It has long been postulated that the multidrug efflux transporter P-glycoprotein (P-gp/ABCB1/MDR1) mediates the main mechanism of resistance of cancer cells to chemotherapeutic agents; however, recent studies have shown that the Hh receptor Ptch1, which is over-expressed in many recurrent and metastatic cancers, pumps chemotherapeutic agents such as doxorubicin out of cancer cells, and thereby also contributes to chemotherapy resistance. The gene discussed is PGP; the disease is metastatic malignant neoplasm.