Cited by 453Drug Transport and Resistance MechanismsAntibiotic Resistance in BacteriaPharmacogenetics and Drug Metabolism

Inhibition of the Multidrug Resistance P-Glycoprotein: Time for a Change of Strategy?

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Callaghan, Richard, Luk, Frederick, Bebawy, Mary·2014·Drug Metabolism and Disposition

Abstract

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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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)
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
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

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