The role of long non-coding RNAs in breast cancer drug resistance: a comprehensive review

Abstract

Breast cancer (BC) remains a major contributor to cancer-related morbidity and mortality among women globally. While systemic therapies have significantly advanced, the emergence of drug resistance continues to hinder durable clinical benefit, leading to treatment failure and disease relapse. Long non-coding RNAs (lncRNAs) have gained recognition as key regulators in BC biology and therapeutic response, with growing evidence implicating them in resistance to chemotherapy, endocrine therapy, targeted agents, and immunotherapy. This review provides a detailed overview of the molecular mechanisms through which specific lncRNAs promote resistance, emphasizing their roles in modulating processes such as programmed cell death, epithelial-mesenchymal transition, and remodeling of the tumor microenvironment. We further highlight common regulatory axes - such as competing endogenous RNA networks and the phosphatidylinositol 3-kinase/protein kinase B pathway - that serve as converging points across distinct resistance mechanisms. In addition, we discuss recent progress in harnessing lncRNAs as liquid biopsy biomarkers and examine the key challenges and opportunities in translating lncRNA-based targets into therapeutic strategies. Together, these insights offer a foundation for future research aimed at overcoming drug resistance in BC through novel lncRNA-centered interventions.

Keywords

Breast cancer / long non-coding RNAs / chemotherapy / endocrine therapy / targeted therapy / immunotherapy

References

[1] Bray F,Sung H.Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin2024;74:229-63

[2] Giaquinto AN,Newman LA.Breast cancer statistics 2024.CA Cancer J Clin2024;74:477-95

[3] Perou CM,Eisen MB.Molecular portraits of human breast tumours.Nature2000;406:747-52

[4] Baselga J,Kim SB.Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer.N Engl J Med2012;366:109-19

[5] Vasan N,Hyman DM.A view on drug resistance in cancer.Nature2019;575:299-309 PMCID:PMC8008476

[6] Karami Fath M,Kiani A.The role of epigenetic modifications in drug resistance and treatment of breast cancer.Cell Mol Biol Lett2022;27:52 PMCID:PMC9238060

[7] Ponting CP.Genome-wide analysis of human long noncoding RNAs: a provocative review.Annu Rev Genomics Hum Genet2022;23:153-72

[8] Shi K,Fu H,Zheng X.Genome-wide analysis of lncRNA stability in human.PLoS Comput Biol2021;17:e1008918 PMCID:PMC8081339

[9] Mattick JS,Carninci P.Long non-coding RNAs: definitions, functions, challenges and recommendations.Nat Rev Mol Cell Biol2023;24:430-47 PMCID:PMC10213152

[10] Chen B,Yang C,Horst D.Targeting non-coding RNAs to overcome cancer therapy resistance.Signal Transduct Target Ther2022;7:121 PMCID:PMC9008121

[11] Zhou W,Cen Y.The role of lncRNAs in the tumor microenvironment and immunotherapy of melanoma.Front Immunol2022;13:1085766 PMCID:PMC9806239

[12] Peng WX,Mo YY.LncRNA-mediated regulation of cell signaling in cancer.Oncogene2017;36:5661-7 PMCID:PMC6450570

[13] Huarte M.The emerging role of lncRNAs in cancer.Nat Med2015;21:1253-61

[14] Chen LL.The biogenesis and emerging roles of circular RNAs.Nat Rev Mol Cell Biol2016;17:205-11

[15] Bhan A,Mandal SS.Long noncoding RNA and cancer: a new paradigm.Cancer Res2017;77:3965-81

[16] Kichi ZA,Rezaei M,Rojhannezhad M.The emerging role of EMT-related lncRNAs in therapy resistance and their applications as biomarkers.Curr Med Chem2022;29:4574-601

[17] Pan G,Shang L,Yang S.EMT-associated microRNAs and their roles in cancer stemness and drug resistance.Cancer Commun2021;41:199-217 PMCID:PMC7968884

[18] Jiang N,Gu X,Shang L.Progress in understanding the role of lncRNA in programmed cell death.Cell Death Discov2021;7:30 PMCID:PMC7870930

[19] Ye P,Shi S.The mechanisms of lncRNA-mediated multidrug resistance and the clinical application prospects of lncRNAs in breast cancer.Cancers2022;14:2101 PMCID:PMC9103444

[20] Zhang JN,Zhou XR,Liu H.Dual role of lncRNA OTUD6B-AS1 in immune evasion and ferroptosis resistance: a prognostic and therapeutic biomarker in breast cancer.Noncoding RNA Res2025;14:156-65 PMCID:PMC12269291

[21] Tong X,Xing J.LncRNA HCP5-encoded protein regulates ferroptosis to promote the progression of triple-negative breast cancer.Cancers2023;15:1880 PMCID:PMC10046773

[22] Li C.Construction and validation of a cuproptosis-related five-lncRNA signature for predicting prognosis, immune response and drug sensitivity in breast cancer.BMC Med Genom2023;16:158 PMCID:PMC10329336

[23] Wu JH,Zhu B,Zheng L.Identification of cuproptosis-related gene SLC31A1 and upstream LncRNA-miRNA regulatory axis in breast cancer.Sci Rep2023;13:18390 PMCID:PMC10603161

[24] Du T,Xu S,Sun H.Long non-coding RNAs in drug resistance of breast cancer.Onco Targets Ther2020;13:7075-87

[25] Wang Y,Qin Z.The role of non-coding RNAs in ABC transporters regulation and their clinical implications of multidrug resistance in cancer.Expert Opin Drug Metab Toxicol2021;17:291-306

[26] Blackley EF.Targeting immune pathways in breast cancer: review of the prognostic utility of TILs in early stage triple negative breast cancer (TNBC).Breast2019;48 Suppl 1:S44-8

[27] Huynh MM,Jayanthan A,Los G.The dawn of targeted therapies for triple negative breast cancer (TNBC): a snapshot of investigational drugs in phase I and II trials.Expert Opin Investig Drugs2020;29:1199-208

[28] Djebali S,Merkel A.Landscape of transcription in human cells.Nature2012;489:101-8

[29] Chen Z,Jiang D.The lncRNA-GAS5/miR-221-3p/DKK2 Axis modulates ABCB1-mediated adriamycin resistance of breast cancer via the wnt/β-catenin signaling pathway.Mol Ther Nucleic Acids2020;19:1434-48 PMCID:PMC7056627

