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Herzig S, Shaw RJ
This has been experimentally demonstrated by silencing the estrogen receptor in breast cancer (ER+) with consequent decrease of OCTN2 expression (Wang et al., 2012)
We take that as a sign that the drug is working at that dose and we wait until that effect wears off before increasing the dose
This approach works best for individuals whose primary barrier is tolerability rather than pure efficacy resistance, and can be combined with genetic testing insights to optimize sustained outcomes
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