Although several agents have been approved for use as maintenance or induction therapy in organ transplantation in recent years, only a handful of compounds are currently in clinical development. Of these, one of the more promising appears to be FK 778, a malononitrilamide derivative of leflunomide. Speaking at a symposium at the American Transplant Congress (ATC) [Washington DC; April-May 2002], Dr Flavio Vincenti from the University of California, San Francisco, US, pointed out that the next 5 years were not looking encouraging, as'currently there are no drugs in phase 3 trials'in the US; consequently, there will be no new drug approvals there until at least 2006. However, Dr Vincenti stated that there were a host of new agents in earlier stages of development that have shown promising activity, adding that FK 778 was the new antimetabolite'most likely to be ultimately developed'.Preclinical data presented at the ATC showed that FK 778 not only has activity when used alone, but also acts synergistically with both of the currently available calcineurin inhibitors, tacrolimus and cyclosporin.*