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5-fluoro-2'-deoxycytidine is a synthetic fluorinated pyrimidine nucleoside analog and antimetabolite with potential antineoplastic activity. It acts as a prodrug, being converted intracellularly by deaminases to the cytotoxic agent 5-fluorouracil (5-FU). The active metabolites of 5-FU, including 5-fluoro-2-deoxyuridine monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP), inhibit thymidylate synthase and interfere with DNA synthesis, RNA synthesis, and cell division. Additionally, when administered with tetrahydrouridine (a cytidine deaminase inhibitor), its bioavailability increases significantly. It has been investigated in clinical trials for various cancers such as breast cancer, non-small cell lung cancer, head and neck cancer, urothelial transitional cell carcinoma, pediatric brain tumors, and other neoplasms[1][3][4][7][8][10].
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