Elevated MDK levels in stromal cells and cancer-associated fibroblasts (CAFs) have been shown to promote cisplatin resistance, while MDK was also found to reduce cisplatin cytotoxicity in AGS human gastric cancer cells, partly through alterations in the Notch signaling pathway [176]. Additionally, MDK has been shown to exert a protective effect against cisplatin-induced damage by upregulating Bcl-2 expression in various tumors [142]. This evidence concerns the gene MDK and gastric cancer.