[Multiple drug resistance--theoretical and clinical aspects].

A major problem in the treatment of cancer is clinical resistance to chemotherapeutic drugs. Multi-drug resistance (MDR) is a well-studied experimental phenomenon which seems to play an important role in clinical resistance to drugs. Tumour cells selected for resistance to a "natural product" anticancer drug display crossresistance to a variety of structurally and functionally unrelated anticancer drugs. Such resistant cells accumulate and retain less drug than retained by their drug sensitive counterparts. This lower grade of accumulation is most likely mediated by P-glycoprotein, an integral membrane protein which functions as an energy-dependent efflux pump. It has now become clear that several lipophilic agents can reverse MDR both in vitro and in vivo. Clinical trials with such modulators (chemosensitizers) have already given promising results.