[30] Zhang H,Kang XN,Wang ZY.LncRNA-SNHG7 enhances chemotherapy resistance and cell viability of breast cancer cells by regulating miR-186.Cancer Manag Res2020;12:10163-72 PMCID:PMC7569248

[31] Liu PF,Peng SY.Regulatory effects of noncoding RNAs on the interplay of oxidative stress and autophagy in cancer malignancy and therapy.Semin Cancer Biol2022;83:269-82

[32] Kacso TP,Tirpe A,Nuțu A.Reactive oxygen species and long non-coding RNAs, an unexpected crossroad in cancer cells.Int J Mol Sci2022;23:10133 PMCID:PMC9456385

[33] Baylie T,Baye G.The role of telomere and telomerase in cancer and novel therapeutic target: narrative review.Front Oncol2025;15:1542930 PMCID:PMC11947687

[34] Dratwa M,Łacina P,Bogunia-Kubik K.TERT-regulation and roles in cancer formation.Front Immunol2020;11:589929 PMCID:PMC7717964

[35] Lu L,Zhu G.Telomerase expression and telomere length in breast cancer and their associations with adjuvant treatment and disease outcome.Breast Cancer Res2011;13:R56 PMCID:PMC3218945

[36] Lipinska N,Paszel-Jaworska A,Kopczynski P.Telomerase and drug resistance in cancer.Cell Mol Life Sci2017;74:4121-32 PMCID:PMC5641272

[37] Cayuela ML,Blasco MA.The telomerase RNA component Terc is required for the tumour-promoting effects of Tert overexpression.EMBO Rep2005;6:268-74 PMCID:PMC1299269

[38] Hu W,He Y,Xu Y.Functional miRNAs in breast cancer drug resistance.Onco Targets Ther2018;11:1529-41

[39] Wang X,Guo G.Exosome-mediated transfer of long noncoding RNA H19 induces doxorubicin resistance in breast cancer.J Cell Physiol2020;235:6896-904

[40] Zheng Z,Xing P,Xie B.Increased expression of exosomal AGAP2-AS1 (AGAP2 antisense RNA 1) in breast cancer cells inhibits trastuzumab-induced cell cytotoxicity.Med Sci Monit2019;25:2211-20

[41] Xu CG,Ren YQ,Wang LQ.Exosomes mediated transfer of lncRNA UCA1 results in increased tamoxifen resistance in breast cancer cells.Eur Rev Med Pharmacol Sci2016;20:4362-8

[42] Kansara S,Lobie PE,Garg M.Mechanistic involvement of long non-coding RNAs in oncotherapeutics resistance in triple-negative breast cancer.Cells2020;9:1511 PMCID:PMC7349003

[43] Veneziano D,Di Bella S,Distefano R.Investigating miRNA-lncRNA interactions: computational tools and resources. In: Laganà A, editor. MicroRNA target identification. New York: Springer; 2019. pp. 251-77.

[44] Guz M,Cybulski M.Interactions between circRNAs and miR-141 in cancer: from pathogenesis to diagnosis and therapy.Int J Mol Sci2023;24:11861 PMCID:PMC10380543

[45] Li Z,Li J.Knockdown of lncRNA-HOTAIR downregulates the drug-resistance of breast cancer cells to doxorubicin via the PI3K/AKT/mTOR signaling pathway.Exp Ther Med2019;18:435-42 PMCID:PMC6580102

[46] Suicmez M,Konus M.Silencing of lncRNA UCA1 reverses doxorubicin resistance of breast cancer through inhibiting PI3K/AKT/mTOR signaling pathway.ChemistrySelect2024;9:e202400819.

[47] Lei C,Fan Y.LncRNA DUXAP8 induces breast cancer radioresistance by modulating the PI3K/AKT/mTOR pathway and the EZH2-E-cadherin/RHOB pathway.Cancer Biol Ther2022;23:1-13

[48] Sadeghalvad M,Mohammadi-Motlagh HR.Long non-coding RNA HOTAIR induces the PI3K/AKT/mTOR signaling pathway in breast cancer cells.Rev Assoc Med Bras2022;68:456-62

[49] Jiang Y,Li S,Tao M.Metformin reverses tamoxifen resistance through the lncRNA GAS5-medicated mTOR pathway in breast cancer.Ann Transl Med2022;10:366 PMCID:PMC9011257

[50] Xiao C,Hu HZ.LncRNA UCA1 promotes epithelial-mesenchymal transition (EMT) of breast cancer cells via enhancing Wnt/β-catenin signaling pathway.Eur Rev Med Pharmacol Sci2016;20:2819-24

[51] Liu H,Yang L,Yang Z.Knockdown of long non-coding RNA UCA1 increases the tamoxifen sensitivity of breast cancer cells through inhibition of Wnt/β-catenin pathway.PLoS One2016;11:e0168406 PMCID:PMC5158064

[52] Huang H,Lei R.lncRNA-WAL promotes triple-negative breast cancer aggression by inducing β-catenin nuclear translocation.Mol Cancer Res2024;22:1036-50

[53] Dashti S,Esfandi F,Arsang-Jang S.Expression analysis of NF-κB interacting long noncoding RNAs in breast cancer.Exp Mol Pathol2020;112:104359

[54] Liu B,Liu Q.A cytoplasmic NF-κB interacting long noncoding RNA blocks IκB phosphorylation and suppresses breast cancer metastasis.Cancer Cell2015;27:370-81

[55] Xu Y,Li Q.LncRNA Uc003xsl.1-mediated activation of the NFκB/IL8 axis promotes progression of triple-negative breast cancer.Cancer Res2022;82:556-70

[56] Zhang D,Peng M.LncRNA SNHG14 accelerates breast cancer progression through sponging miR-543 and regulating KLF7 expression.Arch Gynecol Obstet2022;305:1507-16

[57] Xie SD,Jin LD.Long noncoding RNA SNHG14 promotes breast cancer cell proliferation and invasion via sponging miR-193a-3p.Eur Rev Med Pharmacol Sci2019;23:2461-8

[58] Zhang Y,Chen M.lncRNA TCL6 correlates with immune cell infiltration and indicates worse survival in breast cancer.Breast Cancer2020;27:573-85

[59] Adewunmi O,Zhang XH.Targeted inhibition of lncRNA malat1 alters the tumor immune microenvironment in preclinical syngeneic mouse models of triple-negative breast cancer.Cancer Immunol Res2023;11:1462-79

[60] Desai P,Wagh PR.Cancer chemoprevention using nanotechnology-based approaches.Front Pharmacol2020;11:323 PMCID:PMC7146461

