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Dp44mT (di-2-pyridylketone 4,4-dimethyl-3-thiosemicarbazone) is a potent, redox-active iron chelator developed for the treatment of various cancers. It functions by sequestering intracellular iron, which is essential for cancer cell proliferation, and by forming redox-active metal complexes (particularly with iron and copper) that catalyze the production of reactive oxygen species (ROS) via Fenton-like chemistry. This induction of oxidative stress leads to DNA damage, cell cycle arrest, and apoptosis. Dp44mT is also known to upregulate the metastasis suppressor N-myc downstream regulated gene 1 (NDRG1) and can overcome P-glycoprotein-mediated multidrug resistance by being sequestered into lysosomes, where it induces lysosomal membrane permeabilization. While highly effective in preclinical models of multiple myeloma, melanoma, and other solid tumors, its clinical development has been limited by potential cardiotoxicity at high doses, leading to the investigation of second-generation analogs.
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