Fe-MOF nanoplatform: Specifically overcoming oxaliplatin resistance in colorectal cancer through multifaceted pathways

Oxaliplatin (OXA) is a widely used chemotherapy drug for advanced colorectal cancer (CRC), yet resistance frequently and rapidly develops in patients. Here, we explored a Fe-based metal-organic framework (Fe-MOF) as a nanoplatform to simultaneously deliver OXA and a nitric oxide (NO) donor, specifically l-Arginine (L-Arg). The aim was to overcome OXA resistance in CRC cells, thereby enhancing the anticancer efficacy against drug-resistant CRC. Due to the abundant glutathione (GSH) in tumor tissue, Fe³⁺ in Fe-MOF undergoes reduction to Fe²⁺, causing the collapse of Fe-MOF structure and the subsequent release of OXA and L-Arg. This process is accompanied by GSH depletion, amplifying the effectiveness of OXA against drug-resistant CRC. Fe²⁺ further reacts with overexpressed H₂O₂ to generate ^•OH, inducing direct cell apoptosis and subsequently reacting with L-Arg to rapidly produce NO. NO plays multifaceted roles in the anti-CRC effect, reversing drug resistance in CRC cells through multiple pathways, inducing apoptosis of CRC cells to initiate gas therapy, and reacting with ^•OH to generate highly toxic reactive nitrogen species for cancer cell destruction. This synergistic strategy effectively addresses the challenge of drug resistance in CRC, offering a promising avenue for enhancing the clinical effectiveness of OXA in cases resistant to conventional treatment.