[61] Zhang X,Zhou H.Role of non-coding RNAs and RNA modifiers in cancer therapy resistance.Mol Cancer2020;19:47 PMCID:PMC7050132

[62] Trayes KP.Breast cancer treatment.Am Fam Phys2021;104:171-8.Available from: https://www.aafp.org/pubs/afp/issues/2021/0800/p171.html [Last accessed on 4 Dec 2025]

[63] Loibl S,Morrow M,Curigliano G.Breast cancer.Lancet2021;397:1750-69

[64] Breast Cancer Trialists' Collaborative Group (EBCTCG). Increasing the dose intensity of chemotherapy by more frequent administration or sequential scheduling: a patient-level meta-analysis of 37 298 women with early breast cancer in 26 randomised trials.Lancet2019;393:1440-52 PMCID:PMC6451189

[65] Ahmed Khalil A,Alhumaydhi FA.Recent developments and anticancer therapeutics of paclitaxel: an update.Curr Pharm Des2022;28:3363-73

[66] Jordan MA.Microtubules as a target for anticancer drugs.Nat Rev Cancer2004;4:253-65

[67] Newman DJ,Snader KM.Natural products as sources of new drugs over the period 1981-2002.J Nat Prod2003;66:1022-37

[68] Yan L,Yue CX.Long noncoding RNA H19 acts as a miR-340-3p sponge to promote epithelial-mesenchymal transition by regulating YWHAZ expression in paclitaxel-resistant breast cancer cells.Environ Toxicol2020;35:1015-28

[69] Xing Z,Liu J,Feng K.LINC00337 induces tumor development and chemoresistance to paclitaxel of breast cancer by recruiting M2 tumor-associated macrophages.Mol Immunol2021;138:1-9

[70] Gu M,Zhang M.LncRNA NONHSAT141924 promotes paclitaxel chemotherapy resistance through p-CREB/Bcl-2 apoptosis signaling pathway in breast cancer.J Cancer2020;11:3645-54 PMCID:PMC7150466

[71] Zhu M,Mi H.Long noncoding RNA MEG3 suppresses cell proliferation, migration and invasion, induces apoptosis and paclitaxel-resistance via miR-4513/PBLD axis in breast cancer cells.Cell Cycle2020;19:3277-88 PMCID:PMC7751664

[72] Zheng S,Miao K.lncRNA GAS5-promoted apoptosis in triple-negative breast cancer by targeting miR-378a-5p/SUFU signaling.J Cell Biochem2020;121:2225-35

[73] Zhao T,Zhang Y,Lu X.Paclitaxel resistance modulated by the interaction between TRPS1 and AF178030.2 in triple-negative breast cancer.Evid Based Complement Alternat Med2022;2022:6019975 PMCID:PMC8986375

[74] Zheng P,Zhang B.Long noncoding RNA CASC2 promotes paclitaxel resistance in breast cancer through regulation of miR-18a-5p/CDK19.Histochem Cell Biol2019;152:281-91

[75] Liang M,Wang M.Knockdown of long non-coding RNA DDX11-AS1 inhibits the proliferation, migration and paclitaxel resistance of breast cancer cells by upregulating microRNA-497 expression.Mol Med Rep2022;25:123 PMCID:PMC8864609

[76] Wang R,Yang Z,Seng J.Long non-coding RNA FTH1P3 activates paclitaxel resistance in breast cancer through miR-206/ABCB1.J Cell Mol Med2018;22:4068-75 PMCID:PMC6111805

[77] Luo F,Sun B.LINC00115 promotes chemoresistant breast cancer stem-like cell stemness and metastasis through SETDB1/PLK3/HIF1α signaling.Mol Cancer2024;23:60 PMCID:PMC10958889

[78] Wu H,Zhou D.LINC00160 mediated paclitaxel-and doxorubicin-resistance in breast cancer cells by regulating TFF3 via transcription factor C/EBPβ.J Cell Mol Med2020;24:8589-602 PMCID:PMC7412707

[79] Shi C,Zhao X.lncRNA MALAT1 regulates the resistance of breast cancer cells to paclitaxel via the miR-497-5p/SHOC2 axis.Pharmacogenomics2022;23:973-85

[80] Wei X,Mao H.Exosomal lncRNA NEAT1 induces paclitaxel resistance in breast cancer cells and promotes cell migration by targeting miR-133b.Gene2023;860:147230

[81] Zhu L,Fan W,Teng C.lncRNA NEAT1 promotes the Taxol resistance of breast cancer via sponging the miR-23a-3p-FOXA1 axis.Acta Biochim Biophys Sin2021;53:1198-206

[82] Li PP,Huang YQ,Zhang WJ.LncRNA OTUD6B-AS1 promotes paclitaxel resistance in triple negative breast cancer by regulation of miR-26a-5p/MTDH pathway-mediated autophagy and genomic instability.Aging2021;13:24171-91 PMCID:PMC8610138

[83] Zheng S,Huang Q.LncRNA PRKCQ-AS1 regulates paclitaxel resistance in triple-negative breast cancer cells through miR-361-5p/PIK3C3 mediated autophagy.Clin Exp Pharmacol Physiol2023;50:431-42

[84] Liu C,Zhang X.Long non-coding RNA UCA1 modulates paclitaxel resistance in breast cancer via miR-613/CDK12 axis.Cancer Manag Res2020;12:2777-88

[85] Wang Y,Yang Y.Inhibition of XIST restrains paclitaxel resistance in breast cancer cells by targeting hsa-let-7d-5p/ATG16L1 through regulation of autophagy.Cell Signal2025;127:111534

[86] Wang YY,Yang S.Long noncoding RNA AC073284.4 suppresses epithelial-mesenchymal transition by sponging miR-18b-5p in paclitaxel-resistant breast cancer cells.J Cell Physiol2019;234:23202-15

[87] Huang Y,Shao X,Li G.Long non-coding RNA TPT1-AS1 sensitizes breast cancer cell to paclitaxel and inhibits cell proliferation by miR-3156-5p/caspase 2 axis.Hum Cell2021;34:1244-54

[88] Arcamone F,Fantini G.Adriamycin, 14-Hydroxydaunomycin, a new antitumor antibiotic fromS. peucetius var.caesius.Biotechnol Bioeng2000;67:704-13

[89] Thorn CF,Marsh S.Doxorubicin pathways: pharmacodynamics and adverse effects.Pharmacogenet Genom2011;21:440-6

