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DRUG CLASS:

Progesterone receptor antagonist

19d
Dan'e fukang decoction reduces hemorrhage in a rat model of mifepristone induced incomplete abortion and may correlate with cell adhesion molecule signaling interference. (PubMed, J Ethnopharmacol)
DFD significantly reduced hemorrhage. DFD significantly increased the serum levels of E2 and inhibited CAMs signaling pathway, which was likely to be involved in the mechanism of action of DFD facilitating residual uterine embryo expulsion in the rat model of incomplete abortion.
Preclinical • Journal
|
ER (Estrogen receptor) • ICAM1 (Intercellular adhesion molecule 1) • ITGB2 (Integrin Subunit Beta 2)
|
Mifeprex (mifepristone)
29d
Evaluation of glucocorticoid-related genes reveals GPD1 as a therapeutic target and regulator of sphingosine 1-phosphate metabolism in CRPC. (PubMed, Cancer Lett)
Additionally, GPD1 was shown to be regulated by GR, with the GR antagonist mifepristone enhancing the anti-tumorigenic effects of GPD1 in CRPC cells. Mechanistically, targeting GPD1 induced the production of sphingosine 1-phosphate (S1P) and enhanced histone acetylation, thereby inducing the transcription of p21 that involved in cell cycle regulation. In conclusion, Glu-sig could serve as a robust and promising tool to improve the clinical outcomes of PCa patients, and modulating the GR/GPD1 axis that promotes tumor growth may be a promising approach for delaying CRPC progression.
Journal
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AR (Androgen receptor) • CDKN1A (Cyclin-dependent kinase inhibitor 1A)
|
Mifeprex (mifepristone)
1m
Mifepristone vs Misoprostol (clinicaltrials.gov)
P1, N=94, Recruiting, Montefiore Medical Center | Not yet recruiting --> Recruiting
Enrollment open
|
Mifeprex (mifepristone)
1m
TNF and Glucocorticoid Antagonist for GWI Associated Multi-symptom Disease Homeostasis Reset (clinicaltrials.gov)
P1, N=20, Recruiting, Nova Southeastern University | Trial completion date: Sep 2024 --> Sep 2025 | Trial primary completion date: Jul 2024 --> Sep 2025
Trial completion date • Trial primary completion date
|
Mifeprex (mifepristone)
2ms
Study on pharmacokinetic and tissue distribution of hyperin, astragalin, kaempferol-3-O-β-D-glucuronide from rats with multiple administrations of Semen Cuscutae processed with salt solution with effect of treating recurrent spontaneous abortion. (PubMed, Front Pharmacol)
First, a rat model of RSA was established using hydroxyurea in combination with mifepristone. It was elucidated that all three were involved in the regulation of progesterone levels and immune function. It initially revealed the mechanism of action of YP in enhancing the improvement of RSA, and it provided a theoretical basis for the quality assessment of YP.
PK/PD data • Preclinical • Journal
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TNFA (Tumor Necrosis Factor-Alpha) • IL4 (Interleukin 4)
|
hydroxyurea • Mifeprex (mifepristone)
2ms
Targeting Delivery of Mifepristone to Endometrial Dysfunctional Macrophages for Endometriosis Therapy. (PubMed, Acta Biomater)
The albumin nanoparticles constructed based on SPARC overexpression in macrophages and endometrial cells and albumin biosafety can achieve the targeted therapy of endometriosis by increasing the passive- and active-mediated drug accumulation in ectopic endometrium and remodeling the immune microenvironment based on macrophage regulation. This study has the following implications: i) overcoming the inherent shortcomings of clinical drugs by nanotechnology is an alternative way of developing medication; ii) developing microenvironment modulation strategies based on macrophage regulation for endometriosis management is feasible.
