title: Overcoming multidrug resistance with nanomedicines.
abstract: BACKGROUND
  Cancer remains the leading cause of death worldwide. Numerous therapeutic strategies that include smart biological treatments toward specific cellular pathways are being developed. Yet, inherent and acquired multidrug resistance (MDR) to chemotherapeutic drugs remains the major obstacle in effective cancer treatments.
  
  
  METHODS
  Herein, we focused on an implementation of nanoscale drug delivery strategies (nanomedicines) to treat tumors that resist MDR. Specifically, we briefly discuss the MDR phenomenon and provide structural and functional characterization of key proteins that account for MDR. We next describe the strategies to target tumors using nanoparticles and provide a mechanistic overview of how changes in the influx:efflux ratio result in overcoming MDR.
  
  
  CONCLUSIONS
  Various strategies have been applied in preclinical and clinical settings to overcome cancer MDR. Among them are the use of chemosensitizers that aim to sensitize the cancer cells to chemotherapeutic treatment and the use of nanomedicines as delivery vehicles that can increase the influx of drugs into cancer cells. These strategies can enhance the therapeutic response in resistant tumors by bypassing efflux pumps or by increasing the nominal amounts of therapeutic payloads into the cancer cells at a given time point.
authors.affiliation: The Interdisciplinary Center (IDC) , P.O. Box 167, Herzliya 46150 , Israel.
authors.forename: Assaf
authors.initials: A
authors.lastname: Ganoth
authors.forename: Keren Cohen
authors.initials: KC
authors.lastname: Merimi
authors.forename: Dan
authors.initials: D
authors.lastname: Peer
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D016503:Drug Delivery Systems; D018432:Drug Resistance, Multiple; D019008:Drug Resistance, Neoplasm; D006801:Humans; D050997:Nanomedicine; D053758:Nanoparticles; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: cancer multidrug resistance; drug targeting; multidrug resistance efflux pumps; nanomedicine