What is MDR?
MDR is defined as the development of cross-resistance to chemotherapeutic drugs with chemically distinct structures. It is known that most of the recurrence cases and also the metastasis are due to presence of MDR cancer cells within tumor tissue. Some of these cells are defined as cancer stem cells, which may remain dormant for years circulating in the bloodstream, and reappear either in the primary cancer site or in a distant tissue, where they initiate a new tumor formation in the following years. These recurrent cases are the main cause for mortality, as these cells are usually resistant to chemotherapeutics. It has been reported that breast cancer survivors continue to have a substantial risk of disease recurrence after 5 years of systemic therapy. Among breast cancer patients who were cancer free for 5 years after initiating systemic therapy, 89% remained recurrence-free in the following five years, and 80% remained recurrence-free in the following 10 years.
Currently, there is no rapid detection system for the MDR. It is usually observed when the patients do not respond to chemotherapy and when the tumor progression continues even though the treatment is underway. Once it is diagnosed, a modulatory therapy has been applied, in which an MDR protein inhibitor is used in combination with chemotherapy. However, this extends the duration of treatment and lowers the survival chance, as the number of resistant cells increases during this period. Hence, the detection of MDR in cancer is extremely critical both during initial diagnosis and treatment of disease. Early detection of MDR would decrease the treatment period and hence the associated cost, and increase the success of treatment significantly.
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