Pillar 1 - FTO (new thread), page-2319

There is a Phase II trial looking at repurposing Decitabine for Pancreatic Cancer ...

https://www.anticancerfund.org/en/first-patient-trial-promising-repurposed-drug-pancreatic-cancer

https://clinicaltrials.gov/ct2/show/NCT05360264?term=ORIENTATE&draw=2&rank=1

Why do I think this is interesting?!

1. RACE's EM AML trial is using Zantrene with a Decitabine/cedazuridine combination in Stratum 2.
   
   https://clinicaltrials.gov/ct2/show/NCT05456269?term=bisantrene&draw=2&rank=3
   
   The commercial name for the drug is Inqovi and is a product of Astex pharmaceuticals (Astex are the developer and the drug is marketed by Taiho Oncology).
   https://www.inqovi.com/
   
   RACE's trial will establish maximum tolerated dose and hence dose safety for Zantrene used in combination with Decitabine/cedazuridine (aka Inqovi).
   
   
2. I was pondering if any of the drugs that Bisantrene has been paired with for AML can be used for pancreatic cancer ... the following paper identifies Inqovi (aka Decitabine/cedazuridine)  as a potential therapeutic for Pancreatic Cancer:
   
   https://aacrjournals.org/cancerres/article/80/21/4610/645862/Turning-Up-the-Heat-on-the-Pancreatic-Tumor
   
3. Given the findings of the City of Hope paper, I think there might be potential for the same combination in RACE's Stratum 2 of the EM AML trial to be used for Pancreatic cancer (either in a new Phase 2 trial or for compassionate use ...?)
   
   The more conservative path might be a 10-patient Phase 2 proof of concept trial in Pancreatic Cancer patients where their cancers over-express FTO (although the combination may benefit cohorts that don't overexposes FTO???). This proof of concept trial could potentially leverage the dose escalation findings from RACE's EM AML trial.
   
   Following this there could potentially be a 50-patient US-based Phase 2 trial aiming for Breakthrough Therapy Designation.

IMO this set of trials (a proof of concept followed by a larger Phase 2) would be great fodder for a solid tumour partnership in Pancreatic Cancer. Although RACE might be able to extract more value if they do a proof of concept first.