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A combination therapy of **oral topotecan**, a topoisomerase I inhibitor used as chemotherapy, and **HM30181A**, a novel, selective inhibitor of P-glycoprotein (P-gp/ABCB1). This combination is designed to enhance the oral bioavailability and systemic exposure of topotecan, which is a known P-gp substrate, by inhibiting its efflux from the gastrointestinal tract. HM30181A increases absorption of topotecan, potentially making oral delivery more effective as compared to intravenous administration, allowing for convenient dosing and potentially improved patient outcomes in cancers where topotecan is indicated. Clinical evaluation (such as the KX-ORATOP-001 study) is ongoing primarily in advanced malignancies where topotecan chemotherapy is appropriate. The developer of HM30181A is Hanmi Pharmaceutical; Athenex sponsors the referenced clinical trial[1][2][4].
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