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Pracytarabine (XT-001) is a small molecule prodrug of the nucleoside analog cytarabine (ara-C), developed by Xi'an Xintong Pharmaceutical Research for the treatment of advanced solid tumors, specifically hepatocellular carcinoma (HCC). Designed to overcome the rapid deamination and short half-life of parent cytarabine in the systemic circulation, pracytarabine acts as an antimetabolite. Once converted to its active triphosphate form (ara-CTP), it competes with natural cytidine for incorporation into DNA, thereby inhibiting DNA polymerase and halting DNA synthesis and repair. Pracytarabine is currently being evaluated in a Phase 3 registration trial in China, comparing its efficacy and safety against regorafenib in patients with advanced HCC who have failed prior targeted therapies and immune checkpoint inhibitors.
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