HPGDS and neoplasm: To explore the role of BHB in Oxa resistance, the common reasons are the upregulation of drug transport pumps such as P-gp, BCRP, and MRP, the NER overexpression, the cellular enzyme changes such as cytochrome P450 and glutathione-S-transferase, EMT, and tumor internal environment changes, among others (Riddell 2018).