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**SCO-101 + paclitaxel** is a combination regimen investigated specifically to overcome chemotherapy resistance in cancers such as pancreatic ductal adenocarcinoma (PDAC). SCO-101 is an oral small molecule that inhibits the SRPK1 enzyme, blocks the ABCG2 drug transporter (associated with multi-drug resistance), and inhibits the liver enzyme UGT1A1. Paclitaxel is a widely used microtubule inhibitor that suppresses cancer cell division. Preclinical studies have shown that the combination of SCO-101 and paclitaxel synergistically increases cytotoxicity in paclitaxel-resistant PDAC cells. In a phase Ib trial, the combination's toxicity, pharmacokinetics, and maximum tolerated dose were evaluated, demonstrating manageable safety signals but no clear added efficacy in clinical endpoints. The primary indication under study for this combination is pancreatic cancer refractory to taxane chemotherapies[1].
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