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Pivaloyloxymethyl butyrate (AN-9, Pivanex) is a small molecule prodrug of butyric acid designed to improve the pharmacokinetic and pharmacodynamic properties of its parent compound. It acts as a histone deacetylase inhibitor (HDAC inhibitor), leading to downregulation of apoptosis regulator Bcl-2 and regulation of caspase 8. This results in induction of malignant cell differentiation and inhibition of tumor growth through apoptosis. Preclinical studies demonstrated that AN-9 has greater potency than butyric acid at inducing cancer cell differentiation and tumor growth inhibition with more favorable toxicity profiles. It has been investigated for anticancer activity in various solid tumors and hematologic malignancies, as well as for neuroprotective effects in models of spinal muscular atrophy[1][2][3][4][5].
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