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Muscle is slower to rebuild than fat is to lose, and reduced activity during treatment may accelerate that muscle loss rather than offset it, which can affect strength and mobility over time

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When IGF1 binding to IGF-IR/InsR is blocked by the anti-IGF-IR mAb cixutumumab, IGF1 binding to integrin v3 increases, resulting in activation of v3 and its downstream effectors Src, FAK, and PI3K, which confers cixutumumab resistance [172]

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