Journal
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SPARC (Secreted Protein Acidic And Cysteine Rich)
|
SPARC overexpression
|
Mifeprex (mifepristone)
2ms
A Study of Onapristone ER Alone Or In Combination With Anastrozole in Gynecologic Cancers That Respond to Progesterone (clinicaltrials.gov)
P2, N=34, Completed, Memorial Sloan Kettering Cancer Center | Active, not recruiting --> Completed | Trial completion date: Apr 2025 --> Sep 2024 | Trial primary completion date: Apr 2025 --> Sep 2024
Trial completion • Trial completion date • Trial primary completion date • Combination therapy • Pan tumor
|
PGR expression
|
anastrozole • Apristor (onapristone XR)
2ms
MOLI: Mifepristone Outpatient Labour Induction (clinicaltrials.gov)
P2, N=400, Recruiting, Chelsea and Westminster NHS Foundation Trust | Phase classification: P3 --> P2
Phase classification
|
Mifeprex (mifepristone)
3ms
Effect of Mifepristone on Migration and Proliferation of Oral Cancer Cells. (PubMed, Int J Mol Sci)
Overall, this study found that a high concentration of mifepristone was effective in the suppression of migration and proliferation of oral cancer cells via the inhibition of PI3K-Akt and MAPK signalling pathways. Further investigation is needed to define its impact on epithelial-mesenchymal transition (EMT) markers.
Journal
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CDH1 (Cadherin 1) • CDH2 (Cadherin 2) • NR3C1 (Nuclear Receptor Subfamily 3 Group C Member 1)
|
Mifeprex (mifepristone)
3ms
Enrollment open • Trial initiation date
|
Mifeprex (mifepristone)
4ms
A novel inhibitory pathway of synovial inflammation exerted by glucocorticoids and tumor necrosis factor inhibitors via lymphocyte activation gene-3 up-regulation: an ex-vivo study. (PubMed, Rheumatology (Oxford))
This study proposes a novel regulatory mechanism of GCs and of TNFi mediated by LAG-3 upregulation in synovial monocytes and PBMCs. LAG-3 modulation may be a promising target for development of novel therapies for inflammatory arthritis.
Preclinical • Journal • PD(L)-1 Biomarker • IO biomarker
|
PD-1 (Programmed cell death 1) • LAG3 (Lymphocyte Activating 3) • CD14 (CD14 Molecule)
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methotrexate • Mifeprex (mifepristone)
4ms
Mifepristone vs Misoprostol (clinicaltrials.gov)
P1, N=94, Not yet recruiting, Montefiore Medical Center
New P1 trial
|
Mifeprex (mifepristone)
4ms
Journal • Pan tumor
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PGR (Progesterone receptor)
|
Apristor (onapristone XR)
5ms
Enhancing the Inhibition of Breast Cancer Growth Through Synergistic Modulation of the Tumor Microenvironment Using Combined Nano-Delivery Systems. (PubMed, Int J Nanomedicine)
The in vivo anti-tumor studies further confirmed the enhanced anti-tumor capabilities of Dox@CLGs + Ber/Ru486@CLPs, including smaller tumor volumes, weak collagen deposition, and low expression levels of α-SMA and CD31 proteins, leading to a superior anti-tumor effect. In brief, this combination therapy based on Dox@CLGs and Ber/Ru486@CLPs could effectively inhibit tumor development, which provides a promising approach for the treatment of breast cancer.
Journal
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CD31 (Platelet and endothelial cell adhesion molecule 1) • PECAM1 (Platelet And Endothelial Cell Adhesion Molecule 1)
|
Mifeprex (mifepristone)
6ms
Effect of Shoutai Pills on expression of key glycolytic proteins and apoptosis related factors at maternal fetal interface in mouse model of threatened abortion with syndrome of kidney deficiency (PubMed, Zhongguo Zhong Yao Za Zhi)
At 16:00 every day, mice in the normal group were administrated with an equal volume of distilled water, while those in the model, Shoutai Pills, and dydrogesterone groups were administrated with hydrocortisone solution by gavage for 4 consecutive days...On day 6, mice were administrated with mifepristone by gavage to establish the model of kidney deficiency-induced abortion...Compared with the model group, dydrogesterone and Shoutai Pills reduced the apoptosis rate(P<0.05). In conclusion, Shoutai Pills can reduce the embryo loss rate and protect embryos by promoting aerobic glycolysis at the maternal-fetal interface and inhibiting the apoptosis of trophoblasts in mice.
