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NT4-paclitaxel is a peptide-drug conjugate (PDC) in preclinical development for the treatment of solid tumors, including breast and ovarian cancers. It consists of the cytotoxic agent paclitaxel covalently linked to NT4, a tetrabranched peptide designed to improve the solubility and tumor-specificity of the taxane payload. NT4 acts as a targeting moiety by binding to membrane-sulfated glycosaminoglycans (GAGs) and endocytic receptors such as Low-density lipoprotein receptor-related protein 1 (LRP1) and LRP6, which are frequently overexpressed on the surface of cancer cells. This targeted approach allows for selective internalization of the drug into tumor cells, potentially enhancing therapeutic efficacy while minimizing off-target toxicities like sensory axonal neuropathy. Preclinical studies have demonstrated that NT4-paclitaxel induces significant tumor regression in orthotopic mouse models, whereas unconjugated paclitaxel primarily results in growth inhibition. The conjugate was developed by researchers at the University of Siena and is associated with the spin-off company SetLance.
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