In 3D cultures of ABCB1-high/ABCA1-low chemo-immune-resistant cells, expression of the doxorubicin effluxer ABCB1 was upregulated by the Ras/ERK1/2/HIF-1α signaling axis, which suggests the existence of pathway crosstalk to reinforce an already chemoresistant phenotype in osteosarcoma cells [93]. Here, ABCB1 is linked to osteosarcoma.