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Multidrug resistance in lymphomas

A R Yuen¹, B I Sikic

¹Department of Medicine, Stanford University School of Medicine, CA.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

|November 1, 1994

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Multidrug resistance (MDR) significantly impacts lymphoma treatment outcomes. Clinical trials exploring MDR modulators show promise but require more effective and safer agents for improved patient survival.

Area of Science:

Oncology
Pharmacology

Background:

Multidrug resistance (MDR) poses a significant challenge in treating human lymphomas.
The mdr1 gene and its product, P-glycoprotein (P-gp), are key mediators of MDR.

Purpose of the Study:

To examine the role of MDR in human lymphomas.
To review current clinical trials investigating MDR modulators.

Main Methods:

Literature search for studies on MDR expression and modulation in lymphomas.
Summary of detection methods for mdr1 gene expression (rt-PCR) and P-gp (immunohistochemistry, flow cytometry).
Review of clinical trials using MDR modulators like verapamil and cyclosporine.

Main Results:

MDR expression is low in untreated lymphomas (10-20%) but increases significantly in recurrent disease (50-70%).

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MDR expression may be a prognostic indicator for chemotherapy response and survival.

Early trials with verapamil and cyclosporine showed some MDR modulation but were limited by toxicity.

Conclusions:

MDR is a critical factor in lymphoma progression.
Further research and development of potent, less toxic MDR modulators are essential for improving lymphoma treatment efficacy.