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An early study showed that intravenous or intracerebroventricular obestatin had no effects on pituitary hormone release (GH, prolactin, ACTH and TSH) in male rats (116), consistent with the fact that the obestatin receptor GPR39 is not expressed in the pituitary (115,117,118)

Bone, lung, liver, and brain are the most frequent metastatic sites, and each sites possess different microenvironments to favor survival of metastasizing cancer cells [ Figure 3I ] (186, 187)

Cagrilintide vs tirzepatide (Mounjaro/Zepbound) Mechanism: Cagrilintide: Amylin agonist Tirzepatide: Dual GIP/GLP-1 agonist Both novel approaches Weight loss: Cagrilintide: 10-12% monotherapy Tirzepatide: 15-22% monotherapy Tirzepatide superior as single agent Administration: Both: Weekly subcutaneous injection Both: Similar convenience Side effects: Cagrilintide: Strong GI effects Tirzepatide: Moderate GI effects Similar overall profile Approval status: Cagrilintide: Investigational Tirzepatide: FDA approved Tirzepatide available now Cost (when both available): Likely similar ($1,000-1,500/month) Both premium weight loss options Verdict: Currently, tirzepatide better choice (approved, superior weight loss)

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