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Scandion Oncology
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=== SCO-101 has a dual mechanism of action === With its lead asset SCO-101, Scandion Oncology is targeting two mechanisms of drug resistance in oncology, multi-drug resistance and altered drug metabolism. Scandion claims that SCO-101 is a first-in-class chemosensitiser, a class of compounds that when used in combination with traditional chemotherapy agents may re-sensitise resistant cancer cells to treatment. Specifically, SCO-101 is a potent inhibitor of the ATP Binding Cassette G2 (ABCG2) efflux pump and UTG1A1 enzyme. As a member of the ABC superfamily of transmembrane efflux pumps, ABCG2 (also known as the breast cancer resistance protein, BCRP) is important in the development of chemotherapeutic resistance. In normal tissues, ABCG2 is involved in a range of functions including cell protection (in the brain and placenta), homeostasis, nutrient absorption, and hormone regulation. However, when overexpressed in tumour cells, ABCG2 mediates drug resistance through the increased removal of cytotoxic agents from the cell interior (Exhibit 5). Furthermore, many classes of chemotherapeutics are proven substrates for ABCG2. Examples include topoisomerase I and II inhibitors (irinotecan and doxorubicin, respectively), DNA intercalators, nucleoside analogues (clofarabine), thymidylate synthase inhibitors (5-fluorouracil), EGFR inhibitors (erlotinib) and PARP inhibitors (rucaparib), among others. In Edison Investment Research's view, the prevalence of ABCG2-mediated drug resistance highlights the opportunity for SCO-101 in combination with chemotherapies other than FOLFIRI. '''Exhibit 5: SCO-101 dual mechanism of action<ref>Source: Scandion Oncology corporate presentation.</ref>''' [[File:Image6-b18deb263878259b652ac43cea6d3088.png|600px]] Additionally, as stated above, SCO-101 inhibits the enzyme UDP-glucuronosyltransferase 1A1 (UGT1A1) to block the metabolism of chemotherapy drugs and increase systemic levels. The UGT family of enzymes work by modifying a chemotherapy drug with glucuronic acid, therefore making it more water soluble and easier to eliminate from the body. There is a body of clinical evidence that supports the role of UGTs in the development of drug resistance in multiple classes of chemotherapy agents, including alkylating agents, targeted therapies, antiangiogenics and hormonal therapies. Altogether, SCO-101βs dual mechanism acts to reverse drug resistance by increasing the level of chemotherapy drug in the body (through UGT1A1 inhibition) while simultaneously decreasing the ABCG2 mediated removal of the drug from the cell.
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