The rationale NOX uses for the cold-to-hot tumour story is certainly lacking data. NOX say's Veyonda downregulates S1P in tumours which enables immune cells to access and kill tumours. In defense of NOX, that finding was only made this year, even though this is more of a claim and not yet supported by strong research data. Other biotechs use adjuvants to stimulate the immune system, which struggle to gain access to the tumour environment.
The other claims made by NOX are supported by strong research data. For example the ability for Idronoxil to prevent DNA damage repair and its use as an anti-inflammatory by inhibiting interferon genes (STING)-mediated inflammatory cytokine pathways. However, whether or not it can block cytokine release syndromes is a different story.
The multitude of functions of Idronoxil could be due to its action on ceramide or S1P levels, but also its indiscriminate nature of action i.e. the accumulation of protein ions in the plasma membrane (as indicated below). The latter is more concerning since this will imply possible off-target effects and that the downregulation of S1P is more of an indirect effects of the high proton concetration as opposed to a direct target.
