Rezatapopt

Rezatapopt
Identifiers
  • 4-[3-[4-[[(3S,4R)-3-fluoro-1-methylpiperidin-4-yl]amino]-1-(2,2,2-trifluoroethyl)indol-2-yl]prop-2-ynylamino]-3-methoxy-N-methylbenzamide
CAS Number
PubChem CID
Chemical and physical data
FormulaC28H31F4N5O2
Molar mass545.583 g·mol−1
3D model (JSmol)
  • CNC(=O)C1=CC(=C(C=C1)NCC#CC2=CC3=C(C=CC=C3N2CC(F)(F)F)N[C@@H]4CCN(C[C@@H]4F)C)OC
  • InChI=1S/C28H31F4N5O2/c1-33-27(38)18-9-10-24(26(14-18)39-3)34-12-5-6-19-15-20-22(35-23-11-13-36(2)16-21(23)29)7-4-8-25(20)37(19)17-28(30,31)32/h4,7-10,14-15,21,23,34-35H,11-13,16-17H2,1-3H3,(H,33,38)/t21-,23+/m0/s1
  • Key:NKRKBSQLUPEVCZ-JTHBVZDNSA-N

Rezatapopt (PC14586) is a drug which acts as a p53 reactivator and has potential applications in cancer treatment. The p53 family of proteins are regulatory molecules which usually have an important role in preventing tissues from becoming cancerous. Mutations in p53 are one of the most common steps involved in the progression of tissues toward a cancerous state, and around 50% of human tumours show mutations in p53 which reduce or abolish its activity. One of the more common mutations is Y220C, which leads to an inactive form of p53. Rezatapopt binds to the Y220C mutant form of p53 and causes a conformational change which restores its anti-cancer activity, even though the protein is still mutated. It also shows some restoration of activity of other p53 mutants such as Y220N and Y220S. Rezatapopt has shown promising results in Phase I/II human clinical trials, but with some indications that reactivation of p53 can stimulate further mutation into forms which are no longer activated by rezatapopt. This means that if rezatapopt or drugs like it end up being approved for medical use, it will most likely be as part of a cocktail approach alongside other anti-cancer drugs, rather than as a single agent.[1][2][3][4][5][6][7][8][9]

References

  1. ^ Vu BT, Dominique R, Fahr BJ, Li HH, Fry DC, Xu L, et al. (January 2025). "Discovery of Rezatapopt (PC14586), a First-in-Class, Small-Molecule Reactivator of p53 Y220C Mutant in Development". ACS Medicinal Chemistry Letters. 16 (1): 34–39. doi:10.1021/acsmedchemlett.4c00379. PMC 11726359. PMID 39811143.
  2. ^ Puzio-Kuter AM, Xu L, McBrayer MK, Dominique R, Li HH, Fahr BJ, et al. (June 2025). "Restoration of the Tumor Suppressor Function of Y220C-Mutant p53 by Rezatapopt, a Small-Molecule Reactivator". Cancer Discovery. 15 (6): 1159–1179. doi:10.1158/2159-8290.CD-24-1421. PMC 12130801. PMID 39945593.
  3. ^ Ma Z, Shen Q, Zhou J (April 2025). "Rezatapopt (PC14586): A First-in-Class Small Molecule p53 Y220C Mutant Protein Stabilizer in Clinical Trials". Journal of Medicinal Chemistry. 68 (7): 6847–6849. doi:10.1021/acs.jmedchem.5c00670. PMC 12507176. PMID 40110876.
  4. ^ Papavassiliou KA, Vassiliou AG, Papavassiliou AG (September 2025). "Rezatapopt: A promising small-molecule "refolder" specific for TP53Y220C mutant tumors". Neoplasia. 67 101201. doi:10.1016/j.neo.2025.101201. PMC 12221603. PMID 40543428.
  5. ^ Carter BZ, Mak PY, Ayoub E, Wu X, Ke B, Nishida Y, et al. (November 2025). "Restoring p53 wild-type conformation in TP53-Y220C-mutant acute myeloid leukemia". Blood. 146 (21): 2574–2588. doi:10.1182/blood.2025028935. PMC 12320512. PMID 40608889.
  6. ^ Dumbrava EE, Shapiro GI, Parikh AR, Johnson ML, Tolcher AW, Thompson JA, et al. (February 2026). "Phase 1 Study of Rezatapopt, a p53 Reactivator, in TP53 Y220C-Mutated Tumors". The New England Journal of Medicine. 394 (9): 872–883. doi:10.1056/NEJMoa2508820. PMID 41740031.
  7. ^ Mavridi D, Funk JS, Balourdas DI, Krämer A, Khan Tareque R, Timofeev O, et al. (February 2026). "Targeting the p53 cancer mutants Y220C, Y220N, and Y220S with the small-molecule stabilizer rezatapopt". Cell Death & Disease. 17 (1) 268. doi:10.1038/s41419-026-08492-9. PMC 13004867. PMID 41748563.
  8. ^ Fece de la Cruz F, Varkaris A, Patel PS, Kushner EW, Morales-Giron AA, Lee SS, et al. (April 2026). "Acquired On-Target Alterations Drive Clinical Resistance to p53-Y220C Reactivators". Cancer Discovery. 16 (4): 677–685. doi:10.1158/2159-8290.CD-25-1761. PMC 13040207. PMID 41504628.
  9. ^ Chen S, Shepard HM, Lu M (April 2026). "Reactivating p53 mutants selectively in patients". Cancer Cell. 44 (4): 715–717. doi:10.1016/j.ccell.2026.03.009. PMID 41932331.