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Devimistat is a synthetic lipoic acid analogue and a first-in-class small molecule that targets cancer cell metabolism. It acts as an anti-mitochondrial agent by selectively inhibiting key mitochondrial enzymes—pyruvate dehydrogenase (PDH) and alpha-ketoglutarate dehydrogenase (KGDH)—which are central to the tricarboxylic acid (TCA) cycle. By blocking these enzymes, devimistat disrupts the entry of glucose and glutamine-derived carbons into the TCA cycle, collapsing mitochondrial metabolism in tumor cells and inducing cell death pathways. Devimistat is being developed primarily for hard-to-treat cancers such as metastatic pancreatic cancer and relapsed or refractory acute myeloid leukemia (AML), with ongoing clinical trials also in myelodysplastic syndromes (MDS), peripheral T-cell lymphoma, Burkitt's lymphoma, solid tumors including biliary tract cancer, and small cell lung cancer. The drug has received orphan drug designation from the FDA for several indications[1][2][3][4][5][6][7][8].
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