Asian Pac J Cancer Prev, 15 (21), 9249-9258
IntroductionMultidrug resistance (MDR) is a major problem for the success of cancer chemotherapy and is closely associated with treatment failure in the most common forms of cancer, including lung, colon, breast, and cervical cancer (Chang, 2003). Overexpression of P-glycoprotein (P-gp), a 170-kDa plasma membrane transporter, has been identified as one of the major causes of drug resistance in several cancers. P-gp belongs to the superfamily of ATP-binding cassette (ABC) transporters (Chang, 2003) that act as an ATP-dependent efflux pump and has a broad substrate specificity that includes xenobiotics (Bain et al., 1997), etoposide (Burgio et al., 1998), doxorubicin (Shen et al., 2008), vinblastine (Cisternino et al., 2004, and paclitaxel (PTX) (Jang et al., 2001;Gallo et al., 2003). Increased expression of P-gp, the product of the human MDR1 gene, is a well-characterized mechanism used by cancer cells to avoid the cytotoxic action of anticancer drugs. Based on decreases in intracellular drug accumulation by P-gp,