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Hence, it seems that pharmacokinetic constraints are not responsible for the different outcomes of the short- and extended-access studies

(101) demonstrated that intestinal dysbiosis induced by high-fat diet promotes the release of leucine into the peripheral bloodstream, which further activates the rapamycin complex 1 (mTORC1) signaling in medullary progenitor cells, triggers the differentiation of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) (102), and ultimately results in the adverse clinical outcomes of BC