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MNS-DOX and DNS-DOX were converted by MGST1 and GSTP1-1 via sulfonamide cleavage into the active parent drug (Fig

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The majority of reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea

These metabolic alterations have profound implications for subsequent cellular pathological and physiological processes and revealed the potential correlation between lactylation and acetylation, given their similar mechanisms involving writers, erasers, and readers [18, 60]

Single nucleotide variants (SNVs) in the CYP, ABC , GST , ERC, and XPCC gene families may contribute to interindividual variations in drug toxicity [63,64,65,66,67,68]