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One of the direct mechanisms for developing drug resistance is to increase the expression of ATP-binding cassette transporter family proteins, such as P-gp, breast cancer resistance protein (BCRP) to enhance drug efflux, the overexpression of efflux transporters result in the efflux of paclitaxel, vinblastine, vinblastine, and CPT from cells, thereby reducing therapeutic efficacy

Other therapeutic approaches outlined below include systemically decreasing cysteine levels and inhibiting GPX4

While the WHO recommendations were not effective in PCC patients, supervised low intensity training or inspiratory muscle training improved the fatigue symptoms, muscle strength and quality of life and had minimal effect on exercise tolerance (Jimeno-Almazan et al., 2023)