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5 The nervous system development-related factor L1 cell adhesion molecule (L1CAM), which is expressed in neurons and tumour cells, has been proven to facilitate the spread of BCBM cells to the parenchymal side of capillaries and eventually to establish metastatic outgrowth by activating downstream neuroserpin, which prevents the production of brain-metastasis-suppressing plasmin by astrocytes (see later)

Reducing these can help maintain optimal levels

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