Multidrug resistance in brain tumors: roles of the blood-brain barrier

Cancer Metastasis Rev. 2001;20(1-2):13-25. doi: 10.1023/a:1013104423154.


Malignant brain tumors and brain metastases present a formidable clinical challenge against which no significant advances have been made over the last decade. Multidrug resistance (MDR) is one of the main factors in the failure of chemotherapy against central nervous system tumors. The MDR1 gene encoding P-glycoprotein (P-gp), a drug efflux pump which plays a significant role in modulating MDR in a wide variety of human cancers, is highly expressed in the blood-brain barrier (BBB). The BBB controls central nervous system exposure to many endogenous and exogenous substances. The exact molecular mechanisms by which the BBB is involved in the resistance of brain tumors to chemotherapy remain to be identified. The purpose of this review is to summarize reports demonstrating that P-gp, one of the most phenotypically important markers of the BBB, is present in primary brain tumors and thus plays a crucial role in their clinical resistance to chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / metabolism
  • Antineoplastic Agents / therapeutic use*
  • Blood-Brain Barrier*
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / metabolism
  • Drug Resistance, Multiple*
  • Drug Resistance, Neoplasm*
  • Humans
  • Multidrug Resistance-Associated Proteins / metabolism


  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Antineoplastic Agents
  • Multidrug Resistance-Associated Proteins