Fe-MOF nanoplatform: Specifically overcoming oxaliplatin resistance in colorectal cancer through multifaceted pathways

Oxaliplatin (OXA) is a widely used chemotherapy drug for advanced colorectal cancer (CRC), yet resistance frequently and rapidly develops in patients. Here, we explored a Fe-based metal-organic framework (Fe-MOF) as a nanoplatform to simultaneously deliver OXA and a nitric oxide (NO) donor, specifically L-Arginine (L-Arg). The aim was to overcome OXA resistance in CRC cells, thereby enhancing the anticancer efficacy against drug-resistant CRC. Due to the abundant glutathione (GSH) in tumor tissue, Fe3+ in Fe-MOF undergoes reduction to Fe2+, causing the collapse of Fe-MOF structure and the subsequent release of OXA and L-Arg. This process is accompanied by GSH depletion, amplifying the effectiveness of OXA against drug-resistant CRC. Fe2+ further reacts with overexpressed H2O2 to generate •OH, inducing direct cell apoptosis and subsequently reacting with L-Arg to rapidly produce NO. NO plays multifaceted roles in the anti-CRC effect, reversing drug resistance in CRC cells through multiple pathways, inducing CRC cells to initiate gas therapy, and reacting with •OH to generate highly toxic reactive nitrogen species for cancer cell destruction. This synergistic strategy effectively addresses the challenge of drug resistance in CRC, offering a promising avenue for enhancing the clinical effectiveness of OXA in cases resistant to conventional treatment.