Multi-drug resistance and cancer

Development of drug resistance during chemotherapy is the leading cause of treatment failure and decreased survival in cancer patients. Drug resistance can occur in many ways, such as altering the targets or the metabolism of the drug, and multi-drug resistance is one of the most extensively studied forms for >30 years. The members of the ATP-binding cassette protein family are responsible for multi-drug resistance. There has been a tremendous amount of work done to overcome multi-drug resistance, but real success has not been achieved to date. Pharmacological modulation of the transporters seems to be the first choice, but the effectivity observed in preclinical studies did not translate into a success in clinical applications with the agents developed for this purpose. New strategies to increase the drug efficacy will be the manipulating of multi-drug resistance genes at transcriptional or translational level or targeting mutant genes and replacing or destroying them, rendering the drug resistance proteins ineffective. The research should be directed to the individualised therapies to overcome drug resistance in the future.