[90] Renu K,P B TP.Molecular mechanism of doxorubicin-induced cardiomyopathy - an update.Eur J Pharmacol2018;818:241-53

[91] Lefrak EA,Rosenheim S.A clinicopathologic analysis of adriamycin cardiotoxicity.Cancer1973;32:302-14

[92] Zhang M,Jiang L.LncRNA CBR3-AS1 regulates of breast cancer drug sensitivity as a competing endogenous RNA through the JNK1/MEK4-mediated MAPK signal pathway.J Exp Clin Cancer Res2021;40:41

[93] Tang L,Chen H.DCST1-AS1 promotes TGF-β-induced epithelial-mesenchymal transition and enhances chemoresistance in triple-negative breast cancer cells via ANXA1.Front Oncol2020;10:280 PMCID:PMC7080863

[94] Luo Y,Xu L,Xu Y.Long non-coding RNA PVT1 regulates the resistance of the breast cancer cell line MDA-MB-231 to doxorubicin via Nrf2.Technol Cancer Res Treat2020;19:1533033820980763 PMCID:PMC7750900

[95] Aini S,Ding W.LncRNA SNHG10 suppresses the development of doxorubicin resistance by downregulating miR-302b in triple-negative breast cancer.Bioengineered2022;13:11430-9 PMCID:PMC9275935

[96] Gooding AJ,Gunawardane L,Valadkhan S.The lncRNA BORG facilitates the survival and chemoresistance of triple-negative breast cancers.Oncogene2019;38:2020-41 PMCID:PMC6430670

[97] Ren R,Xu Z.miRNA-144 targeting DNAJC3-AS1 reverses the resistance of the breast cancer cell line Michigan Cancer Foundation-7 to doxorubicin.Bioengineered2021;12:9885-92 PMCID:PMC8810046

[98] Zhu QN,Guo Y.LncRNA H19 is a major mediator of doxorubicin chemoresistance in breast cancer cells through a cullin4A-MDR1 pathway.Oncotarget2017;8:91990-2003 PMCID:PMC5696158

[99] Chang L,Zhou Z.Linc00518 contributes to multidrug resistance through regulating the MiR-199a/MRP1 axis in breast cancer.Cell Physiol Biochem2018;48:16-28

[100] Li Z,Wang X.LINC01977 promotes breast cancer progression and chemoresistance to doxorubicin by targeting miR-212-3p/GOLM1 axis.Front Oncol2021;11:657094 PMCID:PMC8046671

[101] Zheng R,Guan L.Long noncoding RNA lnc-LOC645166 promotes adriamycin resistance via NF-κB/GATA3 axis in breast cancer.Aging2020;12:8893-912 PMCID:PMC7288957

[102] Yue X,Dong M.LncRNA MALAT1 promotes breast cancer progression and doxorubicin resistance via regulating miR-570-3p.Biomed J2021;44:S296-304 PMCID:PMC9068547

[103] Jin YP,Zhang XF.Long non-coding RNA STMN1P2 promotes breast cancer doxorubicin resistance by inhibiting pyroptosis through the hnRNPU-EZH2-TARF6-MALT1-caspase-1 pathway.Acta Pharmacol Sin2025;1-15

[104] Wang S,Zheng X.Interactions between lncRNA TUG1 and miR-9-5p modulate the resistance of breast cancer cells to doxorubicin by regulating eIF5A2.Onco Targets Ther2020;13:13159-70

[105] Zhang M,Xiang Z,Zhou WB.LncRNA XIST promotes chemoresistance of breast cancer cells to doxorubicin by sponging miR-200c-3p to upregulate ANLN.Clin Exp Pharmacol Physiol2020;47:1464-72

[106] Lu Q,Ji Y,Xue X.Ursolic acid enhances cytotoxicity of doxorubicin-resistant triple-negative breast cancer cells via ZEB1-AS1/miR-186-5p/ABCC1 axis.Cancer Biother Radiopharm2022;37:673-83

[107] Cortes JE.Docetaxel.J Clin Oncol1995;13:2643-55

[108] Minckwitz G. Docetaxel/anthracycline combinations for breast cancer treatment.Expert Opin Pharmacother2007;8:485-95

[109] Zhang C,Zhang J,Tang X.LINC00461 overexpression can induce docetaxel resistance in breast cancer by interacting with miR-411-5p.Onco Targets Ther2020;13:5551-62

[110] Ning X,He F,Li B.Long non-coding RNA TMPO-AS1 facilitates chemoresistance and invasion in breast cancer by modulating the miR-1179/TRIM37 axis.Oncol Lett2021;22:500 PMCID:PMC8108256

[111] Li J,Liu W.Docetaxel-resistant triple-negative breast cancer cell-derived exosomal lncRNA LINC00667 reduces the chemosensitivity of breast cancer cells to docetaxel via targeting miR-200b-3p/Bcl-2 axis.Eur J Histochem2022;66 PMCID:PMC9667572

[112] Duan H,Gao Z.Recent advances in drug delivery systems for targeting cancer stem cells.Acta Pharm Sin B2021;11:55-70 PMCID:PMC7838023

[113] Levine M.Epirubicin in breast cancer: present and future.Clin Breast Cancer2000;1 Suppl 1:S62-7

[114] Yao N,Chen L.Long non-coding RNA NONHSAT101069 promotes epirubicin resistance, migration, and invasion of breast cancer cells through NONHSAT101069/miR-129-5p/Twist1 axis.Oncogene2019;38:7216-33

[115] Zheng A,Song X.Clinical significance of SPRY4-IT1 in efficacy and survival prediction in breast cancer patients undergoing neoadjuvant chemotherapy.Histol Histopathol2020;35:361-70

[116] Wang F,Lv M.Novel long noncoding RNA 005620 induces epirubicin resistance in triple-negative breast cancer by regulating ITGB1 expression.Front Oncol2021;11:592215 PMCID:PMC7970185

[117] Heidelberger C,Danneberg P.Fluorinated pyrimidines, a new class of tumour-inhibitory compounds.Nature1957;179:663-6

[118] Longley DB,Johnston PG.5-fluorouracil: mechanisms of action and clinical strategies.Nat Rev Cancer2003;3:330-8

[119] Diasio RB.Clinical pharmacology of 5-fluorouracil.Clin Pharmacokinet1989;16:215-37

[120] Li X,Li Z.The lncRNA NEAT1 facilitates cell growth and invasion via the miR-211/HMGA2 axis in breast cancer.Int J Biol Macromol2017;105:346-53

