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Multidrug Resistance in Cancer: Molecular Mechanisms and Therapeutic Challenges

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Biology".

Deadline for manuscript submissions: 20 April 2026 | Viewed by 3304

Special Issue Editors


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Guest Editor
UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS)—CESPU, 4585-116 Gandra, Portugal
Interests: cancer cell metabolism; multidrug resistance in cancer cells; PGP activity; pH regulators in cancer; new anticancer drugs
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
2. Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, 4585-116 Gandra, Portugal
3. UCIBIO—Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal
Interests: anticancer strategies; targeted therapy; cancer biomarkers; mitosis; apoptosis; drug discovery; bioactive compounds
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cancer is a major cause of morbidity and mortality worldwide. Despite significant and ongoing progress in new and sophisticated therapies, treatment failure and disease recurrence remain a reality and a serious concern. Advances in identifying more specific tumor targets have led to the discovery of a host of novel compounds and innovative treatments that are more selective in identifying cancer cells and more effective at eliminating them. Nevertheless, the effectiveness of many antitumor treatments remains limited, presenting modest efficacy and resulting in the development of the MultiDrug Resistance (MDR) phenotype—a major contributor in treatment failure. The MDR defines a phenotype, either intrinsic or acquired through treatment, in which cancer cells become resistant to multiple drugs, even those with no clear structural similarity and/or that act on different molecular targets. MDR involves multiple mechanisms and molecular players, including pharmacological factors, tumor microenvironment characteristics, and intracellular mechanisms. Thus, a deeper investigation into the biological mechanisms underlying this phenotype, as well as the search for novel compounds capable not only of targeting and eliminating cancer cells but also of overcoming cellular resistance, remains critical. Despite being extensively studied, the precise role of various factors involved in MDR is far from being clarified, and new compounds able of reversing this phenotype are urgently needed.

In this Special Issue, we aim to collect review or original manuscripts covering the main mechanisms contributing to cancer resistance, including pharmacologic, microenvironment, and intracellular mechanisms. Additionally, we welcome studies focused on the development and characterization of novel and effective drugs and therapeutic strategies, either alone or in combination, that show promise in overcoming MDR and create new opportunities for cancer treatment. We therefore encourage the submission of research in this area as original research articles, review papers, or short communications.

Dr. Odília Queirós
Dr. Patrícia M. A. Silva
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • cancer therapy
  • MultiDrug Resistance (MDR)
  • Pgp
  • efflux pumps
  • tumor microenvironment
  • anticancer drug target
  • combination therapy
  • novel anticancer agents

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Published Papers (2 papers)

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Review

59 pages, 1662 KB  
Review
BCL-2 and BCL-xL in Cancer: Regulation, Function, and Therapeutic Targeting
by João P. N. Silva, Bárbara Pinto, Patrícia M. A. Silva and Hassan Bousbaa
Int. J. Mol. Sci. 2026, 27(2), 1123; https://doi.org/10.3390/ijms27021123 - 22 Jan 2026
Viewed by 920
Abstract
The BCL-2 family of proteins plays a central role in the regulation of apoptosis, with BCL-2 and BCL-xL representing two of its most prominent antiapoptotic members. This review explores the molecular regulation of BCL-2 and BCL-xL genes, emphasizing the structural domains that define [...] Read more.
The BCL-2 family of proteins plays a central role in the regulation of apoptosis, with BCL-2 and BCL-xL representing two of its most prominent antiapoptotic members. This review explores the molecular regulation of BCL-2 and BCL-xL genes, emphasizing the structural domains that define the functions of the broader BCL-2 family. Beyond their canonical roles in preventing mitochondrial outer membrane permeabilization, both proteins contribute significantly to cancer development. Their overexpression enhances invasiveness and tumor progression, supports angiogenesis, and critically modulates cellular responses to chemotherapy, often conferring drug resistance. Additional non-apoptotic functions, including roles in metabolism, mitochondrial dynamics, and cellular homeostasis, further expand their biological relevance. Clinical trials exploring strategies to inhibit BCL-2 and BCL-xL, including selective BH3 mimetics and combination regimens, are discussed with emphasis on their potential and limitations in oncology. Overall, this review highlights the multifaceted contributions of BCL-2 and BCL-xL to cancer biology and underscores the importance of continued efforts to refine targeted therapeutic approaches. Full article
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21 pages, 832 KB  
Review
The Managed Acquisition of Chemoresistance as an Informative Tool for Tumor Research
by Tatyana A. Grigoreva, Daria N. Kindt, Aleksandra V. Sagaidak, Angelina A. Romanova and Vyacheslav G. Tribulovich
Int. J. Mol. Sci. 2025, 26(21), 10400; https://doi.org/10.3390/ijms262110400 - 26 Oct 2025
Viewed by 969
Abstract
The problem of acquiring chemoresistance by tumor cells is a growing concern for researchers as the effectiveness of diagnosis and treatment of primary tumors increases. To study the mechanisms of resistance, as well as to evaluate the effectiveness of new drugs, it is [...] Read more.
The problem of acquiring chemoresistance by tumor cells is a growing concern for researchers as the effectiveness of diagnosis and treatment of primary tumors increases. To study the mechanisms of resistance, as well as to evaluate the effectiveness of new drugs, it is necessary to use adequate cell models. The review presents modern methods for obtaining chemoresistant cell lines used by researchers in such studies. It examines the most common cytostatics and targeted drugs, such as cisplatin, oxaliplatin, paclitaxel, doxorubicin, 5-fluorouracil, gemcitabine, gefitinib, bortezomib, erlotinib, and the monoclonal antibody cetuximab. Particular attention is paid to cell mechanisms activated due to drug resistance development and to methods of cell cultivation in the presence of drugs. The presented information provides an opportunity to discuss trends in the creation of chemoresistant cell lines for further research on resistance mechanisms and the development of new therapeutic strategies. Full article
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