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Methods The study was an open label, single arm, multicenter, pilot trial

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Combined with the clinical heterogeneity of PD with how symptoms present, the included studies did not meet the minimum requirements for quantitative synthesis such as comparable populations, intervention regimens, outcome definitions, and effect measures with consistently reported variance hence, meta-analysis was not performed

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P21-activated kinase 2 (PAK2) is a tamoxifen resistance inducer, while IGF1R can lead to the development of tamoxifen resistance by promoting the expression of PAK2 (Zhang et al., 2018)