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The Cochrane Library , 2021 (3)

Instead of delivering a rapid energy spike, they are thought to support more stable energy over time by modulating the stress response, particularly through effects on the hypothalamicpituitaryadrenal (HPA) axis

This further prompts VEGF-dependent endothelial proliferation and vasculogenic mimicry (VM), where tumor cells self-organize into functional microvascular networks, bypassing traditional angiogenic pathways (Rashid et al., 2021)