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Unlike patents of addition (under Section 54), which expire with the core patent, these independent secondary patents have their own 20-year terms

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Tirzepatide: A Novel, Once-weekly Dual GIP and GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes

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[8] The balance between the PI3K/Akt (survival, metabolic, hypertrophic) arm and the MAPK (proliferative) arm is context-dependent, varying by cell type, receptor density, and the presence of co-receptors such as hybrid IGF-1R/insulin-receptor complexes