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Apaziquone is a fully synthetic indolequinone bioreductive prodrug and analog of mitomycin C with potential antineoplastic and radiosensitizing activities. It is designed to be activated in hypoxic tumor cells by intracellular reductases, particularly NAD(P)H:quinone oxidoreductase 1 (NQO1), which are present at higher levels in these cells. Upon activation, apaziquone forms cytotoxic species that can alkylate and crosslink DNA, leading to apoptosis. This mechanism is especially effective under hypoxic conditions commonly found in tumors. Apaziquone has been primarily developed for intravesical treatment of non-muscle invasive bladder cancer (NMIBC) following transurethral resection of bladder tumors (TURBT). The drug shows minimal systemic absorption when administered intravesically, resulting in few systemic side effects[1][2][5][6][7].
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