We speculate that the mechanism by which SP mediates DOX-induced chemoresistance in TNBC may be via activation of Forkhead box protein M1 (FOXM1, a transcription factor that is linked to increased survival of tumor cells) and programmed cell death 1 (PD-1, an immune surveillance escape factor) [33, 40, 41]. Here, FOXM1 is linked to neoplasm.