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DRUG CLASS:

p53 reactivator

5d
New P1 trial
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TP53 (Tumor protein P53)
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TP53 mutation • TP53 Y220C
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FoundationOne® CDx • MSK-IMPACT • MSK-ACCESS
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metformin • rezatapopt (PC14586) • midazolam hydrochloride
14d
Effects of moxibustion on intestinal ferroptosis, lipid peroxidation, and P53 in mice with Crohn's disease (PubMed, Zhongguo Zhen Jiu)
Compared with the inhibitor group, the serum level of IL-6, the contents of 4-HNE and MDA, and protein expression of p53 in colonic tissue in the activator group were elevated (P<0.05), while the body weight, the contents of SOD and GSH, and protein expression of GPX4 in colonic tissue were reduced (P<0.05). Moxibustion at "Tianshu" (ST25) could alleviate intestinal inflammation in CD mice, possibly by downregulating the protein expression of p53, enhancing the activity of the SLC7A11/GSH/GPX4 pathway, reducing the production of lipid peroxides, maintaining intestinal iron homeostasis, and reducing colonic ferroptosis.
Preclinical • Journal
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TP53 (Tumor protein P53) • IL6 (Interleukin 6) • TNFA (Tumor Necrosis Factor-Alpha) • GPX4 (Glutathione Peroxidase 4) • IL17A (Interleukin 17A) • SLC7A11 (Solute Carrier Family 7 Member 11) • IL1B (Interleukin 1, beta)
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RITA
16d
The regulation of CP-31398 on liquid-liquid phase separation of p53. (PubMed, Arch Biochem Biophys)
These findings clarified that CP-31398 could elevate the transcriptional function of p53 probably by modulating the phase behavior. The study provided new insights into the regulation mechanism of p53 and potential therapeutic avenues for cancer.
Journal
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TP53 (Tumor protein P53)
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CP-31398
26d
Acquired on-target alterations drive clinical resistance to p53-Y220C reactivators. (PubMed, Cancer Discov)
Functional modeling confirmed these double mutants eliminate p53 reactivation and target gene induction by rezatapopt. These findings establish a molecular framework for resistance to p53 Y220C reactivators and inform strategies to overcome resistance with next-generation agents.
Journal
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TP53 (Tumor protein P53)
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TP53 mutation • TP53 Y220C
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rezatapopt (PC14586)
1m
Breast Cancer Therapy by Small-Molecule Reactivation of Mutant p53. (PubMed, Curr Oncol)
Furthermore, we will demonstrate the effectiveness of PRIMA-1 at arresting xenograft growth in an animal model and go on to show that the PRIMA-1 analog APR-246 effectively restores wtp53 tumor suppressor activity in TNBC cells. A brief overview of current clinical trials aimed at reactivating p53 to treat certain cancers is provided. Finally, we discuss the possible use of naturally occurring compounds, which are generally non-toxic, to reactivate mutant p53 and control TNBC progression.
Review • Journal
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TP53 (Tumor protein P53)
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TP53 mutation
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eprenetapopt (APR-246)
2ms
Dual-functional copper nanoplatform potentiates cuproptosis through p53 reactivation and metabolic reprogramming. (PubMed, J Colloid Interface Sci)
Here, we report the rational design of CuF16@246, an acid-responsive, dual-functional copper-based nanocoordination polymer that integrates Cu2+ and the p53 reactivator eprenetapopt (APR-246) within a single perfluorosebacic acid (PFSEA)-coordinated framework to synergistically induce cuproptosis and reverse tumor metabolic reprogramming...In vitro and in vivo studies demonstrate that CuF16@246 exhibits more efficient cellular uptake, more potent cytotoxicity, and more significant tumor growth inhibition than individual treatments, without inducing hemolysis or major organ toxicity. This work establishes a dual-functional strategy that combines metabolic reprogramming with sensitized cuproptosis, providing a promising framework for developing advanced copper-based nanomedicines for the treatment of mut-p53-positive cancers.
Journal
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DLAT (Dihydrolipoamide S-Acetyltransferase) • FDX1 (Ferredoxin 1) • LIAS (Lipoic Acid Synthetase) • TIGAR (TP53 Induced Glycolysis Regulatory Phosphatase)
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TP53 mutation
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eprenetapopt (APR-246)
2ms
Post-transplant MRD Monitoring by TP53 Duplex Sequencing with APR-246 + Azacitidine Maintenance Predicts Outcomes. (PubMed, Blood Adv)
Specifically, MRD negativity after cycle 12 strongly predicted OS (33.9 vs 20.4 months; P=.005) and EFS (33.9 vs 10.1 months; P=.004) with a trend for RFS (32.6 vs 13.5 months; P=.06). TP53 MRD was strongly predictive of outcomes, supporting incorporation of this assay in future novel strategies.
