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Studies have shown that tamoxifen resistance is associated with IGFBP-1 accumulation and that the overexpression of IGFBP-1 promotes tamoxifen resistance in breast cancer cells by activating the ERK pathway, which can be reversed by knocking down IGFBP-1 (134)

Notably, the less reactive MNS-DOX was more effective in MGST1 overexpressing cells than DNS-DOX