癌症化疗仍然是一个严峻的挑战。化疗药物的耐药性和破坏性副作用是化疗的最关键限制因素。耐药性是化疗失败的主要原因。耐药性是指癌细胞对化疗药物的抗癌效果表现出的抵抗能力，其原因非常复杂。其中最重要的原因之一是由于ABC转运蛋白的表达和活性增加导致化疗药物外流增加、凋亡减弱和干性增强等特征。在过去的十年里，大量研究关注了纳米技术在癌症治疗中的应用。考虑到锌的抗癌性质，氧化锌纳米颗粒近年来受到了广泛关注。一些研究表明，氧化锌纳米颗粒可以针对癌化疗耐药的关键机制，并增强化疗药物的有效性。这些研究表明，氧化锌纳米颗粒可以降低ABC转运蛋白的活性，增加DNA损伤和凋亡，减弱癌细胞的干性，从而提高化疗药物的敏感性。另一些研究还表明，低剂量氧化锌纳米颗粒有助于减小化疗药物的有害副作用。在本文中，我们将在简要概述耐药机制和锌的抗癌作用之后，详细回顾所有这些研究。 © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Cancer chemotherapy is still a serious challenge. Chemo-resistance and destructive side effects of chemotherapy drugs are the most critical limitations of chemotherapy. Chemo-resistance is the leading cause of chemotherapy failure. Chemo-resistance, which refers to the resistance of cancer cells to the anticancer effects of chemotherapy drugs, is caused by various reasons. Among the most important of these reasons is the increase in the efflux of chemotherapy drugs due to the rise in the expression and activity of ABC transporters, the weakening of apoptosis, and the strengthening of stemness. In the last decade, a significant number of studies focused on the application of nanotechnology in cancer treatment. Considering the anti-cancer properties of zinc, zinc oxide nanoparticles have received much attention in recent years. Some studies have indicated that zinc oxide nanoparticles can target the critical mechanisms of cancer chemo-resistance and enhance the effectiveness of chemotherapy drugs. These studies have shown that zinc oxide nanoparticles can reduce the activity of ABC transporters, increase DNA damage and apoptosis, and attenuate stemness in cancer cells, leading to enhanced chemo-sensitivity. Some other studies have also shown that zinc oxide nanoparticles in low doses can be helpful in minimizing the harmful side effects of chemotherapy drugs. In this article, after a brief overview of the mechanisms of chemo-resistance and anticancer effects of zinc, we will review all these studies in detail.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.