RESISTANCE TO CHEMOTHERAPY IN RENAL-CELL CANCER AND THERAPEUTIC PROSPECTIVES

Usual treatments combining surgery, radiation therapy, chemotherapy an d hormonotherapy are poorly effective. The immunotherapy gave and obje ctive response rats of 25 % but is associated with many side effects. Multidrug resistance (MDR) can be explained, in part, by an mdr1 gene overexpression in renal carcinoma. The MDR is related to expression of a 170 Kda membrane glycoprotein, the so-called P glycoprotein (Pgp). This protein is able to extrude from cytoplasm drugs with various stru ctures and mechanisms. Reversal compounds capable of inhibiting Pgp, g iven with antineoplastic drugs, could be able to increase their intrac ellular concentrations. Nevertheless, renal cell carcinomas are charac terized by their multifactorial resistance and a better knowledge in t his field will allow to design new circumvention resistance to chemoth erapy.