ESR1 and breast cancer: For instance, H19 enhances autophagy in estrogen receptor-positive breast cancer cells by reducing the methylation of the Beclin1 promoter region via the H19/SAHH/DNMT3B axis, leading to drug resistance.35 H19 promotes cancer development mainly by affecting cell functions, such as cell proliferation, anti-apoptosis, and thus leading to angiogenesis and immune escape.36