Preclinical • Journal • IO biomarker
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BCL2 (B-cell CLL/lymphoma 2) • LDHA (Lactate dehydrogenase A) • BAX (BCL2-associated X protein) • CASP3 (Caspase 3) • ENO1 (Enolase 1) • HK2 (Hexokinase 2) • PKM (Pyruvate Kinase M1/2)
|
Mifeprex (mifepristone)
6ms
INIA Stress and Chronic Alcohol Interactions: Glucocorticoid Antagonists in Heavy Drinkers (clinicaltrials.gov)
P1/2, N=65, Completed, Johns Hopkins University | Phase classification: P=N/A --> P1/2
Phase classification
|
Korlym (mifepristone)
7ms
A Study of Onapristone ER Alone Or In Combination With Anastrozole in Gynecologic Cancers That Respond to Progesterone (clinicaltrials.gov)
P2, N=34, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Trial completion date: Apr 2024 --> Apr 2025 | Trial primary completion date: Apr 2024 --> Apr 2025
Trial completion date • Trial primary completion date • Combination therapy • Pan tumor
|
PGR expression
|
anastrozole • Apristor (onapristone XR)
7ms
New P3 trial
|
Mifeprex (mifepristone)
7ms
MIST: Simultaneous Mifepristone and Misoprostol Versus Misoprostol Alone for Induction of Labor of Nonviable Second Trimester Pregnancy: a Pilot Randomized Controlled Trial (clinicaltrials.gov)
P4, N=30, Recruiting, Washington University School of Medicine | Trial completion date: Dec 2024 --> Dec 2025 | Trial primary completion date: Dec 2023 --> Dec 2024
Trial completion date • Trial primary completion date
|
Mifeprex (mifepristone)
8ms
Antiprogestins for breast cancer treatment: we are almost ready. (PubMed, J Steroid Biochem Mol Biol)
However, since mifepristone was developed, its application for breast cancer treatment was immediately proposed...The effects of combined treatments of antiprogestins together with other drugs currently used in the clinic, such as tamoxifen, CDK4/CDK6 inhibitors or pembrolizumab in preclinical models is discussed since it is in this scenario that antiprogestins will be probably introduced. Finally, we explain how transcriptomic or proteomic studies, that were carried out in different luminal breast cancer models and in breast cancer samples that responded or were predicted to respond to the antiprogestin therapy, show a decrease in proliferative pathways. Deregulated pathways intrinsic of each model are discussed, as well as how these analyses may contribute to a better understanding of the mechanisms involved.
Journal • BRCA Biomarker • PD(L)-1 Biomarker
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BRCA1 (Breast cancer 1, early onset) • CDK6 (Cyclin-dependent kinase 6)
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BRCA1 mutation
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Keytruda (pembrolizumab) • tamoxifen • Mifeprex (mifepristone)
8ms
Natural Killer Cell Dysfunction in Premenopausal BRCA1 Mutation Carriers: A Potential Mechanism for Ovarian Carcinogenesis. (PubMed, Cancers (Basel))
Phase-specific differential NK cell activity in BRCA1 mutation carriers, either systemically or locally, may favor site-specific pre-invasive carcinogenesis. These cumulative effects across a reproductive lifecycle in high-risk carriers can have a detrimental effect further supporting epidemiological evidence for ovulation inhibition.
Journal • BRCA Biomarker
|
BRCA1 (Breast cancer 1, early onset) • HIF1A (Hypoxia inducible factor 1, alpha subunit) • NCAM1 (Neural cell adhesion molecule 1)
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BRCA1 mutation
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Mifeprex (mifepristone)
9ms
Trial primary completion date
|
Korlym (mifepristone)
9ms
INIA Stress and Chronic Alcohol Interactions: Glucocorticoid Antagonists in Heavy Drinkers (clinicaltrials.gov)
P=N/A, N=65, Completed, Johns Hopkins University | Recruiting --> Completed | N=150 --> 65
Trial completion • Enrollment change
|
Korlym (mifepristone)
9ms
Selective modulation of the human glucocorticoid receptor compromises GR chromatin occupancy and recruitment of p300/CBP and the Mediator complex. (PubMed, Mol Cell Proteomics)
We found that Dagrocorat and the antagonist RU486 both reduced GR interaction with CREB-binding protein (CBP)/p300 and the Mediator complex compared to the full GR agonist Dexamethasone. Chromatin immunoprecipitation assays revealed that these changes in GR interactome were accompanied by reduced GR chromatin occupancy with Dagrocorat and RU486. Our data offer new insights into the role of differential coregulator recruitment in shaping ligand-specific GR-mediated transcriptional responses.
