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GSK3036656 + delamanid is a combination therapy under clinical investigation for the treatment of pulmonary tuberculosis (including drug-sensitive and multidrug-resistant TB). GSK3036656, also known as ganfeborole, is a small molecule inhibitor of *leucyl-tRNA synthetase*, selectively targeting *Mycobacterium tuberculosis*.[2][5] Delamanid is a prodrug in the nitroimidazole class that inhibits mycolic acid synthesis after activation by bacterial nitroreductase.[7] The combination aims to leverage the distinct mechanisms of both agents to enhance bactericidal activity and reduce development of resistance. GSK3036656 has shown safety and efficacy in Phase 1 trials and entered Phase 2 clinical studies.[2][5] Delamanid has received conditional approval for MDR-TB and is used in regimens for resistant tuberculosis.[7][4][1]
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