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Dalantercept is a recombinant fusion protein that acts as a soluble ligand trap for activin receptor-like kinase 1 (ALK1), a type I receptor in the TGF-beta superfamily expressed on activated endothelial cells. It consists of the extracellular domain of human ALK1 fused to the Fc portion of human IgG1. Dalantercept binds bone morphogenetic protein 9 and bone morphogenetic protein 10 (BMP9 and BMP10), preventing their interaction with endogenous ALK1 receptors, thereby inhibiting ALK1 signaling. This disrupts angiogenesis at the maturation stage, leading to reduced tumor vascularization and inhibition of tumor growth through a mechanism distinct from VEGF pathway inhibitors. Dalantercept was developed primarily for oncology indications such as advanced solid tumors, recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN), hepatocellular carcinoma (HCC), ovarian cancer, fallopian tube cancer, primary peritoneal carcinoma, and multiple myeloma[3][5][6][7][8]. The drug was initially developed by Acceleron Pharma.
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