Journal
|
CREBBP (CREB binding protein)
|
Mifeprex (mifepristone)
9ms
Enrollment change • Metastases
|
HER-2 (Human epidermal growth factor receptor 2) • ER (Estrogen receptor) • PGR (Progesterone receptor)
|
albumin-bound paclitaxel • Korlym (mifepristone)
9ms
TNF and Glucocorticoid Antagonist for GWI Associated Multi-symptom Disease Homeostasis Reset (clinicaltrials.gov)
P1, N=20, Recruiting, Nova Southeastern University | Trial primary completion date: Dec 2023 --> Jul 2024
Trial primary completion date
|
Mifeprex (mifepristone)
9ms
Comprehensive splicing analysis of the alternatively spliced CHEK2 exons 8 and 10 reveals three enhancer/silencer-rich regions and 38 spliceogenic variants. (PubMed, J Pathol)
We identified three minimal (10-, 11-, 15-nt) regions essential for exon recognition: c.863_877del [ex8, Δ(E8): 75%] and c.1073_1083del and c.1083_1092del [ex10, Δ(E10): 97% and 62%, respectively]..
Journal
|
CHEK2 (Checkpoint kinase 2)
|
Mifeprex (mifepristone)
9ms
Significant Palliative Benefits Following Therapy With Mifepristone for Advanced Treatment Resistant Small Cell Lung Cancer. (PubMed, Anticancer Res)
SCLC can be added to the long list of very advanced cancers that are treatment resistant to standard therapy, but respond well to PR antagonists.
Journal • PD(L)-1 Biomarker • Metastases
|
EGFR (Epidermal growth factor receptor)
|
EGFR mutation • EGFR positive
|
Keytruda (pembrolizumab) • Tagrisso (osimertinib) • Tecentriq (atezolizumab) • AiRuiKa (camrelizumab) • Mifeprex (mifepristone)
10ms
Establishment of tumor microenvironment-preserving organoid model from patients with intracranial meningioma. (PubMed, Cancer Cell Int)
Taken together, our MNO model overcame limitations of previous meningioma models and showed superior resemblance to parental tumors. Thus, our model could facilitate translational research identifying and selecting drugs for meningioma in the era of precision medicine.
Journal
|
PGR (Progesterone receptor)
|
Mifeprex (mifepristone)
10ms
Glucocorticoid receptor mediated sensitization of colon cancer to photodynamic therapy induced cell death. (PubMed, J Photochem Photobiol B)
A synthetic glucocorticoid (GC), dexamethasone (Dex) has previously been demonstrated to sensitize cancer cells to chemotherapy...These effects were reversed when cells were pre-treated with RU486, a competitive inhibitor of GCs. Moreover, our in vivo findings of subcutaneous tumor model of Balb/C mice for colon cancer revealed a significant decrease in tumor volume as well as considerable enhancement in the survivability of PDT treated tumor-bearing mice when Dex was present in the formulation. A high Bax/Bcl-xL ratio, high p53 expression, enhanced E-cadherin expression and down-regulation of pro-tumorigenic transcription factors NF-κB and c-Myc were found in tumor lysates from mice treated with D1XP-Nap under PDT, indicating GR-mediated sensitization of the tumor to PDT-induced cell death and enhancement of life-span for tumor bearing mice.
