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For example, a new study found that metformin combined with immune checkpoint blockade (ICB) can improve clinical outcomes by increasing TIL anti-cancer activity and altering tumor metabolism (Eikawa et al., 2015 ) These processes are likely based on AMPK-dependent phosphorylation boosting PD-L1 degradation and AMPK-dependent suppression of tumor cell oxygen consumption (Foretz et al., 2014)

Choline is produced in the liver and can also be gained through eggs, whole grains, beef liver, broccoli, and cabbage