Natural compounds and derivatives as modulators of multidrug resistance and their mechanisms of action: recent studies in vitro, in vivo and in silico

Drug resistance used in chemotherapy is a common challenge in cancer treatment. The present review of resistance-modulating molecules in cancer recapitulates in vitro, in vivo, and in silico studies of flavonoids, lactones, taxanes, curcuminoids, catechins, and chalcones stand out among others. The main mechanisms of action involve inhibiting the overexpression and function of efflux proteins and altering signaling pathways related to resistance. For their part, the discussed in silico studies identified key interactions between modulating molecules and multidrug resistance (MDR) transporters. This information supports research on synthetic modifications to create new scaffolds for reversing MDR and minimizing toxicity.