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**opaganib + hydroxychloroquine** is a combination of two pharmaceuticals: opaganib (ABC294640/Yeliva), a proprietary, orally administered small molecule that selectively inhibits sphingosine kinase-2 (SK2), and hydroxychloroquine, an anti-malarial and anti-inflammatory agent commonly used for autoimmune diseases. Opaganib acts by blocking the synthesis of sphingosine 1-phosphate (S1P), a lipid-signaling molecule promoting cancer growth and inflammation. Its combined use with hydroxychloroquine is designed to enhance anti-inflammatory effects and potentially synergize against cancer and viral diseases, notably COVID-19 and cholangiocarcinoma. In clinical studies, opaganib plus hydroxychloroquine was investigated for advanced cholangiocarcinoma (as part of a phase 1/2a trial) and in compassionate use and exploratory settings for COVID-19, with rationale based on additive anti-inflammatory and possible antiviral actions[1][5][2].
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