Completed Clinical Trials

Resminostat

Domatinostat (4SC-202)

Resminostat monotherapy and S-1/resminostat combination therapy in biliary tract or pancreatic cancer

This is an open-label, dose escalation Phase I study to evaluate the dose-limiting toxicities (DLTs) of resminostat monotherapy and S-1/resminostat combination therapy in Japanese patients with unresectable/recurrent biliary tract or pancreatic cancer to determine the recommended dose regimen/s to be used in subsequent Phase II trials conducted by our cooperation partner Yakult Honsha.

Recruitment status Completed
Study phase Phase I
Enrollment Up to 44
Primary objective
  • Evaluate the dose-limiting toxicities (DLTs) of resminostat monotherapy and S-1/resminostat combination therapy in Japanese patients with unresectable/recurrent biliary tract or pancreatic cancer
Key secondary objective
  • Assess safety and pharmacokinetics
  • Assess efficacy endpoints, such as best overall response (OR), progression free survival (PFS), overall survival (OS)
Publication Phase I study of resminostat, an HDAC inhibitor, combined with S-1 in patients with pre-treated biliary tract or pancreatic cancer

Masafumi Ikeda, Izumi Ohno, Hideki Ueno, Shuichi Mitsunaga, Yusuke Hashimoto, Takuji Okusaka, Shunsuke Kondo, Mitsuhito Sasaki, Yasunari Sakamoto, Hideaki Takahashi, Rina Hara, Shingo Kobayashi, Osamu Nakamura, Chigusa Morizane.

Invest New Drugs. 2019 Feb;37(1):109-117. doi: 10.1007/s10637-018-0634-5. Epub 2018 Jul 11.

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Resminostat in combination with sorafenib in Asian patients with advanced hepatocellular carcinoma (HCC)

NCT02400788

This study was a multi-national, multi-center, randomized, double-blind, placebo-controlled Phase II study to evaluate resminostat in combination with sorafenib for the first-line treatment of advanced HCC, conducted by our cooperation partner Yakult Honsha.

Recruitment status Completed
Study Phase Phase II
Enrollment 170
Primary objective
  • Evaluate efficacy of the combination of resminostat and sorafenib versus sorafenib in the first-line treatment of advanced HCC patients
Secondary objectives
  • Safety
  • Quality of life (QOL)
  • Pharmacokinetic parameters
Exploratory objectives
  • Investigate the ability of plasma or serum biomarkers (e.g. vascular endothelial growth factor A, VEGF-A, or angiopoietin-2, Ang-2) and blood cellular mRNA biomarkers (e.g. zinc-finger protein 64 (Zfp64) mRNA) to predict subject prognosis and clinical efficacy of the treatments
  • Assess pharmacodynamics effects of resminostat and sorafenib
Poster Resminostat and sorafenib combination therapy for advanced hepatocellular carcinoma in patients previously untreated with systemic chemotherapy

Kudo M, Ryoo BY, Lim HY, Kim DY, Okusaka T, Ikeda M, Hidaka H, Yeon JE, Mizukoshi E, Morimoto M, Lee MA, Yasui K, Kawaguchi Y, Heo J, Morita S, Kim TY, Furuse J, Katayama K, Aramaki T, Tak WY.

Publication Phase I/II study of first-line combination therapy with sorafenib plus resminostat, an oral HDAC inhibitor, versus sorafenib monotherapy for advanced hepatocellular carcinoma in east Asian patients

Won Young Tak, Baek-Yeol Ryoo, Ho Yeong Lim, Do-Young Kim, Takuji Okusaka, Masafumi Ikeda, Hisashi Hidaka, Jong-Eun Yeon, Eishiro Mizukoshi, Manabu Morimoto, Myung-Ah Lee, Kohichiroh Yasui, Yasunori Kawaguchi, Jeong Heo, Sojiro Morita, Tae-You Kim, Junji Furuse, Kazuhiro Katayama, Takeshi Aramaki, Rina Hara, Takuya Kimura, Osamu Nakamura, Masatoshi Kudo

Investigational New Drugs, 10 September 2018, DOI: 10.1007/s10637-018-0658-x

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SHELTER – Combination of sorafenib and resminostat in hepatocellular carcinoma (HCC)

NCT00943449

The SHELTER study was a multi-national, multi-center, single arm Phase II study to evaluate efficacy, safety and pharmacokinetics of resminostat and the treatment combination of sorafenib and resminostat in patients with HCC exhibiting progressive disease (PD) under sorafenib treatment.

