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DRUG CLASS:

γ-secretase inhibitor

19h
Enrollment open
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itraconazole • varegacestat (AL102)
7d
Enrollment closed • Enrollment change • Combination therapy
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SDC1 (Syndecan 1)
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pomalidomide • Blenrep (belantamab mafodotin-blmf) • Ogsiveo (nirogacestat)
8d
New P1 trial
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itraconazole • varegacestat (AL102)
18d
AL101 Before Surgery for the Treatment of Notch Activated Adenoid Cystic Cancer (clinicaltrials.gov)
P1, N=14, Active, not recruiting, M.D. Anderson Cancer Center | Recruiting --> Active, not recruiting
Enrollment closed
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AL101
23d
Molecular analysis of BRCA1 and BRCA2 genes in La Rioja (Spain): five new variants. (PubMed, Hered Cancer Clin Pract)
The spectrum of pathogenic variants in the BRCA1/2 genes in La Rioja is similar to that in other Spanish regions, with some unique characteristics. The pathogenic c.6024dupG variant in the BRCA2 gene was detected in a large number of families and could have a founding effect in the Ebro riverside areas in the regions of La Rioja and Navarra.
Journal • BRCA Biomarker
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BRCA1 (Breast cancer 1, early onset) • BRCA2 (Breast cancer 2, early onset)
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BRCA1 mutation • BRCA2 deletion • BRCA1 deletion
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MK-0752
29d
Journal • Tumor cell
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NOTCH1 (Notch 1) • CCNE2 (Cyclin E2)
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crenigacestat (LY3039478)
2ms
RINGSIDE: A Study of AL102 in Patients With Progressing Desmoid Tumors (clinicaltrials.gov)
P2/3, N=192, Active, not recruiting, Immunome, Inc. | Trial completion date: Feb 2025 --> Oct 2026 | Trial primary completion date: Jan 2025 --> Oct 2025
Trial completion date • Trial primary completion date
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varegacestat (AL102)
3ms
A Study of CC-99712, a BCMA Antibody-Drug Conjugate, in Participants With Relapsed and Refractory Multiple Myeloma (clinicaltrials.gov)
P1, N=47, Terminated, Celgene | N=160 --> 47 | Active, not recruiting --> Terminated; Slow accrual
Enrollment change • Trial termination
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crenigacestat (LY3039478) • ispectamab debotansine (BMS-986352)
4ms
Dibenzazepine, a γ-Secretase Enzyme Inhibitor, Protects Against Doxorubicin-Induced Cardiotoxicity by Suppressing NF-κB, iNOS, and Hes1/Hey1 Expression. (PubMed, Inflammation)
DBZ ameliorated DOX-induced cardiotoxicity, evidenced by reducing the cardiac injury biomarkers, improving cardiac histopathological changes, correcting antioxidant levels, and reducing inflammatory and apoptotic proteins. Our study indicates the protective effect of Notch inhibitor against DOX-induced cardiotoxicity.
Journal • IO biomarker
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BCL2 (B-cell CLL/lymphoma 2) • TNFA (Tumor Necrosis Factor-Alpha) • HES1 (Hes Family BHLH Transcription Factor 1) • NICD (NOTCH1 intracellular domain) • HEY1 (Hes Related Family BHLH Transcription Factor With YRPW Motif 1)
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doxorubicin hydrochloride
5ms
DeFi: Nirogacestat for Adults With Desmoid Tumor/Aggressive Fibromatosis (DT/AF) (clinicaltrials.gov)
P3, N=142, Active, not recruiting, SpringWorks Therapeutics, Inc. | Trial completion date: Dec 2023 --> Dec 2024
Trial completion date
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Ogsiveo (nirogacestat)
6ms
AL101 Before Surgery for the Treatment of Notch Activated Adenoid Cystic Cancer (clinicaltrials.gov)
P1, N=14, Recruiting, M.D. Anderson Cancer Center | Trial completion date: Dec 2024 --> Dec 2025 | Trial primary completion date: Dec 2024 --> Dec 2025
Trial completion date • Trial primary completion date
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AL101
6ms
Celastrol inhibits mouse B16-F10 melanoma cell survival by regulating the PI3K/AKT/mTOR signaling pathway and repressing HIF-1α expression. (PubMed, Discov Oncol)
Celastrol inhibits the function of B16-F10 cells by inhibiting the PI3K/AKT/mTOR cellular pathway and regulating the expression of downstream HIF-α mRNA.
