{"entity":{"id":"xevinapant","kind":"drug","name":"Xevinapant","aka":["Debio 1143","AT-406","SM-406"],"tldr":"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.\n\nThe 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.","status":"negative","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Xevinapant","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Xevinapant"}],"tags":["subtype-drugs-wave"],"related":["cisplatin"],"cancers":["hpv-negative-head-and-neck-cancer"],"sections":[],"technologies":["radiosensitisers"],"targets":[],"drugs":[],"companies":["debiopharm","merck-kgaa"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/xevinapant/","neighbours":{"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"}],"cancer":[{"id":"hpv-negative-head-and-neck-cancer","kind":"cancer","name":"HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer)","route":"/cancers/hpv-negative-head-and-neck-cancer/"}],"technology":[{"id":"radiosensitisers","kind":"technology","name":"Radiosensitisers","route":"/technologies/radiosensitisers/"}],"company":[{"id":"debiopharm","kind":"company","name":"Debiopharm","route":"/companies/debiopharm/"},{"id":"merck-kgaa","kind":"company","name":"Merck KGaA (EMD Serono)","route":"/companies/merck-kgaa/"}]}}