Dietary factors may influence the clinical outcome of chemotherapy in cancer multidrug resistance

Abstract

A substantive burden of cancer mortality results from poor prognosis of the disease due to the failure of chemotherapeutic regimen under the influence of Multidrug Resistance (MDR). The outcome of chemotherapy which is the most effective treatment for patients with cancer is impeded by the development of drug resistance. Anticancer drugs can fail to kill cancer cells for various reasons that include variations in the absorption, metabolism, and delivery of drug to target tissues and tumor location in parts of the body into which the drugs do not easily penetrate. In addition, certain cancer cells develop resistance by micro-evolutionary means through mutations occurring in the drug target, thus rendering the drugs ineffective. However, the most common of these mechanisms is the efflux of hydrophobic drugs mediated by energy driven ATP-binding cassette (ABC) family of transporters such as P-glycoprotein (P-gp), an integral membrane protein over-expressed in several malignancies. Various generations of MDR modulators have presented novel and improved interventions, though not to the perfection. Studies have shown that natural compounds found in vegetables, fruits, plant-derived beverages, and herbal dietary supplements not only have anticancer properties but may also modulate P-gp activity. P-gp inhibitors found in natural products, especially those found in plants of dietary origin and traditional medicine, have the potential to be developed as MDR reversing agents as adjuvant to chemotherapy leading to better clinical prognosis.