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metapristone ru-42633 desmethylmifepristone metabolite mifepristone selective progesterone receptor modulator sprm enzyme cyp3a4 affinity receptor pr glucocorticoid gr cancer metastatic chemopreventive chemopreventive agent rendering hormone hormonal therapy replacement function action endocrine endocrinology level prohormone analogue metabolism biosynthesis cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic endogenous contractor