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NCT06925321PHASE3Recruiting

A Phase 3 Efficacy and Safety Study of Fosmanogepix for the Treatment of Adult Patients With Invasive Mold Infections.

Basilea Pharmaceutica

Start Date

8/26/2025

Completion Date

2/1/2028

Summary

The purpose of this study is to evaluate the efficacy and safety of fosmanogepix (administered IV or oral) for the treatment of adult patients with invasive mold infections. The study is looking for patients who have been diagnosed with invasive mold infections. The maximum study duration will be approximately 8 months, including a target study treatment duration of 84 days which can be extended up to 180 days and follow-up period. The patient will be assigned to one of two treatment cohorts: Cohort A (primary therapy): Patients will receive either the study drug or institutional standard of care antifungal treatment. Cohort B (salvage treatment; i.e. treatment given after patients did not respond to previous treatments or did not tolerate them): Patients will receive the study drug The primary aim is to compare the all cause mortality with a fixed threshold at Day 42.

Eligibility Criteria

Age Range: 18 years to No maximum

Main Inclusion Criteria: 1. Diagnosis of proven or probable Invasive mold infection (IMI) defined in accordance with the Revision and Update of the Consensus Definitions of Invasive Fungal Disease from the EORTC/MSGERC as adapted for this study and caused by Aspergillus spp. (in patients with limited treatment options), Fusarium spp., Lomentospora prolificans, Mucorales fungi, or other multi-drug resistant molds. 2. Patient's condition allows for appropriate infection source control measures. Main Exclusion Critera: 1. Refractory hematologic malignancy. 2. Chronic aspergillosis, aspergilloma, or allergic bronchopulmonary aspergillosis. 3. Coronavirus disease 2019 (COVID-19) associated mucormycosis. 4. Invasive fungal disease caused by more than one fungal pathogen is not permitted in Cohort A but is permitted in Cohort B. 5. Patients with a Karnofsky Performance Status \< 20 at Screening. 6. Requirement, or anticipated requirement, for hemodialysis, peritoneal dialysis, or hemofiltration. 7. Patients with known human immunodeficiency virus infection. 8. Ongoing neurological disorders. 9. Patients receiving hospice/comfort care only. 10. Other medical or psychiatric condition. 11. Current use of any prohibited concomitant medication(s). 12. Current/ previous administration of an investigational drug within 30 days. 13. Prior enrollment in this or any previous study of fosmanogepix. 14. Moderate or severe hepatic impairment. 15. Patient who is pregnant or lactating. 16. Known hypersensitivity to fosmanogepix, manogepix, or any of their excipients.

Interventions

DRUG

Fosmanogepix IV infusion

DRUG

Standard of care antifungal therapy

DRUG

Fosmanogepix oral tablet

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Conditions

Invasive Mold Infections

Locations

University of Alabama at Birmingham School of Medicine, Department of Medicine

Birmingham, Alabama 35294-0006

United States

City of Hope

Duarte, California 91010

United States

David Geffen School of Medicine at UCLA

Los Angeles, California 90095-1690

United States

UC Davis Medical Center

Sacramento, California 95817

United States

Memorial Healthcare System

Hollywood, Florida 33021

United States

Rush University Medical Center, Division of Infectious Diseases

Chicago, Illinois 60612

United States

University of Kentucky Medical Center, Division of Infectious Diseases

Lexington, Kentucky 40506

United States

Johns Hopkins Hospital

Baltimore, Maryland 21231

United States

University of Michigan Health System (UMHS) - A. Alfred Taubman Health Care Center

Ann Arbor, Michigan 48109-5000

United States

Karmanos Cancer Institute - Detroit

Detroit, Michigan 48201

United States

University of Minnesota, M Health Fairview Medical Center

Minneapolis, Minnesota 55455

United States

Washington University School of Medicine, Infectious Diseases Clinical Research Unit

St Louis, Missouri 63110

United States

David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center

New York, New York 10065

United States

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina 27514

United States

Duke University Medical Center, Duke Infectious Diseases

Durham, North Carolina 27710

United States

University of Pennsylvania School of Medicine

Philadelphia, Pennsylvania 19104-6243

United States

The University of Texas Health Science Center at Houston, Department of Internal Medicine

Houston, Texas 77030

United States

UT MD Anderson Cancer Center

Houston, Texas 77030

United States

University of Texas Health Science Center at San Antonio

San Antonio, Texas 78229

United States

Monash Medical Center Clayton

Clayton, 3168

Australia

The Alfred Hospital

Melbourne, 3004

Australia

Peter MacCallum Cancer Center

Melbourne, 3050

Australia

Royal Melbourne Hospital

Parkville, 3050

Australia

Westmead Hospital

Westmead, 2145

Australia

Princess Alexandra Hospital

Woolloongabba, 4102

Australia

Kepler University Hospital GmbH, Department of Internal Medicine IV - Pulmonology