Recruitment status Completed
Study phase Phase II
Enrollment 57
Primary objective
  • Evaluate efficacy of combination of resminostat and sorafenib versus standard treatment of sorafenib in second-line treatment of advanced HCC patients, investigating time to progression (TTP)
Secondary objectives
  • Overall survival (OS)
  • Progression free survival (PFS)
  • Overall response rate (ORR)
  • Duration of response (DOR)
  • Disease control rate (DCR)
  • Safety
  • Pharmacokinetics
Publication Resminostat plus sorafenib as second-line therapy of advanced hepatocellular carcinoma – The SHELTER study.

Bitzer M, Horger M, Giannini EG, Ganten TM, Wörns MA, Siveke JT, Dollinger MM, Gerken G, Scheulen ME, Wege H, Zagonel V, Cillo U, Trevisani F, Santoro A, Montesarchio V, Malek NP, Holzapfel J, Herz T, Ammendola AS, Pegoraro S, Hauns B, Mais A, Lauer UM, Henning SW, Hentsch B.

J Hepatol. 2016 Aug;65(2):280-8. doi: 10.1016/j.jhep.2016.02.043.

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SAPHIRE – Resminostat in Hodgkin’s Lymphoma

NCT01037478

The SAPHIRE study was a multi-national, multi-center, single arm Phase II study to evaluate the efficacy, safety and pharmacokinetics of resminostat in patients with relapsed or refractory HL.

Recruitment status Completed
Study Phase Phase II
Enrollment 37
Primary objective
  • Determine objective response rate (ORR)
Secondary objectives
  • Safety and tolerability of repeated oral doses of resminostat
  • Overall survival (OS)
  • Progression free survival (PFS) including radiological and symptomatic progression
  • Time to progression (TTP)
  • Pharmacokinetics of resminostat after oral dosing
Exploratory objectives
  • Investigate effects on histone deacetylase enzyme inhibition, histone acetylation and gene expression in peripheral blood mononuclear cells (PBMCs)
  • Investigate level of chemokine (C-C motif) ligand 17 (TARC) in blood plasma
Publication Resminostat in patients with relapsed or refractory Hodgkin lymphoma: results of the phase II SAPHIRE study

Jan Walewski, Ewa Paszkiewicz-Kozik, Gabriela Borsaru, Andrzej Hellmann, Andrea Janikova, Agnieszka Warszewska, Anna Mais, Astrid Ammendola, Thomas Herz, Babett Krauss & Stefan W. Henning

Leukemia & Lymphoma, 30 August 2018, DOI: 10.1080/10428194.2018.1492122

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Combination of resminostat and docetaxel versus docetaxel in non-small cell lung cancer (NSCLC) in Japan and Korea

This study was a Phase I/II study to evaluate safety, tolerability and anti-tumor activity of resminostat in combination with docetaxel in pretreated Asian patients with NSCLC, conducted by our cooperation partner Yakult Honsha.

Recruitment status Completed
Study phase Phase I/II
Enrollment 9/108
Primary objective (Phase I)
  • Evaluate maximum tolerated dose (MTD) of resminostat in combination with docetaxel by investigating dose-limiting toxicity (DLT) and evaluate the recommended dose
Primary objective (Phase II)
  • Progression free survival (PFS)
Secondary objectives (Phase II)
  • Response rate (RR)
  • Overall survival (OS)
  • Safety parameters
Exploratory objectives (Phase II)
  • To evaluate biomarker and mRNA expression of the targeted genes in peripheral blood mononuclear cells (PBMCs)
Publication Phase I/II study of docetaxel combined with resminostat, an oral hydroxamic acid HDAC inhibitor, for advanced non-small cell lung cancer in patients previously treated with platinum-based chemotherapy.

Tambo Y, Hosomi Y, Sakai H, Nogami N, Atagi S, Sasaki Y, Kato T, Takahashi T, Seto T, Maemondo M, Nokihara H, Koyama R, Nakagawa K, Kawaguchi T, Okamura Y, Nakamura O, Nishio M, Tamura T.

Invest New Drugs. 2017 Jan 30. doi: 10.1007/s10637-017-0435-2. [Epub ahead of print]

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SHORE – Combination of Resminostat and FOLFIRI in Colorectal Cancer (CRC)

NCT01277406

The SHORE study was a national, multi-center Phase I/II study to evaluate safety, tolerability, pharmacokinetics and efficacy of resminostat in combination with a second-line treatment in patients with K-ras mutated advanced CRC. The Phase II part of the study was not conducted.

