Carba1 is a bifunctional carbazole derivative that activates nicotinamide phosphoribosyltransferase (NAMPT) and enhances the biosynthesis of NAD. It binds to the colchicine site on tubulin, potentially boosting the antitumor effects of various chemotherapeutics such as Paclitaxel. Carba1 has neuroprotective properties and regulates cellular energy metabolism. It is applicable in research on cancer and chemotherapy-induced peripheral neuropathy (CIPN).

Carba1 effectively interacts with several chemotherapeutic agents. At a concentration of 12 μM for 72 hours, it synergistically enhances the effects of Paclitaxel, Docetaxel, nab-Paclitaxel, and Epothilone-B in inhibiting HeLa cell viability, reducing the GI50 values by 2.6, 3.8, 1.8, and 4.4 times, respectively. With concentrations ranging from 1-20 μM over 60 minutes, Carba1 increases NAMPT activity in HeLa cells. Additionally, at 12 μM for 72 hours, it safeguards mature mouse DRG neurons from axonal degeneration induced by Paclitaxel, Cisplatin, and Bortezomib, decreasing the degeneration index. Furthermore, with a concentration of 1-10 μM over 24 hours, Carba1 counteracts neurotoxicity and demyelination in rat DRG neurons caused by Cisplatin. When used at 12 μM for 2 hours, Carba1 modulates metabolism in HeLa cells, raising levels of lactate, glutamate, ATP, and GTP, while reducing NAD+ levels, and enhancing glycolysis and glutaminolysis.

Carba1 (50 mg/kg; intraperitoneal injection; on days 0, 1, 2, 4, 7, and 9) effectively prevents tactile allodynia and neurodegeneration in a rat neuropathy model induced by Paclitaxel. Additionally, Carba1 (60 mg/kg; intravenous injection; every 2 days for a total of 10 days) neither promotes tumor growth nor inhibits Paclitaxel's antitumor efficacy in a tumor growth model.