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S64315 (also known as MIK665) is a selective small molecule inhibitor of myeloid cell leukemia 1 (Mcl-1), an antiapoptotic member of the Bcl-2 family of proteins. Overexpression of Mcl-1 in human cancers is associated with high tumor grade, poor survival, and resistance to chemotherapy. By inhibiting Mcl-1, S64315 promotes apoptosis in cancer cells dependent on this protein for survival. The drug has demonstrated potent activity in preclinical models and is being developed primarily for hematologic malignancies such as acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), as well as solid tumors like breast cancer. It has reached Phase I/II clinical trials for AML and breast cancer[3][5][6][7]. The compound was discovered through structure-guided optimization to achieve high selectivity against other Bcl-2 family members[7].
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