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Pre-existing GI Issues: Conditions that already slow down the gut may increase the likelihood of complications

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As the primary factors for the reduced anticancer effect 1) the reduced delivery and uptake of the anticancer agent, 2) the need for the conversion of molecular oxygen (O 2 ) into reactive oxygen species (ROS), 3) the preferred therapeutic effect against highly proliferating cells, which is reduced under hypoxic conditions, or 4) adaptation of the cancer cells by promoting cell survival and upregulating certain resistance pathways, has been suggested 1,2,3,4,5

Whats new in the NEJM paper (vs the topline release)

Users receive protocols from physicians for assessments and receive nutrition consultations and check-ins for ongoing follow-up