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CKD-581 (alteminostat) is a highly water-soluble, pan-histone deacetylase (HDAC) inhibitor with potential antineoplastic activity. It targets and inhibits class I and II HDACs, leading to the accumulation of acetylated histones, chromatin remodeling, and altered gene expression. This results in cell cycle arrest and induction of apoptosis in cancer cells. CKD-581 has demonstrated anti-cancer effects in preclinical models of hematologic malignancies such as multiple myeloma and diffuse large B-cell lymphoma (DLBCL), including double-hit/double-expressor subtypes. Mechanistically, it downregulates oncogenic proteins like MYC and members of the BCL-2 family while upregulating pro-apoptotic pathways involving p53 phosphorylation and p21 expression. The drug also inhibits the Wnt/β-catenin signaling pathway via DACT3 upregulation. Clinical studies indicate that CKD-581 has a favorable safety profile compared to other HDAC inhibitors[1][2][4][8].
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