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Anticancer natural products with collateral sensitivity: a review.

BACKGROUND
Multidrug resistance (MDR) is the resistance of cancer cells against a variety of currently used antineoplastic agents with diverse structural scaffolds and different anticancer mechanisms. It has been recognized as one of the major impediments to successful treatment of cancer, leading to the metastasis and relapse of the malignant diseases.


INTRODUCTION
Collateral sensitivity (CS) is the characteristics of certain chemicals to kill the drug-resistant sublines selectively over the parental cell lines from which the resistant cells were generated. The research and development of new drug candidates with collateral sensitivity will be an efficient approach to conquer multidrug resistance in cancer. We aims to provide an update in the discovery of natural products with collateral sensitivity.


RESULTS AND CONCLUSION
The review focused on the characterized anticancer natural products and their derivatives with collateral sensitivity, their working mechanisms and related structural activity relationships, with the emphasis on recently identified CS compounds. According to their structural features, these MDR-targeting compounds were mainly classified into the following categories: flavonoids, terpenoids, stilbenes, alkaloids and quinones. The exploration of molecular mechanisms of collateral sensitivity and structural features of anticancer agents with collateral sensitivity provided an effective approach for the clinic treatment of MDR in cancer.