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JNJ-74856665 is an orally bioavailable, potent, and selective small molecule inhibitor of dihydroorotate dehydrogenase (DHODH), developed by Janssen Research & Development for the treatment of hematologic malignancies. By binding to the ubiquinone binding site of DHODH, it inhibits this enzyme in the pyrimidine biosynthesis pathway, leading to cell cycle arrest and apoptosis as well as promoting differentiation in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). The drug is currently being evaluated in Phase 1 clinical trials as monotherapy or in combination with azacitidine or venetoclax for AML, MDS, and chronic myelomonocytic leukemia (CMML)[1][2][3][5][7].
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