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Other studies focusing on immune checkpoint inhibitors for acral melanoma identified low objective response rates [100,101,102,103,104,105,106,107], although these studies involved relatively small sample sizes of acral melanoma (639 patients), and the numbers of NAM cases included are not available

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It has been shown that TMAO can inhibit the cellular activity of antioxidant enzymes, including superoxide dismutase (SOD) and catalase (CAT), causing a reduction in the antioxidant activity of cells (He et al., 2021)