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Regulatory concerns are significant

Hyperinsulinemia and insulin resistance promote tumor growth through various mechanisms: directly by activating the insulin receptor signaling pathway and indirectly by stimulating the insulin-like growth factor (IGF) receptor system, which in turn fosters cellular proliferation, migration, and invasion while inhibiting programmed cell death [11]

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N -Fmoc- amino acid (5 equiv) were coupled with PyBOP (5 equiv) and DIEA (10 equiv) as coupling reagent using the standard Liberty Blue TM methods