membrane integrity through pore formation or by interfering with lipid-mediated signaling pathways that promote cell survival (van Blitterswijk and Verheij, 2013, 'Antitumor alkylphospholipids: lessons learned from edelfosine, miltefosine and perifosine'). Because the mechanism of action is often physical or structural, targeting the membrane can potentially overcome common mechanisms of multidrug resistance associated with protein-based targets. Additionally, the membrane's role in cell-cell communication and metastasis makes it a focal point for preventing tumor spread. Therapeutic strategies targeting the bilayer aim to induce rapid cytolysis or trigger apoptotic cascades specifically within the tumor microenvironment. However, achieving high selectivity remains a challenge to avoid collateral damage to healthy tissues, such as red blood cells.
Membrane disruption via pore formation (e.g., toroidal or barrel-stave models), detergent-like lysis, and modulation of lipid-dependent signaling pathways.
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