Normal GPX4 activity is essential for maintaining membrane lipid homeostasis, preventing the excessive accumulation of toxic lipid peroxides and the formation of free radicals (L-OOH and L-O•), thereby reducing ferroptosis (60, 61) Acyl-CoA synthetase long-chain family member 4 (ACSL4) family is an important gene promoting ferroptosis, but the sensitivity of cancer cells to GPX4 inhibitors varies depending on the cancer type, which indicates that there may be another resistance mechanism similar to GPX4-FSP1-CoQ10-NAD(P)H pathway (62). This evidence concerns the gene ACSL4 and cancer.