Multidrug Resistance in Cancer: Understanding Molecular Mechanisms, Immunoprevention and Therapeutic Approaches

Cancer is one of the leading causes of death worldwide. Several treatments are available
for cancer treatment, but many treatment methods are ineffective against multidrug�resistant cancer. Multidrug resistance (MDR) represents a major obstacle to effective
therapeutic interventions against cancer. This review describes the known MDR
mechanisms in cancer cells and discusses ongoing laboratory approaches and novel
therapeutic strategies that aim to inhibit, circumvent, or reverse MDR development in
various cancer types. In this review, we discuss both intrinsic and acquired drug
resistance, in addition to highlighting hypoxia- and autophagy-mediated drug resistance
mechanisms. Several factors, including individual genetic differences, such as mutations,
altered epigenetics, enhanced drug efflux, cell death inhibition, and various other
molecular and cellular mechanisms, are responsible for the development of resistance
against anticancer agents. Drug resistance can also depend on cellular autophagic and