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Imexon + dacarbazine is a combination of two small molecule antineoplastic agents being investigated for the treatment of unresectable and metastatic melanoma. **Imexon** (also called Amplimexon) is an aziridine pro-oxidant compound that increases reactive oxygen species, disrupts mitochondrial membranes, and induces apoptosis (programmed cell death) in cancer cells. **Dacarbazine** is an alkylating agent that damages DNA, leading to cell death. Preclinical and clinical studies suggest that imexon has synergistic or additive effects with dacarbazine, and the combination increases oxidative stress in tumor cells, inducing apoptosis. The drug combination has completed Phase 1-2 trials in patients with advanced melanoma, showing a tolerable safety profile and a median overall survival of about 11.7 months, with improved survival in patients with normal LDH levels compared to dacarbazine alone.
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