OBJECTIVE: This review systematically evaluates why CA derivatives have failed to transition from bench to bedside despite superior preclinical performance. SIGNIFICANCE: efficacy is negated by poor aqueous solubility (≈1 mg/mL), rapid first-pass metabolism, and a short plasma half-life (≈1.7 h). Also, the reactive α,β-unsaturated aldehyde moiety often triggers Pan-Assay Interference (PAINS) behavior. KEY FINDINGS: efficacy in oncological, antiviral, and anti-inflammatory models, progress is halted by a lack of human pharmacokinetic profiling and "safety bridging" toxicology. CONCLUSION: disconnection" through chemoproteomic target validation and IND-enabling PK studies is the essential next step for advancing this reactive scaffold into clinical trials.
Shakir et al. (Sun,) studied this question.