[121] Liang Y,Li Y.A novel long non-coding RNA-PRLB acts as a tumor promoter through regulating miR-4766-5p/SIRT1 axis in breast cancer.Cell Death Dis2018;9:563 PMCID:PMC5948209

[122] Zhang Z,Wang Y.Effect of long noncoding RNA CCAT2 on drug sensitivity to 5-fluorouracil of breast cancer cells through microRNA-145 meditated by p53.J Biochem Mol Toxicol2022;36:e23176

[123] Luo L,Tang H.LncRNA SNORD3A specifically sensitizes breast cancer cells to 5-FU by sponging miR-185-5p to enhance UMPS expression.Cell Death Dis2020;11:329 PMCID:PMC7205983

[124] Yang W,Wang X.Inhibition of circular RNA CDR1as increases chemosensitivity of 5-FU-resistant BC cells through up-regulating miR-7.J Cell Mol Med2019;23:3166-77 PMCID:PMC6484300

[125] Yao X,Xu Y,Yao F.Endoplasmic reticulum stress confers 5-fluorouracil resistance in breast cancer cell via the GRP78/OCT4/lncRNA MIAT/AKT pathway.Am J Cancer Res2020;10:838-55 PMCID:PMC7136914

[126] Villarreal-Garza C,Bouganim N.Platinum-based chemotherapy in triple-negative advanced breast cancer.Breast Cancer Res Treat2014;146:567-72

[127] Galluzzi L,Vitale I.Molecular mechanisms of cisplatin resistance.Oncogene2012;31:1869-83

[128] Kelland L.The resurgence of platinum-based cancer chemotherapy.Nat Rev Cancer2007;7:573-84

[129] Rosenberg B,Trosko JE.Platinum compounds: a new class of potent antitumour agents.Nature1969;222:385-6

[130] Dasari S.Cisplatin in cancer therapy: molecular mechanisms of action.Eur J Pharmacol2014;740:364-78 PMCID:PMC4146684

[131] Siddik ZH.Cisplatin: mode of cytotoxic action and molecular basis of resistance.Oncogene2003;22:7265-79

[132] Zhou L,Sun T.HULC targets the IGF1R-PI3K-AKT axis in trans to promote breast cancer metastasis and cisplatin resistance.Cancer Lett2022;548:215861

[133] Su A,Zhang H,Zhang H.DANCR induces cisplatin resistance of triple-negative breast cancer by KLF5/p27 signaling.Am J Pathol2023;193:248-58

[134] García-Venzor A,Ruiz-Silvestre A.lncMat2B regulated by severe hypoxia induces cisplatin resistance by increasing DNA damage repair and tumor-initiating population in breast cancer cells.Carcinogenesis2020;41:1485-97

[135] Tang T,She Q.Long non-coding RNA TUG1 sponges miR-197 to enhance cisplatin sensitivity in triple negative breast cancer.Biomed Pharmacother2018;107:338-46.

[136] Sheng X,Du Y.LncRNA CARMN overexpression promotes prognosis and chemosensitivity of triple negative breast cancer via acting as miR143-3p host gene and inhibiting DNA replication.J Exp Clin Cancer Res2021;40:205 PMCID:PMC8220716

[137] Wu J,Ma L.Formononetin relieves the facilitating effect of lncRNA AFAP1-AS1-miR-195/miR-545 axis on progression and chemo-resistance of triple-negative breast cancer.Aging2021;13:18191-222 PMCID:PMC8351708

[138] Wu J,Ye M.Long noncoding RNA HCP5 contributes to cisplatin resistance in human triple-negative breast cancer via regulation of PTEN expression.Biomed Pharmacother2019;115:108869

[139] Wu B,Han X.Structure of LINC00511-siRNA-conjugated nanobubbles and improvement of cisplatin sensitivity on triple negative breast cancer.FASEB J2020;34:9713-26

[140] Zhou D,Wang Y.Long non-coding RNA NEAT1 transported by extracellular vesicles contributes to breast cancer development by sponging microRNA-141-3p and regulating KLF12.Cell Biosci2021;11:68 PMCID:PMC8022671

[141] Zhang L,Ni C.Silencing of lncRNA PART1 inhibits proliferation, invasion and migration of breast cancer cells and promotes the efficacy of cisplatin in breast cancer cells.Gen Physiol Biophys2020;39:343-54

[142] Zhang M,Hou L.LncRNA SNHG1 promotes tumor progression and cisplatin resistance through epigenetically silencing miR-381 in breast cancer.Bioengineered2021;12:9239-50 PMCID:PMC8809974

[143] Mi H,Wang F.SNHG15 contributes To cisplatin resistance in breast cancer through sponging miR-381.Onco Targets Ther2020;13:657-66

[144] Zhu M,Peng Z.Silencing the expression of lncRNA SNHG15 may be a novel therapeutic approach in human breast cancer through regulating miR-345-5p.Ann Transl Med2022;10:1173 PMCID:PMC9708471

[145] Zhu D,Lin Y,Song Z.MT1JP inhibits tumorigenesis and enhances cisplatin sensitivity of breast cancer cells through competitively binding to miR-24-3p.Am J Transl Res2019;11:245-56 PMCID:PMC6357327

[146] Sella T,Mittendorf EA.Neoadjuvant endocrine therapy in clinical practice: a review.JAMA Oncol2021;7:1700-8

[147] Hasson S, Brezis MR, Shachar E, Shachar SS, Wolf I, Sonnenblick A. Adjuvant endocrine therapy in HER2-positive breast cancer patients: systematic review and meta-analysis.ESMO Open2021;6:100088

[148] Ballinger TJ,Jansen VM.Current landscape of targeted therapies for hormone-receptor positive, HER2 negative metastatic breast cancer.Front Oncol2018;8:308 PMCID:PMC6095972

[149] Hanker AB,Arteaga CL.Overcoming endocrine resistance in breast cancer.Cancer Cell2020;37:496-513 PMCID:PMC7169993

[150] AlFakeeh A.Overcoming endocrine resistance in hormone receptor-positive breast cancer.Curr Oncol2018;25:S18-27 PMCID:PMC6001756

[151] Howell A.Tamoxifen evolution.Br J Cancer2023;128:421-5 PMCID:PMC9938251

[152] Barchiesi G,Krasniqi E.Neoadjuvant endocrine therapy in breast cancer: current knowledge and future perspectives.Int J Mol Sci2020;21:3528 PMCID:PMC7278946

