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Moreover, a soluble form of the IL-33 receptor (sST2) modulates the TME by stimulating blood vessel development, Th2 and Th1 reactions, macrophage invasion, and M2a polarization, thereby adversely impacting CRC metastasis and confirming the pro-tumor effect of IL-33 in reverse (Figure 4) ( HMGB1 can also be translocated to the extracellular environment, acting as a warning signal to trigger immunological responses and participate in the control of inflammation and the advancement of cancer

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The meta-analysis of these three randomized, double-blind, placebo-controlled trials found no effect of L-carnitine (0.25-4 g/day for 1 week to 3 months) or ALCAR (3 g/day for 6 months) on the level of cancer-related fatigue (108)