Recruitment status Completed
Study phase Phase I/II
Enrollment 17
Primary objective
  • Evaluate maximum tolerated dose (MTD) of resminostat in combination with FOLFIRI by investigating safety, tolerability and pharmacokinetics
Secondary objectives
  • Progression free survival (PFS)
  • Objective response rate (ORR)
  • Time to progression (TTP)
  • Overall survival (OS)

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Resminostat in Japanese patients with advanced solid tumors

This study was a mono-center, single arm Phase I study of resminostat in Japanese patients with solid tumors, conducted by our cooperation partner Yakult Honsha.

Recruitment status Completed
Study phase Phase I
Enrollment 12
Primary objective
  • Evaluate safety of resminostat administered as monotherapy in patients with solid tumors
Secondary objectives
  • Investigate pharmacokinetic and pharmacodynamic characteristics of resminostat to determine recommended dose
  • Efficacy assessments measured by response rate (RR) and disease control rate (DCR)
Publication A phase I study of resminostat in Japanese patients with advanced solid tumors.

Kitazono S, Fujiwara Y, Nakamichi S, Mizugaki H, Nokihara H, Yamamoto N, Yamada Y, Inukai E, Nakamura O, Tamura T.

Cancer Chemother Pharmacol. 2015 Jun;75(6):1155-61. doi: 10.1007/s00280-015-2741-8.

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First-in-human study of resminostat in advanced solid tumors

This study was a first-in-human, mono-center, single arm, open label, dose escalation study of resminostat in patients with advanced solid tumors.

Recruitment status Completed
Study phase Phase I
Enrollment 19
Primary objectives
  • Investigate safety and tolerability of repeated ascending oral doses of resminostat
  • Determine maximum tolerated dose (MTD) and dose-limiting toxicities (DLT)
  • Assess pharmacokinetics of resminostat to evaluate optimal dose scheduling for further studies
Secondary objectives
  • Assess pharmacodynamics of once-daily and, as the study progresses, twice-daily dose administration
  • Investigate effects on histone deacetylase enzyme inhibition, histone acetylation and RNA profile
  • Evaluate potential anti-cancer activity
Publication First-in-human, pharmacokinetic and pharmacodynamic phase I study of Resminostat, an oral histone deacetylase inhibitor, in patients with advanced solid tumors.

Brunetto AT, Ang JE, Lal R, Olmos D, Molife LR, Kristeleit R, Parker A, Casamayor I, Olaleye M, Mais A, Hauns B, Strobel V, Hentsch B, de Bono JS.

Clin Cancer Res. 2013 Oct 1;19(19):5494-504. doi: 10.1158/1078-0432.CCR-13-0735.

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Resminostat plus S-1 in biliary tract cancer (BTC)

This was a double-blind, randomized Phase II study to assess the efficacy of resminostat in combination with S-1 (experimental arm) compared to placebo in combination with S-1 (control arm) in patients with unresectable or platinum-gemcitabine combination refractory biliary tract cancer conducted by our cooperation partner Yakult Honsha.

Recruitment status Completed
Study phase Phase II
Enrollment 101
Primary objective
  • Progression free survival (PFS)
Secondary objective
  • Overall survival (OS)
  • Response rate (RR)
  • Disease control rate (DCR)
  • Safety Data
Exploratory objective
  • Biomarkers in tumor tissue
Publication Phase I study of resminostat, an HDAC inhibitor, combined with S-1 in patients with pre-treated biliary tract or pancreatic cancer.
Invest New Drugs 2019 Feb;37(1):109-117.Doi: 10.1007/s10637-018-0634-5

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TOPAS – First-in-human study of domatinostat (4SC-202) in hematologic malignancies

NCT01344707

The TOPAS study was a first-in-human, multi-center, single arm, open label, dose escalation study of domatinostat in patients with advanced hematologic malignancies.

Recruitment status Completed
Study phase Phase I
Enrollment 24
Primary objectives
  • Evaluate safety and tolerability of repeated ascending oral doses of domatinostat
  • Determine maximum tolerated dose (MTD) and dose-limiting toxicities (DLT)
  • Determine pharmacokinetic profile
Secondary objectives
  • Assess potential anti-cancer activity
  • Objective response rate (ORR)
  • Duration of response (DOR)
  • Progression free survival (PFS)
Exploratory objectives
  • Histone deacetylase (HDAC) inhibition in peripheral mononuclear cells (PBMCs)
  • Histone acetylation in PBMCs
  • Gene expression analysis in peripheral blood
  • Cytokine and miRNA levels in blood plasma
Publication Phase I Study of Domatinostat (4SC‐202), a class I Histone Deacetylase Inhibitor in Patients with Advanced Hematological Malignancies

