P2, N=158, Terminated, GlaxoSmithKline | Active, not recruiting --> Terminated; The study met futility criteria at pre-planned interim analysis, showing no clinical efficacy of the investigational drug. Based on the lack of efficacy at the interim data review, the sponsor decided to terminate the study.

P2, N=158, Active, not recruiting, GlaxoSmithKline | Trial completion date: Feb 2026 --> Oct 2025 | Trial primary completion date: Feb 2026 --> Oct 2025

P2, N=158, Active, not recruiting, GlaxoSmithKline | Recruiting --> Active, not recruiting

P1, N=50, Completed, GlaxoSmithKline | Not yet recruiting --> Completed | N=38 --> 50

P1, N=38, Not yet recruiting, GlaxoSmithKline

P2, N=150, Recruiting, GlaxoSmithKline | Not yet recruiting --> Recruiting

P2, N=186, Completed, Dr. Falk Pharma GmbH | Recruiting --> Completed

P2, N=150, Not yet recruiting, GlaxoSmithKline

These results indicated that the inhibition of TG2 by compound 8j (MD102) could enhance p53 stabilization, thereby ultimately showing anticancer effects in RCC. Compound 8j (MD102), a novel TG2 inhibitor, can be further applied for the development of an anticancer candidate drug targeting RCC.

Interestingly, AA9 treatment induces myo-inositol alteration in both cell lines, indicating action on phosphatidylinositol metabolism, likely modulated by the G-protein activity of TG2 on phospholipase C. Considering the metabolic deregulations that characterize various breast cancer subtypes, the existence of a metabolic pathway affected by AA9 further points to TG2 as a promising hot spot. The metabolomics approach provides a powerful tool to monitor the effectiveness of inhibitors and to better understand the role of TG2 in cancer.

Moreover, when combined with RT, cystamine dihydrochloride (a TGM2 inhibitor) extended the lifespan of GBM-bearing mice. Overall, our findings demonstrated the EPG5 tethering mode with SDC1 and TGM2 during the fusion of autophagosomes with lysosomes, providing new insights into the molecular mechanism and therapeutic target underlying radioresistant GBM.Abbreviations: BafA: bafilomycin A; CQ: chloroquine; Cys-D: cystamine dihydrochloride; EPG5: ectopic P-granules 5 autophagy tethering factor; GBM: glioblastoma multiforme; GFP: green fluorescent protein; LAMP2: lysosomal associated membrane protein 2; LIRs: LC3-interacting regions; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; NC: negative control; RFP: red fluorescent protein; RT: radiotherapy; SDC1: syndecan 1; SNAP29: synaptosome associated protein 29; SQSTM1/p62: sequestosome 1; STX17: syntaxin 17; TGM2: transglutaminase 2; TMT: tandem mass tag; VAMP8: vesicle associated membrane protein 8; WT: wild type.

As a result, compounds with nitrofuran substituents from the TDAE series demonstrated the highest antiproliferative activity with IC = 2.49 ± 1.33 μM and IC = 3.96 ± 2.03 μM for compound 11a and IC = 5.3 ± 2.12 μM and IC = 7.12 ± 1.59 μM for compound 11b against SK-N-SH and IMR-32, respectively. Furthermore, an in silico study was carried out to evaluate the mechanism of action of our lead compounds and predict their pharmacokinetic properties.