Abstract
Multidrug resistance (MDR) of tumors is one of the clinical direct reasons for chemotherapy failure. MDR directly leads to tumor recurrence and metastasis, with extremely grievous mortality. Engineering a novel nano-delivery system for the treatment of MDR tumors has become an important part of nanotechnology. Herein, this review will take those different mechanisms of MDR as the classification standards and systematically summarize the advances in nanotechnology targeting different mechanisms of MDR in recent years. However, it still needs to be seriously considered that there are still some thorny problems in the application of the nano-delivery system against MDR tumors, including the excessive utilization of carrier materials, low drug-loading capacity, relatively narrow targeting mechanism, and so on. It is hoped that through the continuous development of nanotechnology, nano-delivery systems with more universal uses and a simpler preparation process can be obtained, for achieving the goal of defeating cancer MDR and accelerating clinical transformation.
Highlights
Cancer is still a worldwide malignant disease
Repeated treatments of chemotherapeutics lead to multiple drug resistance of tumor cells (Kibria et al, 2014) so that patients with malignant tumors may initially respond to the first-line chemotherapy strategy; their tumor growth is obviously inhibited, but they often have cancer metastasis or recurrence; second-and third-line chemotherapy or other treatments are needed (Wu et al, 2010; Shapira et al, 2011; Brufsky et al, 2012)
This review will focus on the different mechanisms of multidrug resistance and systematically summarize the relevant progress of nanoscale drug delivery systems (NDDSs) which are utilized for synergistically treating tumors effectively and reversing multidrug resistance in recent 3 years, to provide references for exploring the generation NDDSs targeting Multidrug resistance (MDR)
Summary
Cancer is still a worldwide malignant disease. According to the latest statistics of CA 2021 (CA: A Cancer Journal for Clinicians), by 2020, the number of cancer deaths in the world had reached 9.96 million (Sung et al, 2021). With the developments in cancer pathology, the research on chemotherapeutic drugs developed for cancer has obtained tremendous advances. Repeated treatments of chemotherapeutics lead to multiple drug resistance of tumor cells (Kibria et al, 2014) so that patients with malignant tumors (such as non–small cell lung cancer and triple-negative breast cancer) may initially respond to the first-line chemotherapy strategy; their tumor growth is obviously inhibited, but they often have cancer metastasis or recurrence; second-and third-line chemotherapy or other treatments are needed (Wu et al, 2010; Shapira et al, 2011; Brufsky et al, 2012). Finding a broad and effective treatment strategy to reverse multidrug resistance is a very important topic in tumor treatment research. It has been proven that the mechanisms of tumor multidrug resistance mainly include ATPdependent drug efflux, DNA repair, inhibition of the apoptosis pathway, and tumor tissue heterogeneity in recent years (Figure 1)
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