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**Rugocrixan** (KAND567, AZD-8797) is a small molecule antagonist of the fractalkine receptor **CX3CR1**, a G protein-coupled receptor involved in immune cell recruitment and activation in inflammation and cancer. Originally developed by AstraZeneca and acquired pre-clinically by Kancera (now Novakand Pharma) in 2016, it functions as a non-competitive allosteric modulator that blocks CX3CR1 activation by its ligand CX3CL1 (fractalkine), thereby inhibiting disease-promoting immune cells. It has advanced through multiple Phase I/II studies, demonstrating safety, tolerability, and signals of efficacy in acute myocardial infarction (reducing intramyocardial hemorrhage) and platinum-resistant ovarian cancer (additive anti-tumor effects with carboplatin), with a planned Phase IIb trial (FRACTIVE) in STEMI.[1][3][5][9]
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