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Siremadlin is an inhibitor of the protein-protein interaction between the E3 ubiquitin ligase MDM2 and p53 (IC50 = 0.21 nM).1 It selectively inhibits the MDM2-p53 protein-protein interaction over MDM4-p53, YAP1-TEAD4, PCSK9-LDLR, and Bcl-2-Bak interactions in time-resolved FRET (TR-FRET) assays (IC50s = 3.3, >150, >50, and >50 µM, respectively). Siremadlin inhibits the growth of SJSA-1 osteosarcoma cells (GI50 = 38 nM). It also induces apoptosis in SJSA-1 cells when used at a concentration of 100 nM. In vivo, siremadlin (27 mg/kg) induces tumor regression and prevents tumor regrowth in an SJSA-1 rat xenograft model and an HSAX2655 patient-derived xenograft (PDX) rat liposarcoma model.
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1. Dose and schedule determine distinct molecular mechanisms underlying the efficacy of the p53-