Summary Using a doxorubicin-resistant subline (K562/ADM) of human leukaemia K562 cells (Tsuruo et al, 1986), the effect of immunoliposomes that targeted a cellular transferrin receptor (TFR) was examined by neutralization of doxorubicin (DOX) resistance. OKT9-CIL, prepared by conjugation of DOX-encapsulated liposome with an anti-TFR monoclonal antibody, OKT9 (Aisenberg and Wilkes, 1980), showed similar binding to both K562 and K562/ADM. Although an 80-fold higher sensitivity to free DOX on cell growth inhibition in K562 than in K562/ADM was found, the difference was clearly diminished after OKT9-CIL treatment through the increased sensitivity of K562/ADM. The cellular DOX level 30 min after the exposure of free DOX was 45-fold lower in K562/ADM than in K562, whereas nearly equivalent DOX levels were detected in K562 and K562/ADM after OKT9-CIL treatment. In addition, DOX in K562/ADM in the free DOX treatment was efficiently excreted by 54% within 120 min of incubation, whereas almost all DOX supplied by OKT9-CIL remained uncleared. Fluorescence microscopic observation showed that OKT9-CIL was internalized into juxtanuclear vesicles in K562/ADM cells. These results suggest that OKT9-CIL has a potency to accumulate DOX, resulting in augmentation of DOX cytotoxicity in DOX-resistant tumour cells.Keywords: transferrin receptor, doxorubicin, immunoliposomes, multidrug resistance, endocytosis, cancer chemotherapy Multidrug resistance is one of the major factors decreasing the efficacy of tumour chemotherapy (Harris and Hochhauser, 1992). This phenomenon is at least partly mediated by P-glycoprotein, which is highly associated with a membrane factor of various tumour cells. Cellular P-glycoprotein exerts its effect through a pump that excretes intracellular anti-tumour drugs (Gros et al, 1986).We have shown that liposomes encapsulating DOX (chemoimmunoliposomes, CILs), which target tumour-associated antigens, immunoselectively bind to the corresponding tumour cells and are then internalized, resulting in an increase in the intracellular level of DOX (Tanaka et al, 1989;Suzuki et al, 1994 Suzuki et al, , 1995a. Thus CIL-targeting cells with multidrug-resistant phenotype could lead to a distinct intracellular DOX distribution that may result in the decreased excretion of DOX. A membrane transferrin receptor (TFR) is associated with cell growth in malignant cells and some normal cells (Hamilton et al, 1979;Trowbridge and Omary, 1981) and is internalized into cells by endocytosis through the binding of transferrin or anti-TFR antibodies (Weissman et al, 1986;Esserman et al, 1989;Girones and Davis, 1989). Thus TFR possess properties suitable for a target antigen for endocytosis of CILs.In the present study, changes in the intracellular fate of DOX and its cell growth-inhibitory effect were determined after exposure of a DOX-resistant human leukaemia cell to an anti-TFR CIL. The results obtained indicated a possible advantage of the approach for overcoming multidrug resistance in tumour cells.