Just to refresh the memories of the readers: MDR1 refers to the gene and P-glycoprotein (Pgp) is its product located in cell membranes, capable of exporting a variety of unrelated chemotherapeutic agents. This mechanism is widespread and protects normal cells from unwanted toxic levels of anything occurring in the environment. It becomes a serious obstacle to successful cancer chemotherapy, when drug resistance is either innate in the cancer cells or acquired during exposure to cytotoxic or cytostatic agents. There have been innumerable efforts conducted to sensitize such resistant cancer cells by interfering with the Pgp efflux pump. Most of the substances used act only at impractical high levels or are simply inefficient in vivo. A novel approach has been proposed to prevent the development of drug resistance in response to therapy, by pre-treatment with cyclooxygenase inhibitors.
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