“…Thus, utilizing cell lines as models mechanisms mediated through intra-tumoral oncogenes, mutations and signaling cascades, as well as extra-tumoral factors, such as stromal components and non-cellular components, have been identified to affect CDDP sensitivity [ 10 , 14 , 15 , 16 , 17 ]. Multiple mechanisms mediated by oncogenes, such as exosomal-microRNAs and cell signaling pathways, were identified to promote CDDP-insensitivity in neuroblastoma [ 10 , 18 , 19 , 20 ]. The oncogenes, including v-myc avian myelocytomatosis viral oncogene neuroblastoma derived homolog (MYCN) and Hypoxia-inducible factor (HIF)-1∝, were shown to regulate metabolism and mediate CDDP-resistance in neuroblastoma [ 21 , 22 , 23 ].…”