Linz, 4021

Austria

Medical University Vienna, Department of Internal Medicine I, Clinical Department of Infections and Tropical Medicine

Vienna, 1090

Austria

Charleroi Grand Hospital (GHDC) - Les Viviers Site

Charleroi, 6000

Belgium

Jessa Hospital

Hasselt, 3500

Belgium

University Hospitals Leuven, Campus Gasthuisberg, Department of Hematology

Leuven, 3000

Belgium

UCL Mont-Godinne University Hospitals

Yvoir, 5530

Belgium

Porto Alegre Clinical Hospital (HCPA)

Porto Alegre, 90035-903

Brazil

Hospital A.C.Camargo ("Antonio Prudente" Foundation)

São Paulo, 01509-900

Brazil

"Santa Marcelina" Hospital

São Paulo, 08270-070

Brazil

University of Alberta

Edmonton, Alberta T6G 2R3

Canada

Juravinski Hospital - Hamilton Health Sciences

Hamilton, Ontario L8V 1C3

Canada

Vancouver Coastal Health Research Institute (VCHRI)

Vancouver, V5Z 1M9

Canada

Nantes University Hospital Center - Hotel Dieu Hospital, Department of Infectious and Tropical Diseases

Nantes, 44000

France

Necker Children's Hospital, Department of Infectious and Tropical Diseases

Paris, 75015

France

Rennes University Hospital Center - Pontchaillou Site

Rennes, 35000

France

University Hospital Cologne, Internal Medicine I - Oncology, Hematology, Clinical Infectiology, Clinical Immunology, Hemostaseology, Internal Intensive Care Medicine, Clinical Study Centre II for Infectious Diseases

Cologne, North Rhine-Westphalia 50937

Germany

University Medical Center of Johannes Gutenberg University Mainz

Mainz, Rhineland-Palatinate 55131

Germany

Frankfurt University Clinic

Frankfurt, 60590

Germany

"LAIKO" General Hospital

Athens, 115 27

Greece

General Hospital of Athens "Evangelismos"

Athens, PC 10676

Greece

University General Hospital "Attikon", 2nd Department of Internal Medicine, Propaedeutic, Hematology Unit

Athens, PC 12462

Greece

General Hospital of Thessaloniki "Ippokratio"

Thessaloniki, 54642

Greece

Rambam Health Care Campus, Institute of Infectious Diseases

Haifa, 3109601

Israel

Chaim Sheba Medical Center, Department of Infectious Diseases

Ramat Gan, 52621

Israel

The Tel Aviv Sourasky Medical Center, Infectious Diseases Unit

Tel Aviv, 6423906

Israel

Shamir Medical Center, Department of Infectious Diseases

Ẕerifin, 7033001

Israel

IRCCS Policlinic Hospital San Martino

Genova, 16132

Italy

Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda

Milan, 20122

Italy

University Polyclinic Hospital of Modena

Modena, 41124

Italy

Polyclinic San Matteo, IRCCS

Pavia, 27100

Italy

University Hospital of Pisa

Pisa, 56126

Italy

Giuliano Isontina University Health Authority

Trieste, 34125

Italy

Radboud University Medical Center (Radboudumc), Department of Intensive Care

Nijmegen, 6525GA

Netherlands

Erasmus Medical Center, Deoartment of Infectious Diseases

Rotterdam, 3015 GD

Netherlands

University Hospital Virgen Macarena

Seville, Andalusia 41009

Spain

Hospital del Mar, Department of Infectious Diseases

Barcelona, Catalonia 08003

Spain

Hospital de la Santa Creu i Sant Pau

Barcelona, Catalonia 08041

Spain

University Hospital Cruces

Barakaldo, 48903

Spain

Hospital de la Santa Creu i Sant Pau

Barcelona, 08025

Spain

University Hospital Ramon y Cajal, Department of Infectious Diseases

Madrid, 28034

Spain

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, 807377

Taiwan

China Medical University Hospital

Taichung, 404327

Taiwan

Taichung Veterans General Hospital

Taichung, 407219

Taiwan

National Taiwan University Hospital

Taipei, 100226

Taiwan

Taipei Medical University Hospital

Taipei, 110301

Taiwan

Taipei Veterans General Hospital

Taipei, 112201

Taiwan

Linkou Chang Gung Memorial Hospital

Taoyuan, 333

Taiwan

Faculty of Medicine, Siriraj Hospital

Bangkok, 10700

Thailand

Maharaj Nakorn Chiang Mai Hospital

Chiang Mai, 50200

Thailand

Songklanagarind Hospital

Hat Yai, 90110

Thailand

Srinagarind Hospital

Khon Kaen, 40002

Thailand