NCT06925321

Brief 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.

Trial Health

88
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
234

participants targeted

Target at P25-P50 for phase_3

Timeline
22mo left

Started Aug 2025

Geographic Reach
11 countries

44 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress29%
Aug 2025Feb 2028

First Submitted

Initial submission to the registry

March 27, 2025

Completed
17 days until next milestone

First Posted

Study publicly available on registry

April 13, 2025

Completed
5 months until next milestone

Study Start

First participant enrolled

August 26, 2025

Completed
2.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2028

Last Updated

April 22, 2026

Status Verified

April 1, 2026

Enrollment Period

2.4 years

First QC Date

March 27, 2025

Last Update Submit

April 21, 2026

Conditions

Keywords

Fungal infectionAntifungalMold infectionRare moldsMultidrug resistant moldAspergillus spp.Fusarium spp.Lomentospora prolificansMucorales fungiScedosporium spp.

Outcome Measures

Primary Outcomes (1)

  • Day 42 all-cause mortality rate

    Day 42

Secondary Outcomes (11)

  • Proportion of patients with overall response of treatment success

    Day 42, Day 84 and up to 180 days

  • Proportion of patients with clinical response of treatment success

    Day 42, Day 84 and up to 180 days

  • Proportion of patients with mycological response of eradication or presumed eradication

    Day 42, Day 84 and up to 180 days

  • Proportion of patients with radiological response of complete response or partial response

    Day 42, Day 84 and up to 180 days

  • All-cause mortality rate at Day 84

    Day 84

  • +6 more secondary outcomes

Study Arms (3)

Cohort A: Experimental Treatment

EXPERIMENTAL

Patients will receive the study drug. Fosmanogepix will be administered as an Intravenous (IV) infusion or in oral form.

Drug: Fosmanogepix IV infusionDrug: Fosmanogepix oral tablet

Cohort A: Comparator Antifungal Treatment

ACTIVE COMPARATOR

Best available therapy (BAT) administered as IV or orally per standard guidelines.

Drug: Standard of care antifungal therapy

Cohort B

EXPERIMENTAL

Patients will receive the study drug. Fosmanogepix will be administered as an Intravenous (IV) infusion or in oral form.

Drug: Fosmanogepix IV infusionDrug: Fosmanogepix oral tablet

Interventions

Fosmanogepix will be administered IV

Cohort A: Experimental TreatmentCohort B

Standard of care antifungal therapy will be administered in accordance with their respective product labels and/or standard practice guidelines

Cohort A: Comparator Antifungal Treatment

Fosmanogepix will be administered orally.

Cohort A: Experimental TreatmentCohort B

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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.
  • Patient's condition allows for appropriate infection source control measures.
  • Refractory hematologic malignancy.
  • Chronic aspergillosis, aspergilloma, or allergic bronchopulmonary aspergillosis.
  • Coronavirus disease 2019 (COVID-19) associated mucormycosis.
  • Invasive fungal disease caused by more than one fungal pathogen is not permitted in Cohort A but is permitted in Cohort B.
  • Patients with a Karnofsky Performance Status \< 20 at Screening.
  • Requirement, or anticipated requirement, for hemodialysis, peritoneal dialysis, or hemofiltration.
  • Patients with known human immunodeficiency virus infection.
  • Ongoing neurological disorders.
  • Patients receiving hospice/comfort care only.
  • Other medical or psychiatric condition.
  • Current use of any prohibited concomitant medication(s).
  • Current/ previous administration of an investigational drug within 30 days.
  • Prior enrollment in this or any previous study of fosmanogepix.
  • +3 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (49)

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

Birmingham, Alabama, 35294-0006, United States

RECRUITING

City of Hope

Duarte, California, 91010, United States

RECRUITING

David Geffen School of Medicine at UCLA

Los Angeles, California, 90095-1690, United States

RECRUITING

UC Davis Medical Center

Sacramento, California, 95817, United States

RECRUITING

University of Kentucky Medical Center, Division of Infectious Diseases

Lexington, Kentucky, 40506, United States

RECRUITING

Johns Hopkins Hospital

Baltimore, Maryland, 21231, United States

RECRUITING

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

Ann Arbor, Michigan, 48109-5000, United States

RECRUITING

Karmanos Cancer Institute - Detroit

Detroit, Michigan, 48201, United States

RECRUITING

University of Minnesota, M Health Fairview Medical Center

Minneapolis, Minnesota, 55455, United States

RECRUITING

Washington University School of Medicine, Infectious Diseases Clinical Research Unit

