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Additionally, CD117 is expressed at high levels in OCSCs and plays a role in tumor initiation and resistance to cisplatin/paclitaxel by activating the Wnt/-catenin-ABCG 2 pathway (76)

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From this perspective, MDR manifests biologically and clinically as four highly intertwined evolutionary subtypes: Firstly, de novo(primary) resistance, where tumors inherently harbor resistance mutations or exist in a profoundly immunosuppressed state, exhibiting absolute non-response from the initial treatment phase [14]