Heme oxygenase-1 (HO-1)-mediated ferroptosis is an anti-tumor therapeutic strategy, and betulinic acid has different effects on HO-1 at different concentrations, thereby decreasing the expression of HO-1 at low concentrations and increasing it at high concentrations of HO-1 expression (Malfa et al., 2019). This evidence concerns the gene HMOX1 and neoplasm.