ivaltinostat + capecitabine

**Ivaltinostat + capecitabine** is a combination therapy under clinical investigation for the maintenance treatment of patients with locally advanced or metastatic pancreatic ductal adenocarcinoma (mPDAC) who have not progressed after front-line fluoropyrimidine-based chemotherapy, particularly FOLFIRINOX. Ivaltinostat is a pan-histone deacetylase (HDAC) inhibitor that modulates gene expression by increasing histone acetylation, leading to activation of tumor suppressor genes, suppression of cancer cell proliferation, and promotion of apoptosis. Capecitabine is an oral prodrug of 5-fluorouracil (5-FU), an antimetabolite that interferes with DNA synthesis. Preclinical studies showed synergy between ivaltinostat and capecitabine. The combination is currently being evaluated in a Phase 1b/2 clinical trial (NCT05249101) to determine safety, efficacy, optimal dosing, and progression-free survival in mPDAC[1][2][3][5][6].