Nanomedicine therapeutic approaches to overcome cancer drug resistance

Adv Drug Deliv Rev. 2013 Nov;65(13-14):1866-79. doi: 10.1016/j.addr.2013.09.019. Epub 2013 Oct 10.


Nanomedicine is an emerging form of therapy that focuses on alternative drug delivery and improvement of the treatment efficacy while reducing detrimental side effects to normal tissues. Cancer drug resistance is a complicated process that involves multiple mechanisms. Here we discuss the major forms of drug resistance and the new possibilities that nanomedicines offer to overcome these treatment obstacles. Novel nanomedicines that have a high ability for flexible, fast drug design and production based on tumor genetic profiles can be created making drug selection for personal patient treatment much more intensive and effective. This review aims to demonstrate the advantage of the young medical science field, nanomedicine, for overcoming cancer drug resistance. With the advanced design and alternative mechanisms of drug delivery known for different nanodrugs including liposomes, polymer conjugates, micelles, dendrimers, carbon-based, and metallic nanoparticles, overcoming various forms of multi-drug resistance looks promising and opens new horizons for cancer treatment.

Keywords: AML; CAM-DR; CCP; CLL; CNS; CSC; Drug delivery; EGFR; EPR; H(2)N-Leu-Leu-Leu-OH; HIF-1; IGF-1R; IL-2; LLL; MDR; MRP; NF-κB; NSCLC; Nanobiopolymers; Nanodrug; PDGFR-β; PEG; RES; SDF-1/CXCL12; TAT; TG2; TLR; TMZ; TNFα; TfR; Tumor multidrug resistance; acute myeloid leukemia; cancer stem cell; cell adhesion-mediated drug resistance; central nervous system; charge-conversion polymer; chronic lymphocytic leukemia; enhanced permeability and retention; epidermal growth factor receptor; hypoxia-inducible factor 1; insulin-like growth factor 1 receptor; interleukin-2; mAb; monoclonal antibody; multidrug resistance; multidrug-resistance-associated protein; non-small cell lung cancer; nuclear factor κB; platelet-derived growth factor receptor-β; polyethylene glycol; reticuloendothelial system; short interfering RNA; siRNA; stromal cell-derived factor 1; temozolomide; tissue transglutaminase; toll-like receptor; transactivator of transcription; transferrin receptor; tumor necrosis factor α.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / therapeutic use
  • Cell Line, Tumor
  • Clinical Trials as Topic
  • Drug Carriers / chemistry*
  • Drug Design
  • Drug Resistance, Multiple*
  • Drug Resistance, Neoplasm*
  • Humans
  • Nanomedicine / methods*
  • Nanomedicine / trends
  • Nanoparticles / chemistry*
  • Neoplasms / drug therapy
  • Neoplasms / pathology
  • Neoplastic Stem Cells / drug effects
  • Neoplastic Stem Cells / pathology
  • Tumor Microenvironment / drug effects


  • Antineoplastic Agents
  • Drug Carriers