Preclinical • Journal
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HIF1A (Hypoxia inducible factor 1, alpha subunit)
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HIF1A expression
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Compound E
9ms
RINGSIDE: A Study of AL102 in Patients With Progressing Desmoid Tumors (clinicaltrials.gov)
P2/3, N=192, Active, not recruiting, Ayala Pharmaceuticals, Inc, | Recruiting --> Active, not recruiting
Enrollment closed
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varegacestat (AL102)
9ms
A Study of CC-99712, a BCMA Antibody-Drug Conjugate, in Participants With Relapsed and Refractory Multiple Myeloma (clinicaltrials.gov)
P1, N=160, Active, not recruiting, Celgene | Trial completion date: May 2025 --> Aug 2024 | Trial primary completion date: May 2025 --> Aug 2024
Trial completion date • Trial primary completion date
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crenigacestat (LY3039478) • ispectamab debotansine (BMS-986352)
9ms
TENACITY: A Study of AL101 Monotherapy in Patients With Notch Activated Triple Negative Breast Cancer (clinicaltrials.gov)
P2, N=18, Terminated, Ayala Pharmaceuticals, Inc, | N=67 --> 18 | Active, not recruiting --> Terminated; Sponsor's decision
Enrollment change • Trial termination
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HER-2 (Human epidermal growth factor receptor 2) • PGR (Progesterone receptor)
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HER-2 negative
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AL101
9ms
Phase II Trial of the Gamma-Secretase Inhibitor PF-03084014 in Adults With Desmoid Tumors/Aggressive Fibromatosis (clinicaltrials.gov)
P2, N=17, Completed, National Cancer Institute (NCI) | Active, not recruiting --> Completed
Trial completion
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Ogsiveo (nirogacestat)
10ms
ACCURACY: A Study Of AL101In Patients With Adenoid Cystic Carcinoma (ACC) Bearing Activating Notch Mutations (clinicaltrials.gov)
P2, N=87, Completed, Ayala Pharmaceuticals, Inc, | Active, not recruiting --> Completed
Trial completion
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AL101
10ms
An Essential Role of c-Fos in Notch1-mediated Promotion of Proliferation of KSHV-Infected SH-SY5Y Cells. (PubMed, Curr Mol Pharmacol)
Our findings strongly indicate that c-Fos plays a crucial role in the promotion of cell proliferation through Notch1 signaling in KSHV-infected cells. Furthermore, our results suggest that the inhibition of expression of key viral pathogenic proteins is likely involved in this process.
