A comprehensive review on overcoming the multifaceted challenge of cancer multidrug resistance: The emerging role of mesoporous silica nanoparticles
Adel Mahmoudi Gharehbaba, Fatemeh Soltanmohammadi, Somayeh Vandghanooni, Morteza Eskandani, Khosro Adibkia
Abstract
Multidrug resistance (MDR) is a significant challenge in tumor treatment, severely reducing the effectiveness of anticancer drugs and contributing to high mortality rates. This article overviews the various factors involved in the development of MDR, such as changes in drug targets, increased DNA repair mechanisms, and the impact of the tumor microenvironment. It also emphasizes the potential of mesoporous silica nanoparticles (MSNs) as a drug delivery system to combat MDR. With their unique characteristics—such as a high surface area, adjustable pore sizes, and the ability to be functionalized for targeted delivery—MSNs serve as excellent carriers for the simultaneous delivery of chemotherapeutics and siRNAs aimed at reversing resistance pathways. The paper focuses on innovative methods using MSNs for direct intranuclear delivery of their cargos to overcome efflux barrier and improve the effectiveness of combination therapies. This review highlights a promising approach for enhancing cancer treatment outcomes by integrating advanced nanotechnology with traditional therapies, addressing the ongoing challenge of MDR in oncology. • This review focuses on the critical challenge of MDR in cancer therapy and its impact on treatment efficacy. • MSNs enhance drug delivery by improving therapeutic agents' bioavailability with unique properties as innovative carriers. • Discusses the potential of MSNs in combination with photothermal and photodynamic therapies to overcome MDR pathways. • Identifies future directions, including synthesis optimization, combination strategies, and regulatory considerations. • Highlights the importance of translating nanotechnology solutions for clinical use to improve outcomes in cancer treatment.