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An RCT in patients receiving cisplatin chemotherapy found that NAC (1,200 mg/day) significantly reduced nephrotoxicity and ototoxicity without reducing antitumor efficacy (Riga et al., Am J Clin Oncol, 2013) [77]

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It upregulated GPX4 (improving ROS detoxification) and SLC7A11 (facilitating glutathione synthesis for redox balance) at transcriptional and protein levels

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