Multidrug resistance (MDR) in tumors hampers effective chemotherapy, driven by multiple molecular pathways. The bioactive compounds in medicine food homology plants (MFHPs) have unique advantages in overcoming MDR by targeting multifaceted mechanisms, including inhibition of ATP-binding cassette (ABC) transporter activity to reduce drug efflux, induction of tumor cell apoptosis, and regulation of the tumor microenvironment. Research has shown that active ingredients in various MFHPs, represented by curcumin, exhibit strong MDR-reversal activity. Their “networked” regulatory mechanism—characterized by synergistic effects of multiple components, targets, and pathways—provides a new approach to overcome drug resistance. Although higher doses of MFHPs are required in combination therapy to achieve comparable intervention effects as traditional reversal agents, they have higher safety and almost no toxic side effects. This characteristic has important clinical value for advanced cancer patients receiving chemotherapy. This review first elaborates on the complex mechanisms underlying the development of MDR, with a focus on summarizing the mechanisms by which active compounds in MFHPs reverse MDR, providing new directions for the development and application of safe MDR-reversal agents.
Bai et al. (Fri,) studied this question.
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