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Mechanisms of chemoresistance in OS. 1, Decreased intracellular drug accumulation mediated by lower RFC. 2, Increased efflux of drugs through P-GP. 3, Drug inactivation by GSTP1. 4, Enhanced DNA repair by APE1 or ERCC. 5, miRNA dysregulation. OS, osteosarcoma; RFC, reduced folate carrier; P-GP, P-glycoprotein; GSTP1, glutathione S-transferase P1; APE1, apurinic endonuclease 1; ERCC, excision repair cross-complementing; miRNA, microRNAs.
