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. 2017 Dec 13;7:17524. doi: 10.1038/s41598-017-16085-y

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Proposed metabolism basis underlying the chemo-drug resistance. The correlated events of glycolysis, gluconeogenesis, and glucose-alanine cycle provide protein synthesis materials and energy for cellular platinum efflux and DNA repair; both actions contribute to platinum drug resistance. One mole of glucose breaks down into two mole of pyruvate, during which the net energy obtaining is two mole of ATP. These ATP can be utilized in the activity of DNA repair from the damage of platinum-DNA adducts, as well as the platinum efflux from the cell.