[153] Tsang JYS.Molecular classification of breast cancer.Adv Anat Pathol2020;27:27-35

[154] Shi Q,Li S.LncRNA DILA1 inhibits Cyclin D1 degradation and contributes to tamoxifen resistance in breast cancer.Nat Commun2020;11:5513 PMCID:PMC7608661

[155] Wang J,Yang J.The long noncoding RNA H19 promotes tamoxifen resistance in breast cancer via autophagy.J Hematol Oncol2019;12:81 PMCID:PMC6657081

[156] Lin X,Cao S.Enhancer-driven lncRNA BDNF-AS induces endocrine resistance and malignant progression of breast cancer through the RNH1/TRIM21/mTOR cascade.Cell Rep2020;31:107753

[157] Xue X,Zhang A.LncRNA HOTAIR enhances ER signaling and confers tamoxifen resistance in breast cancer.Oncogene2016;35:2746-55 PMCID:PMC4791209

[158] Li Z,Li H,Li S.Long non-coding RNA UCA1 confers tamoxifen resistance in breast cancer endocrinotherapy through regulation of the EZH2/p21 axis and the PI3K/AKT signaling pathway.Int J Oncol2019;54:1033-42

[159] Shi YF,Wang HB.Downregulated lncRNA ADAMTS9-AS2 in breast cancer enhances tamoxifen resistance by activating microRNA-130a-5p.Eur Rev Med Pharmacol Sci2019;23:1563-73

[160] Barazetti JF,Carvalho TM.From micro to long: non-coding RNAs in tamoxifen resistance of breast cancer cells.Cancers2021;13:3688 PMCID:PMC8345104

[161] Farhan M,Dandawate P.Non-coding RNAs as mediators of tamoxifen resistance in breast cancers. In: Ahmad A, editor. Breast cancer metastasis and drug resistance. Cham: Springer International Publishing; 2019. pp. 229-41.

[162] Yu S,Gong X.LncRNA AGPG confers endocrine resistance in breast cancer by promoting E2F1 activity.Cancer Res2023;83:3220-36

[163] Zhang H,Dong L.LncRNA ATXN8OS enhances tamoxifen resistance in breast cancer.Open Med2021;16:68-80 PMCID:PMC7754175

[164] Horie K,Takeiwa T.Estrogen-inducible LncRNA BNAT1 functions as a modulator for estrogen receptor signaling in endocrine-resistant breast cancer cells.Cells2022;11:3610 PMCID:PMC9688125

[165] Liu Y,Yu H.lncRNA CYTOR promotes tamoxifen resistance in breast cancer cells via sponging miR-125a-5p.Int J Mol Med2020;45:497-509 PMCID:PMC6984795

[166] Liang X,Fang Z.DLGAP1-AS2 promotes estrogen receptor signalling and confers tamoxifen resistance in breast cancer.Mol Biol Rep2022;49:3939-47

[167] Ma Y,Long J,Dong J.LncRNA DSCAM-AS1 acts as a sponge of miR-137 to enhance Tamoxifen resistance in breast cancer.J Cell Physiol2019;234:2880-94

[168] Ren L,Lei L,Cai H.Long non-coding RNA FOXD3 antisense RNA 1 augments anti-estrogen resistance in breast cancer cells through the microRNA-363/trefoil factor 1/phosphatidylinositol 3-kinase/protein kinase B axis.Bioengineered2021;12:5266-78 PMCID:PMC8806484

[169] Li Y,Lv Y.Silencing long non-coding RNA HNF1A-AS1 inhibits growth and resistance to TAM of breast cancer cells via the microRNA-363/SERTAD3 axis.J Drug Target2021;29:742-53

[170] Kim CY,Lee JY.The LncRNA HOTAIRM1 promotes tamoxifen resistance by mediating HOXA1 expression in ER+ breast cancer cells.J Cancer2020;11:3416-23 PMCID:PMC7150441

[171] Lee J,Kim EA.Differential expression of long non-coding RNA IGF2-as in tamoxifen-resistant breast cancer cells.Biomedicines2025;13:2087 PMCID:PMC12467862

[172] Peng WX,Zhou H.Lnc-DC promotes estrogen independent growth and tamoxifen resistance in breast cancer.Cell Death Dis2021;12:1000 PMCID:PMC8546148

[173] Liao M,Coonrod EM,Maher CA.BCAR4 expression as a predictive biomarker for endocrine therapy resistance in breast cancer.Clin Breast Cancer2024;24:368-75.e2 PMCID:PMC12337818

[174] Chen X,Hu GS.Estrogen-induced LncRNA, LINC02568, promotes estrogen receptor-positive breast cancer development and drug resistance through both in trans and in cis mechanisms.Adv Sci2023;10:e2206663 PMCID:PMC10477896

[175] Ma T,Li Y.LncRNA LINP1 confers tamoxifen resistance and negatively regulated by ER signaling in breast cancer.Cell Signal2020;68:109536

[176] Sun W,Jiang Y.Transcriptome analysis of luminal breast cancer reveals a role for LOL in tumor progression and tamoxifen resistance.Int J Cancer2019;145:842-56

[177] Feng J,Li Z.Cross-talk between the ER pathway and the lncRNA MAFG-AS1/miR-339-5p/ CDK2 axis promotes progression of ER+ breast cancer and confers tamoxifen resistance.Aging2020;12:20658-83 PMCID:PMC7655217

[178] Wu C,Lu Y.Cancer-associated fibroblast promotes tamoxifen resistance in estrogen receptor positive breast cancer via exosomal LncRNA PRKCQ-AS1/miR-200a-3p/MKP1 axis-mediated apoptosis suppression.J Exp Clin Cancer Res2025;44:274 PMCID:PMC12487062

[179] Peng WX,Yang L,Mo YY.Linc-RoR promotes MAPK/ERK signaling and confers estrogen-independent growth of breast cancer.Mol Cancer2017;16:161 PMCID:PMC5645922

[180] Khan MI.LncRNA SNHG6 sponges miR-101 and induces tamoxifen resistance in breast cancer cells through induction of EMT.Front Oncol2022;12:1015428 PMCID:PMC9539827

[181] Fang J,Huang C,Ni Q.LncRNA TTN-AS1 confers tamoxifen resistance in breast cancer via sponging miR-107 to modulate PI3K/AKT signaling pathway.Am J Transl Res2022;14:2267-79 PMCID:PMC9091103