Journal
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NOTCH1 (Notch 1) • CCND1 (Cyclin D1) • CDK4 (Cyclin-dependent kinase 4) • CDK6 (Cyclin-dependent kinase 6) • FOS (Fos Proto-Oncogene AP-1 Transcription Factor Subunit 2)
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CCND1 expression • CCND1 expression + CDK4 expression • CDK6 expression
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LY-411575
10ms
A Study of CC-99712, a BCMA Antibody-Drug Conjugate, in Participants With Relapsed and Refractory Multiple Myeloma (clinicaltrials.gov)
P1, N=160, Active, not recruiting, Celgene | Trial completion date: Apr 2024 --> May 2025 | Trial primary completion date: Apr 2024 --> May 2025
Trial completion date • Trial primary completion date
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crenigacestat (LY3039478) • ispectamab debotansine (BMS-986352)
10ms
A Study of LY3039478 in Japanese Participants With Advanced Solid Tumors (clinicaltrials.gov)
P1, N=11, Completed, Eli Lilly and Company | Active, not recruiting --> Completed | Trial completion date: Oct 2023 --> May 2023
Trial completion • Trial completion date • Metastases
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crenigacestat (LY3039478)
10ms
NCI-2018-00514: BCMA-Specific CAR T-Cells Combined With a Gamma Secretase Inhibitor (JSMD194) to Treat Relapsed or Persistent Multiple Myeloma (clinicaltrials.gov)
P1, N=19, Terminated, Fred Hutchinson Cancer Center | Active, not recruiting --> Terminated; Closed per SRC Low Accrual Policy
Trial termination • Combination therapy • CAR T-Cell Therapy • IO biomarker
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SDC1 (Syndecan 1)
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cyclophosphamide • fludarabine IV • BCMA targeted CAR T • crenigacestat (LY3039478)
11ms
Enrollment closed • Combination therapy • CAR T-Cell Therapy • IO biomarker
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SDC1 (Syndecan 1)
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cyclophosphamide • fludarabine IV • BCMA targeted CAR T • crenigacestat (LY3039478)
11ms
Nirogacestat in Ovarian Granulosa Cell Tumors (clinicaltrials.gov)
P2, N=53, Active, not recruiting, SpringWorks Therapeutics, Inc.
Trial completion date • Trial primary completion date
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Ogsiveo (nirogacestat)
11ms
Evaluation of the Response and Non-response of Nirogacestat in Desmoid Tumors- Clinical Study (clinicaltrials.gov)
P2, N=40, Not yet recruiting, M.D. Anderson Cancer Center | Initiation date: Oct 2023 --> Oct 2024
Trial initiation date
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Ogsiveo (nirogacestat)
1year
Impact of Gamma-Secretase Inhibition on the Multiple Myeloma Immune Microenvironment (ASH 2023)
In a phase I, first-in-human clinical trial (n=18; relapsed/refractory MM) combining the GSI, crenigacestat, with anti-BCMA CAR T-cell therapy (FCARH143), we recently demonstrated that plasma cell BCMA antibody-binding capacity increased a median of 12-fold among 17/18 (94%) of participants after they received a 5-day GSI "run-in" (25 mg orally administered QOD for 3 doses) [Cowan AJ, et al...Accessibility of CD38, the target of daratumumab, was significantly increased in B cells, and SLAMF7, the target of elotuzumab, was significantly increased in plasma cells... BCMA cleavage from myeloma cells' surface is a putative resistance mechanism to BCMA-targeting immunotherapy. This study assessed the single-cell transcriptome and chromatin accessibility in the bone marrow environment of 16 patients given GSI monotherapy to ultimately enhance the efficacy of subsequent anti-BCMA CAR T-cell therapy. We found that prior BCMA-targeted therapy resulted in reduced chromatin accessibility within the BCMA epigenome.
IO biomarker
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NOTCH1 (Notch 1) • TNFRSF17 (TNF Receptor Superfamily Member 17) • NOTCH2 (Notch 2) • ERBB4 (erb-b2 receptor tyrosine kinase 4) • HES1 (Hes Family BHLH Transcription Factor 1) • SLAMF7 (SLAM Family Member 7)
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TNFRSF17 expression
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Darzalex (daratumumab) • Empliciti (elotuzumab) • FCARH143 • crenigacestat (LY3039478)
1year
In vitro antineoplastic effects of MK0752 in HPV-positive head and neck squamous cell carcinoma. (PubMed, J Cancer Res Clin Oncol)
Our novel findings indicate a therapeutic potential of MK0752 in HPV-positive HNSCC. Indeed, further investigation is needed for validation of our results and for the assessment of the mechanistic background.
