The emergence of resistance to multiple unrelated chemotherapeutic drugs impedes the treatment of several cancers. Although the involvement of ATP-binding cassette transporters has long been known, there is no in situ method capable of tracking this transporter-related resistance at the single-cell level without interfering with the cell's environment or metabolism. Here, we demonstrate that scanning electrochemical microscopy (SECM) can quantitatively and noninvasively track multidrug resistance-related protein 1-dependent multidrug resistance in patterned adenocarcinoma cervical cancer cells. Nonresistant human cancer cells and their multidrug resistant variants are arranged in a side-by-side format using a stencil-based patterning scheme, allowing for precise positioning of target cells underneath the SECM sensor. SECM measurements of the patterned cells, performed with ferrocenemethanol and [Ru(NH 3 ) 6 ] 3+ serving as electrochemical indicators, are used to establish a kinetic "map" of constant-height SECM scans, free of topography contributions. The concept underlying the work described herein may help evaluate the effectiveness of treatment administration strategies targeting reduced drug efflux.ancer cells, such as lung cancer or leukemia, acquire resistance to multiple unrelated drugs in response to treatment with chemotherapeutic agents (1, 2). Resistance impedes therapeutic effectiveness, which in turn, reduces the long-term survival rate of cancer patients (2). The emergence of multidrug resistance (MDR) involves the overexpression of transmembrane proteins P-glycoprotein (P-gp) and MDR-related protein 1 (MRP1), which both belong to the family of 5′-triphosphatebinding cassette transporters (known as ABC transporters). P-gp and MRP1 act as molecular "pumps," actively removing therapeutic agents from the cancer cells, thereby preventing the drug from inducing the desired effect on the cell nucleus or cytoplasm. MDR based on P-gp is relatively well understood and involves binding of hyaluronan to the cell surface glycoprotein CD44. The resulting up-regulation of the transcriptional cofactor p300 expression and therefore the NFkappaB-specific transcriptional up-regulation lead to the production of P-gp, and with that chemoresistance in cells (3). However, the mechanism that causes MRP1-mediated MDR remains unclear.Currently, quantification of MDR relies on immunohistochemical analyses, such as real-time PCR, focusing mostly on P-gp or other members of ABC transporters (4-9). Fluorescent MRP1-specific studies were also conducted, revealing that resistant and nonresistant cancer cells have differential intracellular content of glutathione and GST, which affect their cell death mechanism during hyperthermia (10). Microvoltammetry was also used to measure the efflux of chemotherapeutic drugs from normal and MDR cancer cells on the single-cell level, with detection limits in the nanomolar range (11). Finally, flow cytometry has routinely been used to quantify and compare expression levels and activity of dif...