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They can assess whether the vial appearance, color, or clarity has changedsigns of degradation

While classical gene mutations are region-limited, epimutations often occur early in cancer development and have a genome-wide impact, boosting on the one hand the expression of cell survival genes or proto-oncogenes and deactivating on the other hand tumor suppressor genes (TSGs), DNA repair mechanisms as well as cell division brakes, thus leading to carcinogenesis (Karius et al., 2012

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Using sterile water for multi-dose vials creates contamination risk

This may be a result of the slow intestinal absorption rate and/or the rapid first-pass metabolism (32)