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AVA4746 is an experimental, non-peptidic small molecule antagonist of integrin α4 (VLA-4), developed as a therapeutic strategy primarily for drug-resistant B-cell acute lymphoblastic leukemia (B-ALL). It binds with high affinity to VLA-4 on B-ALL cells, efficiently blocking the interaction between VLA-4 and its ligand, VCAM-1, which is a key mechanism in cell adhesion-mediated drug resistance (CAM-DR). AVA4746 induces de-adhesion of leukemic cells from VCAM-1, decreases cell surface and intracellular expression of integrin α4, and inhibits angiogenesis in vitro. In combination with chemotherapy, it has been shown to prolong survival in xenograft models of B-ALL, highlighting its potential as an adjuvant therapy for resistant leukemia[1][3][10].
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