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Alrizomadlin is an orally available, selective small-molecule inhibitor of the human homolog of double minute 2 (HDM2; also known as MDM2), developed for its potential antineoplastic activity. By binding to MDM2, alrizomadlin blocks the interaction between MDM2 and the tumor suppressor protein p53, preventing proteasome-mediated degradation of p53 and restoring its transcriptional activity. This leads to reactivation of p53 signaling pathways and induction of tumor cell apoptosis. Alrizomadlin also acts as a host immunomodulator, potentially enhancing T-cell mediated antitumor immunity and restoring efficacy in tumors resistant to PD-1/PD-L1 inhibitors. It is being investigated primarily for various cancers including malignant melanoma (especially after progression on immunotherapy), solid tumors, acute myeloid leukemia, liposarcoma, salivary gland cancer, myelodysplastic syndromes, neuroblastoma, dry age-related macular degeneration (preclinical), multiple myeloma (preclinical), uveal melanoma (preclinical), with orphan drug status granted for several rare cancers[1][2][3][4][5][6][7][8].
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