Journal
|
TP53 (Tumor protein P53) • MYC (V-myc avian myelocytomatosis viral oncogene homolog) • BCL2L1 (BCL2-like 1) • HIF1A (Hypoxia inducible factor 1, alpha subunit) • CDH1 (Cadherin 1) • STAT3 (Signal Transducer And Activator Of Transcription 3) • BAX (BCL2-associated X protein) • NR3C1 (Nuclear Receptor Subfamily 3 Group C Member 1)
|
TP53 expression • CDH1 expression • HIF1A expression
|
Mifeprex (mifepristone)
11ms
Tongxie Yaofang regulates tumor-associated macrophage polarization in colorectal cancer under chronic stress (PubMed, Zhongguo Zhong Yao Za Zhi)
BALB/C mice were randomized into blank, control, model, mifepristone, and low-, medium-, and high-dose Tongxie Yaofang groups...Moreover, the treatment caused different degrees of necrosis in the tumor tissues, down-regulated the protein levels of CD206, JAK1, JAK2, JAK3, STAT3, and STAT6, and up-regulated the protein level of CD86. In summary, Tongxie Yaofang can promote the transformation of M2 macrophages to M1 macrophages and change the tumor microenvironment under chronic stress to inhibit the development of colorectal cancer, which may be related to the JAK/STAT signaling pathway.
Journal
|
JAK1 (Janus Kinase 1) • STAT3 (Signal Transducer And Activator Of Transcription 3) • JAK3 (Janus Kinase 3) • IL10 (Interleukin 10) • STAT6 (Signal transducer and activator of transcription 6) • IL1B (Interleukin 1, beta) • IL4 (Interleukin 4) • MRC1 (Mannose Receptor C-Type 1) • CD86 (CD86 Molecule)
|
IL10 elevation
|
Mifeprex (mifepristone)
12ms
Repositioning of mifepristone as an integrated stress response activator to potentiate cisplatin efficacy in non-small cell lung cancer. (PubMed, Cancer Lett)
Our in vitro and in vivo models demonstrated mifepristone's potential to inhibit NSCLC re-proliferation following cisplatin treatment and tumor growth, respectively, via the ISR-mediated cell death pathway. These findings suggest that mifepristone, as an ISR activator, could enhance the efficacy of cisplatin-based therapy for NSCLC, highlighting the potential of drug repositioning in the search for effective chemosensitizers.
Journal
|
ATF4 (Activating Transcription Factor 4) • TRIB3 (Tribbles Pseudokinase 3) • ATF3 (Activating Transcription Factor 3)
|
cisplatin • Mifeprex (mifepristone)
12ms
Identification and targeting of cancer-associated fibroblast signature genes for prognosis and therapy in Cutaneous melanoma. (PubMed, Comput Biol Med)
The findings indicated that FBLN1 and COL5A1 were the CAF signature genes in CM, which were associated with the progression, treatment, and prognosis of CM. The comprehensive exploration of CAF signature genes is expected to provide new insight for clinical CM therapy.
Journal • Tumor mutational burden • IO biomarker
|
TMB (Tumor Mutational Burden) • COL5A1 (Collagen Type V Alpha 1 Chain)
|
Mifeprex (mifepristone)
12ms
Novel Approaches to Possible Targeted Therapies and Prophylaxis of Uterine Fibroids. (PubMed, Diseases)
The methods of treatment include surgical (myomectomy and hysterectomy, embolization of arteries) and therapeutic treatment (ulipristal acetate, leuprolide acetate, cetrorelix, goserelin, mifepristone). Three different nosological forms of the disease associated with driver mutations in the MED12, HMGA2, and FH genes should be considered when developing or prescribing drugs. For example, synthetic inhibitors and vaccines based on matrix metalloproteinases MMP11 and MMP16 are expected to be effective only for the prevention of the occurrence of MED12-dependent nodules.
Review • Journal
|
HMGA2 (High mobility group AT-hook 2) • MMP11 (Matrix Metallopeptidase 11) • MMP16 (Matrix Metallopeptidase 16)
|
goserelin acetate • leuprolide acetate for depot suspension • Cetrotide (cetrorelix) • Mifeprex (mifepristone)
1year
Steroid profile in patients with breast cancer and in mice treated with mifepristone. (PubMed, Endocr Relat Cancer)
The increase in progesterone levels was the most significant side effect detected in mifepristone-treated mice after 14 or 21 days of treatment, probably due to an ovarian compensatory effect not observed in postmenopausal patients. We conclude that in future clinical trials using mifepristone, the possibility of lowering the standard daily dose of 200 mg should be considered.
