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Life sciences · Journal article
Frontiers in Oncology · October 22, 2026
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Introduction As a core drug in chemotherapy regimens for colorectal cancer, the clinical efficacy of oxaliplatin is compromised by multiple resistance mechanisms. Lipid metabolism, a crucial component of metabolic pathways, is known to affect the efficacy of various chemotherapeutic agents. However, to the best of our knowledge, the role of lipid metabolism in oxaliplatin resistance remains unreviewed. Areas covered In this review, we analyze the relationship between lipid metabolism and oxaliplatin efficacy from the perspectives of DNA damage, ferroptosis, ROS accumulation, cellular dormancy, antitumor immunity, vascular remodeling, and autophagy. This review covers nearly all known oxaliplatin resistance factors, summarizing the regulatory role of lipid metabolism across both basic and clinical studies. Given that clinical studies remain relatively scarce compared to basic research, the impact of factors directly regulated by lipid metabolism on clinical outcomes is analyzed. Based on this, their relationship with oxaliplatin efficacy is inferred, and potential directions for future clinical research are highlighted. Expert opinion/commentary By summarizing the relationship between lipid metabolism and oxaliplatin resistance, this review provides an important theoretical basis for improving chemotherapy efficacy in colorectal cancer and developing novel combination therapies based on metabolic interventions.