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Monitoring and Managing Vitamin B12 Levels During Treatment Serum vitamin B12 and related biomarkers are measured through blood tests

A US multicenter, double-blind, randomized phase 3 RAINBOW trial was conducted in 170 centers in 27 countries in North America, South America, Asia and Australia (66), and it also recruited patients with GC or gastroesophageal junction adenocarcinoma

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Extensive preclinical studies show no organ toxicity up to twenty milligrams per kilogram across various administration routes, and limited human trials report excellent tolerability