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In fact, NNMT levels vary between the stroma and cancer cells and patients with high stromal NNMT tend to have a poor prognosis ( Biological Roles of the NNMT Cancer cells and other cells in the tumor microenvironment (TME) have tumor heterogeneity and plasticity, which endows cancer cells with great adaptability to therapy, leading to drug resistance ( Cancer Cells NNMT is implicated in regulating tumor proliferation, invasion, and drug resistance by affecting multiple signaling pathways in vivo ( Figure 1 )