Journal
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TP53 (Tumor protein P53)
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TP53 mutation
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azacitidine • eprenetapopt (APR-246)
3ms
Mutant p53 Regulates Pyruvate Dehydrogenase Kinase 1 (PDK1) to Promote Proliferation and Migration in Breast Cancer. (PubMed, Cancer Sci)
Moreover, PDK1 inhibition increased the therapeutic effect of APR-246 on TP53 mutant breast cancer in xenograft tumors. Our results suggested that intervention of PDK1 could potentially emerge as a new therapeutic strategy to impede the progression of TP53 mutant breast cancer.
Journal
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TP53 (Tumor protein P53) • EGR1 (Early Growth Response 1) • PDK1 (Pyruvate Dehydrogenase Kinase 1)
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TP53 mutation • TP53 wild-type
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eprenetapopt (APR-246)
3ms
LT1-3, a Slit2-Derived Peptide, Exhibits Anti-Tumor Activity and Improves Cisplatin Therapy. (PubMed, Cells)
The p53 reactivator APR-246 restores sensitivity of p53R273H-expressing cells to LT1-3. Therefore, LT1-3 possesses multifunctional antitumor properties, directly inhibiting tumor cells and enhancing the efficacy of cisplatin, without causing toxicity to normal cells. Combining LT1-3 with cisplatin holds promise as a first-line therapy for lung cancer, while LT1-3 alone may be suitable for maintenance therapy.
Journal
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PRKACA (Protein Kinase CAMP-Activated Catalytic Subunit Alpha) • SLIT2 (Slit Guidance Ligand 2) • MAPK8 (Mitogen-activated protein kinase 8)
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TP53 mutation
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cisplatin • eprenetapopt (APR-246)
3ms
Pan-cancer multi-omics analysis reveals IQCE as a malignant cell-restricted oncogenic biomarker driving immunosuppression and chemoresistance in cutaneous melanoma. (PubMed, Discov Oncol)
IQCE emerges as a novel oncogene-associated biomarker with significant diagnostic and prognostic utility, particularly in SKCM. It promotes an immunosuppressive TME and oncogenic signaling while being localized to malignant cells. Although associated with chemoresistance, the vulnerability of IQCE-high tumors to RITA offers a promising therapeutic strategy. IQCE represents a compelling target for precision oncology.
Journal • Pan tumor
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TP53 (Tumor protein P53)
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RITA
3ms
Mutant p53 binds and controls estrogen receptor activity to drive endocrine resistance in ovarian cancer. (PubMed, Genes Dev)
In this work, we show that missense mutant forms of p53, which occur in >60% of HGSOC, bind and inhibit ERα function and confer resistance to fulvestrant and elacestrant. Mechanistically, we show that mutant p53 predominantly inhibits one arm of the ERα pathway-the transactivation of jointly regulated ERα-SP1 target genes such as the mTOR regulator DEPTOR We show that silencing mutant p53 restores the ability of ERα to transactivate ERα-SP1 target genes and renders HGSOC markedly more sensitive to endocrine therapy. Consistent with this premise, we show that the p53 mutant Y220C refolding compound rezatapopt enhances fulvestrant response in a Y220C mutant cell line.
Journal
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ER (Estrogen receptor) • TP53 (Tumor protein P53)
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TP53 mutation • TP53 Y220C
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fulvestrant • Orserdu (elacestrant) • rezatapopt (PC14586)
3ms
The Evaluation of PC14586 in Patients With Advanced Solid Tumors Harboring a TP53 Y220C Mutation (PYNNACLE) (clinicaltrials.gov)
P1/2, N=300, Recruiting, PMV Pharmaceuticals, Inc | N=230 --> 300 | Trial completion date: Jul 2026 --> Dec 2027 | Trial primary completion date: Mar 2026 --> Aug 2026
Enrollment change • Trial completion date • Trial primary completion date
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TP53 (Tumor protein P53)
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TP53 mutation • TP53 Y220C
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Keytruda (pembrolizumab) • rezatapopt (PC14586)