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Given that ACLY cleaves citrate into oxaloacetate and acetyl-CoA, the increase in citrate and ACLY levels induced by trastuzumab could reflect: 1) a need for TCA cycle fueled energy through oxphos as well as 2) an alteration of lipid metabolism in trastuzumab resistant cells

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Speichinger notes that sometimes there is a second step to the progesterone challenge, where estrogen is given first and followed by progesterone, to cause the withdrawal period