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Secretagogues like these two work by amplifying that pulsatile pattern rather than overriding it which is also why, in research settings, GH secretagogues have typically been administered to coincide with the natural nocturnal pulse

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The absence of tumour control likely reflects elevated IL-6, which can regulate PD-L1 expression 66 , myeloid differentiation/suppression 67 and antitumour immunity 68

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