ABCC2 is an ATP-dependent transporter belonging to the ABC family that actively transports conjugated organic anions across cell membranes, including sulfate-, glucuronide-, and glutathione-conjugates of xenobiotics and endogenous compounds 1234. It plays a critical role in hepatobiliary excretion of bilirubin and other glucuronide conjugates, contributing to bilirubin detoxification 23. ABCC2 mediates transport of anticancer drugs (anthracyclines, vinca alkaloids, methotrexate) and HIV protease inhibitors, conferring resistance to chemotherapeutic agents including cisplatin, doxorubicin, and etoposide 135. Disease associations include Dubin-Johnson syndrome and multidrug resistance in various cancers. In colorectal cancer, elevated ABCC2 expression occurs early in adenoma-carcinoma progression 6. However, in gastric cancer, high ABCC2 expression correlates with better prognosis through GSH efflux-mediated ferroptosis vulnerability 7. ABCC2 genetic variants (rs717620, rs3740067, rs3740073) associate with chemotherapy toxicity and survival outcomes in pancreatic cancer 8 and irinotecan toxicity 9. Polymorphisms also influence oxcarbazepine maintenance doses in epilepsy treatment 10. Clinical significance includes ABCC2 as a potential therapeutic target and biomarker for cancer prognosis and drug response prediction.