Preclinical • Journal
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CASP3 (Caspase 3) • CASP7 (Caspase 7)
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MK-0752
1year
Enrollment open • Combination therapy
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CD4 (CD4 Molecule)
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lenalidomide • Blenrep (belantamab mafodotin-blmf) • Ogsiveo (nirogacestat)
1year
Phase II Trial of the Gamma-Secretase Inhibitor PF-03084014 in Adults With Desmoid Tumors/Aggressive Fibromatosis (clinicaltrials.gov)
P2, N=17, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Sep 2024 --> Dec 2023
Trial completion date
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CTNNB1 (Catenin (cadherin-associated protein), beta 1) • APC (APC Regulator Of WNT Signaling Pathway)
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Ogsiveo (nirogacestat)
1year
γ-Secretase Inhibitor Potentiates the Activity of Suberoylanilide Hydroxamic Acid by Inhibiting Its Ability to Induce Epithelial to Mesenchymal Transition and Stemness via Notch Pathway Activation in Triple-Negative Breast Cancer Cells. (PubMed, ACS Pharmacol Transl Sci)
Therefore, we have focused on combination therapy using a γ-secretase inhibitor LY411575 that would enhance the efficacy of SAHA by blocking the canonical Notch pathway mediated via its intracellular domain. Besides, it also mediates autophagy-independent cell death and diminishes the expression of inflammatory cytokines, along with the downregulation in the expression of the Notch downstream genes and mesenchymal markers. Altogether, our study provides a mechanistic basis for combating EMT potentiated by SAHA, which could be utilized as a rational strategy for the treatment of solid tumors, especially triple-negative breast cancer.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • HES1 (Hes Family BHLH Transcription Factor 1)
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Zolinza (vorinostat) • LY-411575
1year
Gamma Secretase Inhibition Sensitizes Pancreatic Adenocarcinoma Tumors to RT In Vivo. (PubMed, Int J Radiat Oncol Biol Phys)
Notch pathway inhibition sensitizes PDAC tumors to RT in vivo, but not in vitro, suggesting involvement of the TME. Indeed, co-culture with PDAC cells stimulates notch signaling in fibroblasts, suggesting non-cell autonomous mechanisms mediating fibrosis in the TME driving radioresistance. Future studies will determine if ADAM10 inhibition targeting PDAC cells and/or gamma secretase inhibition targeting the TME enhances radiation sensitivity in vivo by blocking fibroblast Notch signaling.
Preclinical • Journal
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HES1 (Hes Family BHLH Transcription Factor 1) • NICD (NOTCH1 intracellular domain) • ADAM10 (ADAM Metallopeptidase Domain 10)
1year
NOTCH2 gene mutation and gamma-secretase inhibitor in mediating the malignancy of ovarian cancer. (PubMed, Aging (Albany NY))
Furthermore, the NOTCH2-mediated tumorigenesis was mostly reversed after NF-κB inhibitor Bay11-7082 treatment. These findings identified the NOTCH2 P2113S mutation in ovarian carcinogenesis, and NOTCH2 P2113S is a potential target in treating OC.
Journal • IO biomarker
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BCL2 (B-cell CLL/lymphoma 2) • NOTCH2 (Notch 2) • BAX (BCL2-associated X protein) • HES1 (Hes Family BHLH Transcription Factor 1)
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NOTCH2 mutation • NOTCH mutation
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Bay11-7082
1year
Inhibition of Notch Signaling Enhances Antitumor Activity of Histone Deacetylase Inhibitor LAQ824. (PubMed, Int J Mol Sci)
We also demonstrated that the combination of LAQ and a Notch signaling pathway inhibitor significantly inhibited the growth of tumor cells in vivo using an allograft tumor model. This study indicates that inhibition of the Notch signaling pathway provides a valuable strategy for enhancing solid tumor sensitivity to LAQ.
Journal • Epigenetic controller
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Ogsiveo (nirogacestat)
1year
GOunder/Desmoid Tumor Research Foundation DEsmoid Symptom/Impact Scale (GODDESS): psychometric properties and clinically meaningful thresholds as assessed in the Phase 3 DeFi randomized controlled clinical trial. (PubMed, Qual Life Res)
GODDESS was found to be reliable, valid, responsive, and interpretable as a clinical trial endpoint in the pooled sample of DT/AF patients. Estimated MCTs can be used to define responders and assess group-level differences in future, unblinded, efficacy analyses.
