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Clinical evidence for IGF-associated immunosuppression comes from reports of low tumor infiltrating lymphocytes (TILs) in high IGF-1R PCa bone metastases, and genomic aberrations in cancer patients with hyper-progressive disease post-ICB, including mutations in negative IGF regulator IGFBP2 and transcriptional upregulation of IGF-1, PI3K-AKT and ERK pathways 17,18

In the same study, a plasma clearance of 7.2 mL/min was determined, resulting in a median biological half-life of 9.4 h (Degen et al

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