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4.3.1 Impact of surgical resection on the TME Whilst tumor resection does not introduce any drugs to the TME like chemotherapy, or directly induce cell damage and death at the target site in the same manner as radiation therapy, surgical resection of tumors also has a substantial impact on the TME, not just at the primary resection site but also at distant, metastasis sites (Alieva et al., 2018)

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That means large-scale clinical trials, rigorous manufacturing standards, and ongoing FDA oversight of every batch produced