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A study demonstrated that hyperglycemia induces excess ROS production from mononuclear cells, which subsequently triggers the release of tumor necrosis factor- (TNF-) (105)

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However, the efficacy of this passive targeted delivery is low, and sufficiently high levels of drug concentrations at the tumor sites are not generally seen in practice

Before that, however, it must survive being degraded in the gut by enzyme -glutamyl transpeptidase (GGT)