Bastian von Tresckow, Cyrus Sayehli, Walter E. Aulitzky, Maria‐Elisabeth Goebeler, Matthias Schwab, Eunice Braz, Babett Krauss, Rolf Krauss, Frank Hermann, René Bartz, Andreas Engert

European Journal of Haematology, 2018 Oct 22; doi: 10.1111/ejh.13188

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SENSITIZE – Domatinostat in Combination With Pembrolizumab in Patients Primary Refractory/Non-responding to Prior Anti-PD-1 Therapy

NCT03278665

The SENSITIZE study is an open-label, multi-center, Phase Ib/II study to evaluate the combination treatment of domatinostat with the anti-PD-1 antibody pembrolizumab (Keytruda®) in patients suffering from advanced-stage cutaneous melanoma who are refractory or non-responding to prior treatment with anti-PD-1 antibodies.

Recruitment status Completed
Study phase Phase Ib/II
Enrollment 40
Primary objective
  • Determine the safety and tolerability of domatinostat in combination with pembrolizumab
Key secondary objectives
  • Objective response rate (ORR)
  • Best overall response (BOR)
  • Disease control rate (DCR)
  • Duration of response (DOR)
  • Progression free survival (PFS)
  • Overall survival (OS)
Exploratory objective
  • Comprehensive biomarker program

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EMERGE – Epigenetic Modulation of the immunE Response in GastrointEstinal Cancers (investigator-sponsored trial)

NCT03812796

The EMERGE study is an open-label, multi-center, Phase II study to evaluate the combination treatment of domatinostat with the anti-PD-L1 antibody avelumab (Bavencio®) in patients suffering from microsatellite-stable esophago-gastric and colorectal (MSS-GI) cancer.  The investigator-sponsored study is conducted by Prof. David Cunningham from The Royal Marsden NHS Foundation Trust (London, UK).

Recruitment status Completed
Study phase Phase II
Enrollment 29
Primary objective
  • Determine the safety, tolerability and efficacy of domatinostat in combination with avelumab
Key secondary objectives
  • Duration of objective response (DoOR)
  • Progression free survival (PFS)
  • Overall survival (OS)
  • Disease control rate (DCR)

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DONIMI – Multicenter Phase 1b Trial Testing the Neoadjuvant Combination of Domatinostat, Nivolumab and Ipilimumab in IFN-gamma Signature-low and IFN-gamma Signature-high RECIST 1.1-measurable Stage III Cutaneous or Unknown Primary Melanoma (investigator-sponsored trial)

NCT04133948

The multicenter phase 1b study DONIMI is testing the combination of domatinostat, nivolumab, and ipilimumab, in high risk stage III melanoma in the neoadjuvant setting. The investigator-sponsored study is conducted by Prof. Christian Blank, MD, Medical Oncologyst, and Group Leader at the Division of Immunology, The Netherlands Cancer Institute, Amsterdam.

Recruitment status Completed
Study phase Phase Ib
Enrollment 44
Primary objective
  • To determine the safety and feasibility of neoadjuvant nivolumab +/- ipilimumab +/- domatinostat.
Key secondary objectives
  • Pathologic response rates (pCR, near pCR, pPR)
  • Frequency of treatment-related adverse events (safety)
  • Radiologic response rates acc. to RECIST 1.1
  • Relapse free survival (RFS)
  • Identification of biomarkers predictive for response to combination treatment
  • Evaluation of health-related quality of life
  • Analysis of fecal microbiome

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TURANDOT – Checkpoint Inhibition With or Without Domatinostat in Urothelial Cancer (investigator sponsored trial)

NCT04871594

The multicenter phase 1b study TURANDOT is testing the combination of domatinostat, nivolumab, and ipilimumab, in high risk stage II-III urothelial cancer in the neoadjuvant setting. The investigator-sponsored study is conducted by Prof. Michiel S. van der Heijden, MD, Medical oncologist and Group Leader at The Netherlands Cancer Institute, Amsterdam.

Recruitment status Terminated
Study phase Phase Ib
Enrollment 9
Primary objective
  • To determine the safety and feasibility of neoadjuvant nivolumab +/- ipilimumab +/- domatinostat.
Key secondary objectives
  • Pathologic complete response rate
  • Frequency of treatment-related adverse events (safety)
  • Relapse free survival (RFS)
  • Overall survival
  • Identification of biomarkers predictive for response to combination treatment

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