Clinical • P3 data • Journal
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Ogsiveo (nirogacestat)
1year
Gamma Secretase Inhibition Sensitizes Pancreatic Adenocarcinoma Tumors to RT In Vivo (ASTRO 2023)
Notch pathway inhibition sensitizes PDAC tumors to RT in vivo , but not in vitro , suggesting involvement of the TME. Indeed, co-culture with PDAC cells stimulates notch signaling in fibroblasts, suggesting non-cell autonomous mechanisms mediating fibrosis in the TME driving radioresistance. Future studies will determine if ADAM10 inhibition targeting PDAC cells and/or gamma secretase inhibition targeting the TME enhances radiation sensitivity in vivo by blocking fibroblast Notch signaling.
Preclinical
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HES1 (Hes Family BHLH Transcription Factor 1) • NICD (NOTCH1 intracellular domain) • ADAM10 (ADAM Metallopeptidase Domain 10)
1year
Combined inhibition of surface CD51 and γ-secretase-mediated CD51 cleavage improves therapeutic efficacy in experimental metastatic hepatocellular carcinoma. (PubMed, J Hepatol)
To sum up, we revealed previously unrecognized action mechanisms of CD51 on HCC progression and uncovered the underlying cause of cilengitide treatment failure and supported the translational prospects of combined CD51-targeted therapy in the clinic.
Journal • Metastases
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POSTN (Periostin)
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Cilcane (cilengitide) • crenigacestat (LY3039478)
over1year
Evidence-based identification of breast cancer and associated ovarian and uterus cancer risk components in source waters from high incidence area in the Pearl River Basin, China. (PubMed, Sci Total Environ)
Moreover, these identified water components were present at levels comparable to other regions with high female cancer prevalence, suggesting that the potential risk of these components may not be exclusive to the study region. Together, multiple levels of evidence suggested that long-term co-exposures to source water estrogenic components may be important to the development of breast, ovarian, and uterus cancers.
Journal
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ER (Estrogen receptor)
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Compound E
over1year
Efficacy of NOTCH inhibitors (Ni) relative to prior systemic therapy or observation in patients (pts) with recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC) (ESMO 2023)
Ni included AL101, a gamma-secretase inhibitor, or OMP-52M51, an antibody targeting N1...The efficacy of Ni compares favorably with efficacy of systemic therapies administered prior to Ni. The limited PFS and high rate of tumor progression on non-target lesions suggests Ni combination therapy may be necessary to address ACC heterogeneity.
Clinical • Metastases
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NOTCH1 (Notch 1)
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AL101 • brontictuzumab (OMP-52M51)
over1year
AL101 therapy in patients with recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC): Final ACCURACY trial results and meta-analysis of clinical outcomes (ESMO 2023)
*Inverse variance method, no transformation, 0.5 continuity correction. ORR: CR + PR; DCR: CR + PR + SD Conclusions AL101 showed acceptable safety and tolerability in ACC pts with Notchmut and a response rate comparable to pooled estimates for available therapies in pts regardless of Notch status.
Clinical data • Retrospective data • Metastases
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NOTCH1 (Notch 1)
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NOTCH mutation
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AL101
over1year
A Study of CC-99712, a BCMA Antibody-Drug Conjugate, in Participants With Relapsed and Refractory Multiple Myeloma (clinicaltrials.gov)
P1, N=160, Active, not recruiting, Celgene | Recruiting --> Active, not recruiting | Trial completion date: May 2025 --> Apr 2024 | Trial primary completion date: Dec 2024 --> Apr 2024
Enrollment closed • Trial completion date • Trial primary completion date
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crenigacestat (LY3039478) • ispectamab debotansine (BMS-986352)
over1year
New P2 trial
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Ogsiveo (nirogacestat)