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However, acral melanoma and NAM have a much lower tumor mutation burden [46], so they are likely to be refractory to immune checkpoint inhibitors [96,97,98]

GalA gene knockout mice were treated with acetyl-l-carnitine for 30 days

The researchers discovered that inhibiting PD-L1 using immune checkpoint inhibitors resulted in a reduction in the number of stem cells associated with cancer recurrence (111)