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Fostroxacitabine bralpamide is a liver-targeting nucleotide phosphoramidate prodrug of troxacitabine monophosphate, designed to deliver the active cytotoxic agent selectively to the liver. Upon oral administration, it is rapidly hydrolyzed in hepatocytes by carboxylesterase 1, generating high levels of troxacitabine triphosphate in the liver. This metabolite is incorporated into tumor cell DNA, leading to chain termination and inhibition of DNA synthesis, resulting in antitumor activity. The drug aims to maximize exposure within the liver while minimizing systemic toxicity and adverse effects on other organs. It is under development primarily for hepatocellular carcinoma (HCC) and other primary or secondary tumors affecting the liver[1][2][4][5][6].
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