Preclinical • Journal
|
PGR (Progesterone receptor)
|
Mifeprex (mifepristone)
1year
Evaluating the neuroprotective effects of progesterone receptors on experimental traumatic brain injury: The PI3K/Akt pathway. (PubMed, Brain Behav)
According to these findings, PRs are acting as critical mediators for the neuroprotective properties of P4 on oxidative stress, pro-inflammatory cytokine levels, and neurological outcomes. PRs also play an important role in regulating the PI3K/p-Akt expression and nongenomic function of P4.
Journal
|
PGR (Progesterone receptor) • TNFA (Tumor Necrosis Factor-Alpha) • IL1B (Interleukin 1, beta)
|
Mifeprex (mifepristone)
1year
Establishment of tumor microenvironment-preserving organoid model from patients with intracranial meningioma (SNO 2023)
As a representative application, we utilized MNOs in drug screening, and mifepristone, an antagonist of progesterone receptor, showed prominent antitumor efficacy in respect to viability, invasiveness, and protein expression. Taken together, our MNO model overcame limitations of previous meningioma models and showed superiority in terms of resemblance with parental tumors. Thus, we expect that our model can facilitate translational research of identifying and selecting drugs for meningioma in the era of precision medicine.
Clinical
|
PGR (Progesterone receptor)
|
Mifeprex (mifepristone)
1year
Onapristone and Fulvestrant for ER+ HER2- Metastatic Breast Cancer After Endocrine Therapy and CDK4/6 Inhibitors (The SMILE Study) (clinicaltrials.gov)
P2, N=11, Terminated, University of Wisconsin, Madison | Trial completion date: Mar 2025 --> May 2023 | Active, not recruiting --> Terminated | Trial primary completion date: Mar 2024 --> Apr 2023; funding
Trial completion date • Trial termination • Trial primary completion date • Combination therapy • Metastases
|
HER-2 (Human epidermal growth factor receptor 2) • ER (Estrogen receptor) • PGR (Progesterone receptor)
|
ER positive • HER-2 negative • PGR positive
|
fulvestrant • Apristor (onapristone XR)
1year
New P2 trial • Combination therapy • Metastases
|
HER-2 (Human epidermal growth factor receptor 2) • PD-L1 (Programmed death ligand 1) • AR (Androgen receptor)
|
PD-L1 expression • HER-2 negative • AR positive
|
carboplatin • paclitaxel • capecitabine • Xtandi (enzalutamide capsule) • Halaven (eribulin mesylate) • Korlym (mifepristone) • Mifeprex (mifepristone)
1year
Mifepristone inhibits hepatoma growth by enhancing the GR-HSP60-survivin interaction to facilitate survivin degradation. (PubMed, J Cancer)
Animal models have confirmed the growth inhibitory effects of mifepristone on HCC, including changes in the abundance of HSP60 in mitochondria and cytosol, decreased survivin and Ki-67-positive cells, as well as increased cell apoptosis. In conclusion, the inhibition of HCC growth by mifepristone may be achieved by altering the subcellular distribution of HSP60 to enhance the formation of cytosolic GR-HSP60-survivin complexes in the cells, leading to the degradation of survivin.
Journal
|
BIRC5 (Baculoviral IAP repeat containing 5) • HSPD1 (Heat Shock Protein Family D (Hsp60) Member 1)
|
Mifeprex (mifepristone)
1year
The Use of Letrozole or Mifepristone for Pretreatment of Medical Termination of Pregnancy (clinicaltrials.gov)
P4, N=144, Recruiting, KK Women's and Children's Hospital | Not yet recruiting --> Recruiting | Trial completion date: Nov 2023 --> Nov 2024 | Trial primary completion date: Aug 2023 --> Aug 2024
Enrollment open • Trial completion date • Trial primary completion date • Head-to-Head
|
letrozole • Mifeprex (mifepristone)