[182] Ratre P,Dubey A,Jain A.Aromatase inhibitors for the treatment of breast cancer: a journey from the scratch.Anticancer Agents Med Chem2020;20:1994-2004

[183] Sood A,Kaur R,Arora S.Relevance of aromatase inhibitors in breast cancer treatment.Curr Top Med Chem2021;21:1319-36

[184] Nagini S.Breast cancer: current molecular therapeutic targets and new players.Anticancer Agents Med Chem2017;17:152-63

[185] Chen X,Zhang Y.Long noncoding RNA DIO3OS induces glycolytic-dominant metabolic reprogramming to promote aromatase inhibitor resistance in breast cancer.Nat Commun2022;13:7160 PMCID:PMC9684133

[186] Huang S,Chi W.LINC00309 is associated with short disease-free survival in breast cancer.Cancer Cell Int2019;19:210 PMCID:PMC6686222

[187] Ingle JN,Ellis MJ.Genetic polymorphisms in the long noncoding RNA MIR2052HG offer a pharmacogenomic basis for the response of breast cancer patients to aromatase inhibitor therapy.Cancer Res2016;76:7012-23

[188] Gu G,Fuqua SA.Targeted therapy for breast cancer and molecular mechanisms of resistance to treatment.Curr Opin Pharmacol2016;31:97-103

[189] Schlam I,Morganti S.Emerging targeted therapies for early breast cancer.Drugs2022;82:1437-51

[190] Lau KH,Shi Y.New and emerging targeted therapies for advanced breast cancer.Int J Mol Sci2022;23:2288 PMCID:PMC8874375

[191] Greenwalt I,Das S.Precision medicine and targeted therapies in breast cancer.Surg Oncol Clin N Am2020;29:51-62

[192] Jacobs AT,Rose MM.Targeted therapy for breast cancer: an overview of drug classes and outcomes.Biochem Pharmacol2022;204:115209

[193] Clarke R,Dixon JM.Endocrine resistance in breast cancer-an overview and update.Mol Cell Endocrinol2015;418 Pt 3:220-34 PMCID:PMC4684757

[194] Waks AG.Breast cancer treatment: a review.JAMA2019;321:288-300

[195] Curigliano G.Successes and limitations of targeted cancer therapy in breast cancer. In: Peters S, Stahel R, editors. Successes and limitations of targeted cancer therapy; 2014. pp. 15-35.

[196] Henriques B,Martins D.Immunotherapy in breast cancer: when, how, and what challenges?.Biomedicines2021;9:1687 PMCID:PMC8616011

[197] Wang ZH,Jia SC.Trastuzumab resistance in HER2-positive breast cancer: mechanisms, emerging biomarkers and targeting agents.Front Oncol2022;12:1006429 PMCID:PMC9584623

[198] Ghafouri-Fard S,Hussen BM.An update on the role of long non-coding RNAs in the pathogenesis of breast cancer.Pathol Res Pract2021;219:153373

[199] Dong H,Mo S.Long non-coding RNA SNHG14 induces trastuzumab resistance of breast cancer via regulating PABPC1 expression through H3K27 acetylation.J Cell Mol Med2018;22:4935-47 PMCID:PMC6156344

[200] Zhu HY,Ye XM,Jia LT.Long non-coding RNA UCA1 desensitizes breast cancer cells to trastuzumab by impeding miR-18a repression of Yes-associated protein 1.Biochem Biophys Res Commun2018;496:1308-13

[201] Ghazimoradi MH.The role of CircRNA/miRNA/mRNA axis in breast cancer drug resistance.Front Oncol2022;12:966083 PMCID:PMC9484461

[202] Zou Y,Chen B.crVDAC3 alleviates ferroptosis by impeding HSPB1 ubiquitination and confers trastuzumab deruxtecan resistance in HER2-low breast cancer.Drug Resist Updat2024;77:101126

[203] Misir S,Petrović N,Hepokur C.circRNAs in drug resistance of breast cancer.Oncol Res2022;30:157-72 PMCID:PMC10208077

[204] Guo J,Ming Y.A circular RNA overcomes acquired resistance to BET inhibitors by antagonizing IGF2BP2-mediated c-MYC translation in TNBC.Proc Natl Acad Sci USA2025;122:e2504320122 PMCID:PMC12260563

[205] Shi SJ,Yu B,Jin Y.LncRNA-ATB promotes trastuzumab resistance and invasion-metastasis cascade in breast cancer.Oncotarget2015;6:11652-63 PMCID:PMC4484483

[206] Song X,Zeng Y,Luo H.BANCR-containing extracellular vesicles enhance breast cancer resistance.J Biol Chem2025;301:108304 PMCID:PMC11999273

[207] Ye X,Qin X.BCAR4 facilitates trastuzumab resistance and EMT in breast cancer via sponging miR-665 and interacting with YAP1.FASEB J2024;38:e23589

[208] Sun Z,Wang T,Tian X.Correlation between long non-coding RNAs (lncRNAs) H19 expression and trastuzumab resistance in breast cancer.J Cancer Res Ther2019;15:933-40

[209] Chen T,Zeng W.Down-regulation of long non-coding RNA HOTAIR sensitizes breast cancer to trastuzumab.Sci Rep2019;9:19881 PMCID:PMC6934784

[210] Bai W,Zhang J.LINC00589-dominated ceRNA networks regulate multiple chemoresistance and cancer stem cell-like properties in HER2⁺ breast cancer.NPJ Breast Cancer2022;8:115 PMCID:PMC9617889

[211] Liu C,Yixi L.Exosomal Linc00969 induces trastuzumab resistance in breast cancer by increasing HER-2 protein expression and mRNA stability by binding to HUR.Breast Cancer Res2023;25:124 PMCID:PMC10580635

[212] Yu Q,Peng S,Qin X.Exosomal-mediated transfer of OIP5-AS1 enhanced cell chemoresistance to trastuzumab in breast cancer via up-regulating HMGB3 by sponging miR-381-3p.Open Med2021;16:512-25 PMCID:PMC8010158

[213] Han M,Cao H.lncRNA ZNF649-AS1 induces trastuzumab resistance by promoting ATG5 expression and autophagy.Mol Ther2020;28:2488-502 PMCID:PMC7647669

[214] Dong H,Chen X,Han M.LncRNA ZNF649-AS1 promotes trastuzumab resistance and TAM-dependent PD-L1 expression in breast cancer by regulating EXOC7 alternative splicing.Arch Biochem Biophys2024;761:110128

