“…However, the ineffectiveness of MTX has been often reported for patients with certain cancers, due to the multidrug resistance as well documented (Gottesman, 2020). In general, the MTX resistance is partly related with a reduced MTX transfer because of defects of RFC (Frei 3rd et al, 1984;Jansen et al, 1998); and/or decreased activity of MTX polyglutamation because of reduced FPGS expression (Cowan & Jolivet, 1984;Roy, Egan, Sirlin, & Sirotnak, 1997); and/or enhanced levels of DHFR because of the gene amplification (Alt, Kellems, Bertino, & Schimke, 1978;Frei 3rd et al, 1984;Schimke, 1984) or DHFR mutation giving rise to the reduced affinity for MTX (Dicker, Volkenandt, Schweitzer, Banerjee, & Bertino, 1990;Srimatkandada, Schweitzer, Moroson, Dube, & Bertino, 1989;Yu & Melera, 1993). As can be seen in Figure 3, how the intact MTX or the MTX-LDH nanohybrid could influence on the suppression of tumor cell growth were studied in MTX sensitive HOS cells and MTX resistant HOS cells, respectively, on the basis of MTT assay.…”