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While no direct pharmacokinetic contraindication exists, stacking multiple weekly injections increases the risk of overlapping side effects, injection site reactions, and difficulty identifying which agent caused harm if problems arise

However, the thermodynamic driving force for these reactions is probably derived from chargecharge repulsion between the phosphate and carboxylate groups of 2-phosphoglycerate and the isomerization of enolpyruvate to pyruvate following the phosphorylation reaction

This system is so ingeniously designed that the lactate production remains high-speed owing to the constant export of lactate, which promotes the ongoing of glycolysis (removing products keeps the reaction forward), and the reuse of lactate diminishes energy waste and thus aids the high-flux metabolism of cancer cells

doi: 10.1038/sj.onc.1209974 73 LeeYSLeeDHChoudryHABartlettDLLeeYJ