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Under aerobic conditions, pyruvate is converted to ATP via mitochondrial oxidation, whereas under hypoxia, it is transformed into lactate by LDH, which also plays a crucial role in gluconeogenesis and lactate biosynthesis [15, 25]

Future outlook: data from preclinical studies Although the mechanisms underlying CIPN are relatively well understood, the available results of clinical trials clearly indicate that the success rate for the introduction of novel drugs that are able to prevent CIPN is low [50], the progress in this area is slow and, at present, there is insufficient evidence to recommend any specific agent for CIPN prevention

Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8): an open-label randomised controlled phase 3 trial

Anything which irritates the mucosal lining of the nose wouldnt be tolerated, congested nasal passages could inhibit delivery, and its not clear how far or where into the brain the substances might reach

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Guo H, Xu Y, Wang F, Shen Z, Tuo X, Qian H, et al