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A B12 vitamin deficiency usually indicates a health issue thats affecting the digestive tracts ability to work properly. In rare cases, a B12 deficiency may be caused by a hereditary condition or an inadequate amount of B12 in the diet

Many candidate compounds (such as curcumin) have poor oral bioavailability, rapid metabolism, formulation-dependent exposure, and uncertain CNS penetration, while plasma pharmacokinetics may not accurately represent drug levels within compartmentalized CNS lesions, especially in progressive disease (Liu et al., 2016

However, preclinical successes were not successfully translated into early clinical trials (e.g., VNP20009) due to a critical immunogenicity-safety trade-off, in which the attenuation required to ensure safety compromised the ability to generate effective anti-tumor immunity

For patients with neurological involvement, maintenance injections are typically given every 2 months