[215] Li W,Wang H.Downregulation of LncRNA GAS5 causes trastuzumab resistance in breast cancer.Oncotarget2016;7:27778-86 PMCID:PMC5053687

[216] Convit J,Oviedo H.Autologous tumor lysate/Bacillus Calmette-Guérin immunotherapy as an adjuvant to conventional breast cancer therapy.Clin Transl Oncol2015;17:884-7 PMCID:PMC4608991

[217] Morales MA, Barrera Rodríguez R, Santiago Cruz JR, Teran LM. Overview of new treatments with immunotherapy for breast cancer and a proposal of a combination therapy.Molecules2020;25:5686 PMCID:PMC7730494

[218] Pilipow K,Losurdo A.T-cell-based breast cancer immunotherapy.Semin Cancer Biol2021;72:90-101

[219] Schmid P,Rugo HS.Atezolizumab and Nab-paclitaxel in advanced triple-negative breast cancer.N Engl J Med2018;379:2108-21

[220] Jia H,Wang B.Immunotherapy for triple-negative breast cancer: existing challenges and exciting prospects.Drug Resist Updat2017;32:1-15

[221] Li S,Li J.A novel prognostic signature of immune-related long noncoding RNA pairs for tumor-infiltrating immune cells and drug susceptibility in breast cancer.DNA Cell Biol2022;41:103-15

[222] Shen S,Hu X,Luo L.Predicting the immune landscape of invasive breast carcinoma based on the novel signature of immune-related lncRNA.Cancer Med2021;10:6561-75 PMCID:PMC8446415

[223] Xu Y,Zhou T,Xu Q.Necroptosis-related LncRNAs signature and subtypes for predicting prognosis and revealing the immune microenvironment in breast cancer.Front Oncol2022;12:887318 PMCID:PMC9171493

[224] Zhang X,Li G.A novel necroptosis-associated lncRNA signature can impact the immune status and predict the outcome of breast cancer.J Immunol Res2022;2022:3143511 PMCID:PMC9107037

[225] Zhang D,Zhuo Z,Zhang W.Comprehensive analysis of a cuproptosis-related ceRNA network implicates a potential endocrine therapy resistance mechanism in ER-positive breast cancer.BMC Med Genomics2023;16:96 PMCID:PMC10161630

[226] Liao B,Xie Y,Min J.LINK-A: unveiling its functional role and clinical significance in human tumors.Front Cell Dev Biol2024;12:1354726 PMCID:PMC11032015

[227] Hu Q,Chan LC.Oncogenic lncRNA downregulates cancer cell antigen presentation and intrinsic tumor suppression.Nat Immunol2019;20:835-51 PMCID:PMC6619502

[228] Lian B,Tang S,Li J.Targeting LINC02544/miR-497-5p/CAPRIN1 axis via exosome-based siRNA to overcome immunotherapy resistance in triple-negative breast cancer.Mol Med2025;31:278 PMCID:PMC12357379

[229] Sun C,Tan Z.Tumor-associated nonmyelinating Schwann cell-expressed PVT1 promotes pancreatic cancer kynurenine pathway and tumor immune exclusion.Sci Adv2023;9:eadd6995 PMCID:PMC9891701

[230] Famta P,Khatri DK,Singh SB.Enigmatic role of exosomes in breast cancer progression and therapy.Life Sci2022;289:120210

[231] Rezaee M,Keshavarzmotamed A.The landscape of exosomal non-coding RNAs in breast cancer drug resistance, focusing on underlying molecular mechanisms.Front Pharmacol2023;14:1152672 PMCID:PMC10154547

[232] Huang D,Yang L.NKILA lncRNA promotes tumor immune evasion by sensitizing T cells to activation-induced cell death.Nat Immunol2018;19:1112-25

[233] Pei X,Li H.LncRNA SNHG1 regulates the differentiation of Treg cells and affects the immune escape of breast cancer via regulating miR-448/IDO.Int J Biol Macromol2018;118:24-30

[234] Yang H,Li B.Non-coding RNAs as novel biomarkers in cancer drug resistance.Curr Med Chem2022;29:837-48

[235] Wu J,Li H,Chen J.Competing endogenous RNAs network dysregulation in oral cancer: a multifaceted perspective on crosstalk and competition.Cancer Cell Int2024;24:431 PMCID:PMC11673722

[236] To KKW,Cho WC.Competing endogenous RNAs (ceRNAs) and drug resistance to cancer therapy.Cancer Drug Resist2024;7:37 PMCID:PMC11472581

[237] Wu B,Yu Y.Long noncoding RNA H19: a novel therapeutic target emerging in oncology via regulating oncogenic signaling pathways.Front Cell Dev Biol2021;9:796740 PMCID:PMC8716783

[238] Su WY,Guo LP,Gao WY.PI3K signaling-regulated metabolic reprogramming: from mechanism to application.Biochim Biophys Acta Rev Cancer2023;1878:188952

[239] Cirone M.Cancer cells dysregulate PI3K/AKT/mTOR pathway activation to ensure their survival and proliferation: mimicking them is a smart strategy of gammaherpesviruses.Crit Rev Biochem Mol Biol2021;56:500-9

[240] Raju GSR,Bandaru SS.HOTAIR: a potential metastatic, drug-resistant and prognostic regulator of breast cancer.Mol Cancer2023;22:65 PMCID:PMC10061914

[241] Barwal TS,Bazala S.MicroRNAs and long noncoding RNAs as novel therapeutic targets in estrogen receptor-positive breast and ovarian cancers.Int J Mol Sci2021;22:4072 PMCID:PMC8071157

[242] Hu X,Xing W.Role of microRNA/lncRNA intertwined with the Wnt/β-Catenin axis in regulating the pathogenesis of triple-negative breast cancer.Front Pharmacol2022;13:814971 PMCID:PMC9263262

[243] Ebrahimnezhad M,Rezaie M,Yousefi B.lncRNAs: new players of cancer drug resistance via targeting ABC transporters.IUBMB Life2024;76:883-921

[244] Rembiałkowska N,Kłosińska A.Inflammation-driven genomic instability: a pathway to cancer development and therapy resistance.Pharmaceuticals2025;18:1406 PMCID:PMC12472738

[245] Han C,Wang H.Exosome-mediated communication between tumor cells and tumor-associated macrophages: implications for tumor microenvironment.Oncoimmunology2021;10:1887552

[246] Zhang W,Peng J.Decoding roles of exosomal lncRNAs in tumor-immune regulation and therapeutic potential.Cancers2022;15:286 PMCID:PMC9818565