Differential synergistic effects of palbociclib and doxorubicin on doxorubicin-resistant cancer cells with diverse tumor origins

Palbociclib is a dual inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6). Palbociclib has frequently been studied in breast cancer cells and has also been linked to function of P-glycoprotein (P-gp), main protein responsible for cancer drug resistance. However, the effect of Palbociclib on cancer drug resistance and specifically doxorubicin-resistant cells overexpressing P-gp have limitedly been studied in the literature. Here, we aimed to decipher the possible synergistic effects of Palbociclib and Doxorubicin combination treatment in doxorubicin-resistant not only breast cancer, which has restrictedly been studied previously, but leukemia and cervical cancer cell lines in the presence of sensitive counterparts to totally explore the mechanistic properties of the Palbociclib in cancer drug resistance. Our results underlined that Palbociclib differentially displayed synergistic effect with doxorubicin in a cell type-specific manner and increased the efficacy of Doxorubicin in Doxorubicin-resistant cells. As a monotherapy, palbociclib has been shown to decrease the expression of MDR-1 in doxorubicin-resistant cells, and when used in combination with doxorubicin, it has been shown to increase the accumulation of doxorubicin in the cell and consequently induce apoptosis. This is the first report that proposes the Palbociclib as a candidate for combination therapy to limit the Doxorubicin resistance in different cancer origins in clinics.