# Xevinapant

Source: https://onco.cc/drugs/xevinapant/  
OnCo record `xevinapant` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Xevinapant was a tablet meant to make head and neck cancer cells easier to kill with chemoradiation by removing the proteins that stop them dying. A promising mid-stage trial was followed by a phase 3 that was stopped in 2024 because it was not working.

## Summary

Xevinapant (Debio 1143) is an oral antagonist of the inhibitor-of-apoptosis proteins developed by Debiopharm and licensed to Merck KGaA in 2021. In a randomised phase 2 trial in locally advanced squamous cell carcinoma of the head and neck, adding it to cisplatin-based chemoradiation improved locoregional control and, on longer follow-up, survival, which made it the most anticipated radiosensitiser in the disease.

The confirmatory phase 3 TrilynX trial in unresected locally advanced disease was stopped for futility in 2024 after an interim analysis found it was unlikely to improve event-free survival, and the companion trial XRay Vision in resected high-risk disease was also halted; Merck KGaA returned the rights. The HPV-negative head and neck cancer page records it among the treatments that failed to improve chemoradiation.

## Fields

- Kind: Treatment
- Status: negative
- Last checked: 2026-09-17
- Also known as: Debio 1143; AT-406; SM-406
- Tags: subtype-drugs-wave
- Code: Debio 1143
- Modality: Oral IAP antagonist (SMAC mimetic) radiosensitiser
- Mechanism: Mimics the SMAC protein to block inhibitor-of-apoptosis proteins (XIAP, cIAP1 and cIAP2), restoring the cancer cell's ability to die after the DNA damage of radiotherapy and cisplatin.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Xevinapant
- Wikipedia: https://en.wikipedia.org/wiki/Xevinapant

## Connected records

- drugs: [Cisplatin](https://onco.cc/drugs/cisplatin/)
- cancers: [HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer)](https://onco.cc/cancers/hpv-negative-head-and-neck-cancer/)
- technologies: [Radiosensitisers](https://onco.cc/technologies/radiosensitisers/)
- companies: [Debiopharm](https://onco.cc/companies/debiopharm/), [Merck KGaA (EMD Serono)](https://onco.cc/companies/merck-kgaa/)

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JSON: https://onco.cc/api/v1/entities/xevinapant.json