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CUDC-427 is an orally bioavailable small molecule that acts as a second-generation pan-selective inhibitor of apoptosis protein (IAP) antagonist. It is designed to mimic the activity of the second mitochondrial-derived activator of caspases (Smac/DIABLO), binding to the Smac binding groove on IAPs such as XIAP and cellular IAPs 1 and 2. By inhibiting these proteins, CUDC-427 promotes apoptosis in tumor cells through activation of apoptotic signaling pathways. Preclinical studies demonstrated antitumor activity both as a single agent and in combination with chemotherapeutic agents or TRAIL receptor-targeting antibodies. The drug was developed for cancer indications including solid tumors and lymphomas, with phase I clinical trials showing manageable toxicity profiles but no further development reported beyond early-stage trials[1][3][4][5][6][8].
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