{"entity":{"id":"efflux-pump","kind":"term","name":"Drug efflux pumps (ABC transporters)","aka":[],"tldr":"Molecular pumps on cancer cells that eject chemotherapy and ADC payloads before they can act.","summary":"Drug efflux pumps are ABC transporters on cancer cells that eject chemotherapy and ADC payloads before they can act. The main ones are ABCB1 (P-glycoprotein or MDR1), ABCG2 (BCRP) and ABCC1 (MRP1), with substrates including taxanes, anthracyclines, MMAE, DXd and, for ABCG2, SN-38. They are upregulated in mesenchymal and stem-like states, hence the term's place in the Epithelial-mesenchymal transition & drug efflux pathway; some newer payloads and radiation are efflux-independent, whereas pump inhibitors failed clinically because of toxicity. It is linked to the Antibody-drug conjugate (ADC) and Cytotoxic chemotherapy technologies, to the bottleneck Acquired resistance to every therapy, and to ideas on payload-class switching and efflux-agnostic therapy for mesenchymal TNBC.","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/P-glycoprotein","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/P-glycoprotein"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["adc","cytotoxic-chemotherapy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":["emt"],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Resistance"},"route":"/terms/efflux-pump/","neighbours":{"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"pathway":[{"id":"drug-efflux-pumps","kind":"pathway","name":"Drug efflux pumps (ABC transporters)","route":"/pathways/drug-efflux-pumps/"},{"id":"emt","kind":"pathway","name":"Epithelial-mesenchymal transition & drug efflux","route":"/pathways/emt/"},{"id":"keap1-nrf2","kind":"pathway","name":"KEAP1-NRF2 antioxidant pathway","route":"/pathways/keap1-nrf2/"},{"id":"resistance-routes-map","kind":"pathway","name":"Resistance routes: how a blocked pathway comes back","route":"/pathways/resistance-routes-map/"},{"id":"blood-brain-barrier-metastasis","kind":"pathway","name":"The blood-brain barrier & brain metastasis","route":"/pathways/blood-brain-barrier-metastasis/"}],"drug":[{"id":"cabazitaxel","kind":"drug","name":"Cabazitaxel","route":"/drugs/cabazitaxel/"}],"term":[{"id":"blood-brain-barrier","kind":"term","name":"Blood-brain barrier (BBB)","route":"/terms/blood-brain-barrier/"},{"id":"cell-membrane","kind":"term","name":"Cell membrane","route":"/terms/cell-membrane/"},{"id":"chemotherapy-term","kind":"term","name":"Chemotherapy","route":"/terms/chemotherapy-term/"},{"id":"dxd","kind":"term","name":"DXd","route":"/terms/dxd/"},{"id":"hydrophilic-next-gen","kind":"term","name":"Hydrophilic next-generation linkers (TMALIN, Dolaflexin, sulfonyl-pyrimidine, PEG-containing)","route":"/terms/hydrophilic-next-gen/"},{"id":"mmae","kind":"term","name":"MMAE","route":"/terms/mmae/"},{"id":"sn-38","kind":"term","name":"SN-38","route":"/terms/sn-38/"},{"id":"t030","kind":"term","name":"T030 (belotecan derivative)","route":"/terms/t030/"},{"id":"topoisomerase-i-payloads","kind":"term","name":"Topoisomerase-I inhibitor payloads","route":"/terms/topoisomerase-i-payloads/"},{"id":"tubulin-inhibitor-payloads","kind":"term","name":"Tubulin inhibitor payloads","route":"/terms/tubulin-inhibitor-payloads/"}],"idea":[{"id":"idea-tr2-resistance-mechanism-baskets","kind":"idea","name":"Combination baskets defined by resistance mechanism rather than by cancer type","route":"/ideas/idea-tr2-resistance-mechanism-baskets/"},{"id":"idea-efflux-agnostic","kind":"idea","name":"Efflux-agnostic therapy for mesenchymal TNBC","route":"/ideas/idea-efflux-agnostic/"},{"id":"idea-payload-switching","kind":"idea","name":"Payload-class switching as the rule for ADC sequencing","route":"/ideas/idea-payload-switching/"},{"id":"idea-tr2-smart-sequencing-adc","kind":"idea","name":"Sequential multiple-assignment randomised trials to find the best order of ADCs","route":"/ideas/idea-tr2-smart-sequencing-adc/"}],"bottleneck":[{"id":"b-resistance","kind":"bottleneck","name":"Acquired resistance to every therapy","route":"/bottlenecks/b-resistance/"}]}}