Figure 3.

Different underlying mechanisms associated with drug resistance. This figure shows different intrinsic and extrinsic factors responsible for cancer drug resistance starting from alteration of signaling pathways, remodeling of drug efflux pumps expression, overexpression of genes related to cell cycle and apoptosis, enhanced expression of nucleic acid synthesis genes, enhanced DNA repair ability, alteration of drug target sites, alteration in functioning of drug metabolizing enzymes, genetic alternations, and epigenetics. Reproduced from Ref. [40], (2022), with permission from Elsevier.