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Enocitabine is a synthetic nucleoside analog belonging to the cytarabine family, characterized by the attachment of a behenoyl group to cytarabine. It functions as an antimetabolite and is used primarily as a chemotherapeutic agent for the treatment of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). The behenoyl modification allows for a different pharmacokinetic profile compared to cytarabine, potentially resulting in altered cellular uptake and metabolism. Mechanistically, enocitabine inhibits DNA synthesis by incorporation into DNA during the S-phase of the cell cycle, leading to impaired DNA elongation and cell death in rapidly dividing cells. It has been used in Japan for remission induction and consolidation therapy in AML, and is sometimes employed in combination regimens with other agents such as daunorubicin and gemtuzumab ozogamicin[8][5][2].
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