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Vorbipiprant is a potent, selective, orally bioavailable small molecule antagonist of the prostaglandin E2 receptor subtype 4 (EP4, also known as PTGER4). It acts as a targeted immunomodulator and has demonstrated both anti-inflammatory and antineoplastic activities. By blocking EP4, vorbipiprant inhibits the binding of immunosuppressive prostaglandin E2 (PGE2), thereby preventing downstream signaling that promotes tumor cell proliferation and immune evasion. This mechanism also reduces interleukin-23 (IL-23) production and limits expansion of T helper 17 (Th17) cells in the tumor microenvironment. Vorbipiprant is being developed primarily for use in combination with immune checkpoint inhibitors to enhance their efficacy in cancers such as metastatic microsatellite-stable colorectal cancer and other gastrointestinal tumors. It has also been investigated for rheumatoid arthritis due to its disease-modifying anti-rheumatic drug (DMARD) effects[1][3][5][8][10].
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