pixatimod

A synthetic sugar modified heparan sulfate mimetic and agonist of toll-like receptor 9 (TLR9), with potential immunostimulating, antineoplastic and anti-viral activities. Upon administration, pixatimod binds to and activates TLR9 expressed by dendritic cells (DCs) and B cells. This initiates cytokine release from DCs and activates innate immune signaling pathways, and leads to the activation of natural killer (NK) cells to destroy tumor cells. The combination of pixatimod with certain checkpoint inhibitors may enhance the activation of cytotoxic T lymphocytes to further kill tumor cells. In addition, pixatimod inhibits the cleavage of heparan sulfate from cell surface proteoglycan by heparanase (HPSE) and inhibits the infiltration of tumor-associated macrophages (TAMs). TLR9, a member of the TLR family, plays a fundamental role in pathogen recognition and activation of innate immunity.