• FOXM1 is highly expressed in osteosarcoma tissues and methotrexate-resistant cells, contributing to drug resistance.
• FOXM1 promotes methotrexate resistance by enhancing autophagy via the HMMR/ATG7 pathway.
• Silencing FOXM1 or inhibiting autophagy reverses methotrexate resistance in osteosarcoma cells.
• Targeting FOXM1 or autophagy represents a promising strategy to improve osteosarcoma chemotherapy outcomes.
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