MTOR and infection: Sirolimus, an mTOR inhibitor, has shown clinical efficacy in reducing LM burden, with partial response rates between 55% and 65% after 12 to 52 weeks of therapy.4 However, adverse events, such as stomatitis, infections, hyperlipidemia, and hematologic abnormalities, have occurred in more than 80% of patients, often requiring dose adjustment or discontinuation.4