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Itareparib (NMS-293) is a next-generation, highly selective small molecule inhibitor of Poly (ADP-ribose) polymerase 1 (PARP1). Developed by Nerviano Medical Sciences (NMS), it is specifically engineered to avoid PARP trapping, a mechanism associated with the hematological toxicity seen with first-generation PARP inhibitors. By selectively inhibiting PARP1 without trapping the enzyme on DNA, itareparib maintains potent DNA damage repair inhibition while offering a superior safety profile, particularly regarding bone marrow tolerability. This differentiated profile allows for effective combination with DNA-damaging agents such as temozolomide and topotecan. It is currently being evaluated in Phase 2 clinical trials for relapsed glioblastoma and high-grade astrocytoma, and in Phase 1 for small cell lung cancer and BRCA wild-type ovarian cancer.
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