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196 When tumor cells metastasize to distant sites through the circulatory system, they are exposed to severe stress within the blood vessels, such as hemodynamic shear forces and attacks of the immune system

MAA-adducts that are derived from the reaction of MAA and proteins have been proven to be immunogenic and possess proinflammatory and profibrogenic properties [104]

In addition to metabolizing bilirubin and certain anti-cancer drugs in the liver, the alpha class of these enzymes exhibit glutathione peroxidase activity thereby protecting the cells from reactive oxygen species and the products of peroxidation

When combined with CpG, the system achieved stronger tumor inhibition by coupling SDT with immune activation ( Figure 8D )