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5.4 Biomarker-guided treatment In the precision treatment strategy for gemcitabine resistance, biomarker guided treatment based on dynamic monitoring of RRM2 copy number based on ctDNA and multi-omics prediction models (such as the EXPLOR trial) provides a new paradigm for individualized intervention: Gemcitabine resistance, RRM2 gene copy number amplification drives resistance by accelerating deoxyribonucleotide triphosphate (dNTP) synthesis and enhancing DNA repair, while ctDNA-based liquid biopsy technology (such as ddPCR/NGS) can dynamically monitor the level of RRM2 amplification and track the evolution of resistant clones in real time

Magnetic beads are removed from the solution manually by using a magnetic stand or automatically by using an instrument

This is followed by the action of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) synthase, which catalyzes the condensation of acetoacetyl-CoA with a third acetyl-CoA molecule to form HMG-CoA [14]

Substrate working solution, Coenzyme working solution and GSH standard solution can be stored at -20C for 2 months