Natural products and derivatives hold promise to improve treatment of unresponsive tumours.

Abstract

Multidrug resistance (MDR) is a significant barrier to cancer treatment. Various mechanisms contribute to MDR development, including failure of apoptosis, angiogenesis, progression of cancer stem cells and drug efflux. Resistant cells often exhibit multiple genetic and epigenetic alterations. Identifying suitable chemical compounds to modulate or inhibit MDR is a slow and complex process. Natural products possess unique characteristics including, no toxicity, selective effects and good tolerance in the human body that make them more effective MDR modulators than synthetic drugs. Biologically active components from plants, bacteria, marine organisms, insects and honey can enhance cancer treatment outcomes by inducing apoptosis, inhibiting ATP-binding cassette transporters, reducing angiogenesis, eliminating cancer stem cells and restoring epigenetic patterns. Natural compounds may also serve as effective adjuvants to traditional chemotherapy, helping to manage drug resistance in patients.