Inhibition of the Multidrug Resistance P-Glycoprotein: Time for a Change of Strategy?
Open accessAbstract
P-glycoprotein (P-gp) is a key player in the multidrug-resistant phenotype in cancer. The protein confers resistance by mediating the ATP-dependent efflux of an astonishing array of anticancer drugs. Its broad specificity has been the subject of numerous attempts to inhibit the protein and restore the efficacy of anticancer drugs. The general strategy has been to develop compounds that either compete with anticancer drugs for transport or act as direct inhibitors of P-gp. Despite considerable in vitro success, there are no compounds currently available to "block" P-gp-mediated resistance in the clinic. The failure may be attributed to toxicity, adverse drug interaction, and numerous pharmacokinetic issues. This review provides a description of several alternative approaches to overcome the activity of P-gp in drug-resistant cells. These include 1) drugs that specifically target resistant cells, 2) novel nanotechnologies to provide high-dose, targeted delivery of anticancer drugs, 3) compounds that interfere with nongenomic transfer of resistance, and 4) approaches to reduce the expression of P-gp within tumors. Such approaches have been developed through the pursuit of greater understanding of resistance mediators such as P-gp, and they show considerable potential for further application.
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Lactam 4 has a further advantage over the diacetonide of 20E, namely it would likely be free from potential adverse effects and unwanted drug-drug interactions connected to P-gp inhibitors.
“this compound has a further advantage over the diacetonide of 20E, namely that it would likely be free from the potential adverse effects and unwanted drug-drug interactions”
From Nitrogen-containing ecdysteroid derivatives vs. multi-drug resistance in cancer: Preparation and antitumor activity of oximes, oxime ethers and a lactam (2018) · cites this paper as [27]
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- Authors
- Callaghan, R., Luk, F., & Bebawy, M.
- Affiliations
- University of Technology Sydney (AU)
- Venue
- Drug Metabolism and Disposition
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 42
- Issue
- 4
- Pages
- 623-631
- ISSN
- 0090-9556 (ISSN-L)
- PMC
- PMC3965902
- OpenAlex
- W2152368724
- Cited by
- 453
- References
- 169
- Citations by year
- 2026: 28 · 2025: 48 · 2024: 41 · 2023: 38 · 2022: 33 · 2021: 52 · 2020: 40 · 2019: 43 · 2018: 37 · 2017: 43 · 2016: 24 · 2015: 21 · 2014: 1
- FWCI
- 14.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Drug Metabolism and Disposition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Funders
- Wellcome Trust (094392/Z/10/Z)
- Topics
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Keywords
- P-glycoprotein, multidrug resistance, cancer chemotherapy resistance, P-glycoprotein inhibitors, drug efflux, targeted drug delivery, nanotechnology, adverse drug interactions, pharmacokinetics
- MeSH terms
- Animals, Antineoplastic Agents, Biological Transport, Humans, Neoplasms, Substrate Specificity, Drug Delivery Systems, Drug Resistance, Multiple, Drug Resistance, Neoplasm, ATP Binding Cassette Transporter, Subfamily B, Member 1
About these checks
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