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Fostroxacitabine bralpamide (fostrox, also known as MIV-818) is an orally administered anti-tumor drug designed to selectively target cancer cells in the liver while minimizing effects on other tissues. It is a nucleoside analog prodrug that becomes activated in the liver, leading to DNA damage and cell death specifically in hepatocellular carcinoma (HCC) cells. Lenvatinib is a small molecule receptor tyrosine kinase inhibitor that blocks multiple targets involved in tumor angiogenesis and growth, including VEGFR1–3, FGFR1–4, PDGFRα, KIT, and RET. The combination of fostroxacitabine bralpamide with lenvatinib has shown acceptable safety and promising efficacy for patients with advanced or unresectable HCC who have progressed on prior systemic therapies. This combination is being developed by Medivir AB and evaluated in clinical trials for second-line or later treatment of HCC[2][3][4][5][8].
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