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110,111 Causes of ER expression loss include epigenetic regulation, hypoxia, overexpression of epidermal growth factor receptor (EGFR) or human epidermal growth factor receptor 2 (HER2), and dysregulation of tumor suppressors such as p53 and pRb2/p130

& Samavat, H

The washout allows tirzepatide levels (half-life 5 days) to drop substantially before adding a new triple agonist

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However, animal model findings do not always translate directly to human pregnancy outcomes, and the relevance of supraphysiologic doses to real-world clinical practice remains unclear