Drug resistance is a major challenge to the effective treatment of cancer. We have developed two nanoparticle formulations, cationic liposome-polycation-DNA (LPD) and anionic liposome-polycation-DNA (LPD-II), for systemic co-delivery of doxorubicin (Dox) and a therapeutic small interfering RNA (siRNA) to multiple drug resistance (MDR) tumors. In this study, we have provided four strategies to overcome drug resistance. First, we formed the LPD nanoparticles with a guanidinium-containing cationic lipid, i.e. N,N-distearyl-N-methyl-N-2-(N-arginyl) aminoethyl ammonium chloride, which can induce reactive oxygen species, down-regulate MDR transporter expression, and increase Dox uptake. Second, to block angiogenesis and increase drug penetration, we have further formulated LPD nanoparticles to co-deliver vascular endothelial growth factor siRNA and Dox. An enhanced Dox uptake and a therapeutic effect were observed when combined with vascular endothelial growth factor siRNA in the nanoparticles. Third, to avoid P-glycoprotein-mediated drug efflux, we further designed another delivery vehicle, LPD-II, which showed much higher entrapment efficiency of Dox than LPD. Finally, we delivered a therapeutic siRNA to inhibit MDR transporter. We demonstrated the first evidence of c-Myc siRNA delivered by the LPD-II nanoparticles down-regulating MDR expression and increasing Dox uptake in vivo. Three daily intravenous injections of therapeutic siRNA and Dox (1.2 mg/kg) co-formulated in either LPD or LPD-II nanoparticles showed a significant improvement in tumor growth inhibition. This study highlights a potential clinical use for the multifunctional nanoparticles with an effective delivery property and a function to overcome drug resistance in cancer. The activity and the toxicity of LPDand LPD-II-mediated therapy are compared.The occurrence of drug resistance is a main impediment to the success of cancer chemotherapy. Cancer cells develop different ways to be resistant to chemotherapy drugs. Overexpression of drug transporter proteins, such as P-glycoprotein (P-gp) 2 plays a key role in regulating drug resistance. Development of strategies to down-regulate the expression of P-gp or inhibit P-gp function has been the major subject of cancer research. For example, one of the strategies to overcome MDR is to use carriers like nanoparticles to avoid P-gp-mediated drug efflux. Only the drug presenting in the cell membrane can be effluxed out of the cancer cell. The drug delivered by nanoparticles is internalized in the cytoplasm or the lysosome and not pumped out by P-gp (1). Dox-loaded liposomes are able to overcome MDR by increasing Dox uptake in the nuclei and extending retention in the nuclei of the MDR cells (2, 3). Small interfering RNA (siRNA) is a promising novel approach of cancer therapy. It offers a new strategy to downregulate the targeted oncogene for therapeutic intervention. Systemically delivering siRNA to tumors remains a major hurdle in cancer gene therapy (4, 5). Major problems of siRNA delivery include poor cellula...