St Louis, Missouri, 63110, United States

RECRUITING

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, 27514, United States

RECRUITING

Duke University Medical Center, Duke Infectious Diseases

Durham, North Carolina, 27710, United States

RECRUITING

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

Houston, Texas, 77030, United States

RECRUITING

UT MD Anderson Cancer Center

Houston, Texas, 77030, United States

RECRUITING

Monash Medical Center Clayton

Clayton, 3168, Australia

RECRUITING

The Alfred Hospital

Melbourne, 3004, Australia

RECRUITING

Peter MacCallum Cancer Center

Melbourne, 3050, Australia

RECRUITING

Royal Melbourne Hospital

Parkville, 3050, Australia

RECRUITING

Princess Alexandra Hospital

Woolloongabba, 4102, Australia

RECRUITING

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

Linz, 4021, Austria

RECRUITING

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

Vienna, 1090, Austria

RECRUITING

Charleroi Grand Hospital (GHDC) - Les Viviers Site

Charleroi, 6000, Belgium

RECRUITING

University Hospitals Leuven, Campus Gasthuisberg, Department of Hematology

Leuven, 3000, Belgium

RECRUITING

UCL Mont-Godinne University Hospitals

Yvoir, 5530, Belgium

RECRUITING

University of Alberta

Edmonton, Alberta, T6G 2R3, Canada

RECRUITING

Juravinski Hospital - Hamilton Health Sciences

Hamilton, Ontario, L8V 1C3, Canada

RECRUITING

Vancouver Coastal Health Research Institute (VCHRI)

Vancouver, V5Z 1M9, Canada

RECRUITING

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

Nantes, 44000, France

RECRUITING

University Medical Center of Johannes Gutenberg University Mainz

Mainz, Rhineland-Palatinate, 55131, Germany

RECRUITING

Rambam Health Care Campus, Institute of Infectious Diseases

Haifa, 3109601, Israel

RECRUITING

Chaim Sheba Medical Center, Department of Infectious Diseases

Ramat Gan, 52621, Israel

RECRUITING

The Tel Aviv Sourasky Medical Center, Infectious Diseases Unit

Tel Aviv, 6423906, Israel

RECRUITING

Shamir Medical Center, Department of Infectious Diseases

Ẕerifin, 7033001, Israel

RECRUITING

Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda

Milan, 20122, Italy

RECRUITING

University Polyclinic Hospital of Modena

Modena, 41124, Italy

RECRUITING

Polyclinic San Matteo, IRCCS

Pavia, 27100, Italy

RECRUITING

University Hospital of Pisa

Pisa, 56126, Italy

RECRUITING

Giuliano Isontina University Health Authority

Trieste, 34125, Italy

RECRUITING

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

Nijmegen, 6525GA, Netherlands

RECRUITING

Erasmus Medical Center, Deoartment of Infectious Diseases

Rotterdam, 3015 GD, Netherlands

RECRUITING

University Hospital Virgen Macarena

Seville, Andalusia, 41009, Spain

RECRUITING

Hospital del Mar, Department of Infectious Diseases

Barcelona, Catalonia, 08003, Spain

RECRUITING

University Hospital Cruces

Barakaldo, 48903, Spain

RECRUITING

Hospital de la Santa Creu i Sant Pau

Barcelona, 08025, Spain

RECRUITING

University Hospital Ramon y Cajal, Department of Infectious Diseases

Madrid, 28034, Spain

RECRUITING

Faculty of Medicine, Siriraj Hospital

Bangkok, 10700, Thailand

RECRUITING

Maharaj Nakorn Chiang Mai Hospital

Chiang Mai, 50200, Thailand

RECRUITING

Songklanagarind Hospital

Hat Yai, 90110, Thailand

RECRUITING

Srinagarind Hospital

Khon Kaen, 40002, Thailand

RECRUITING

MeSH Terms

Conditions

Mycoses

Condition Hierarchy (Ancestors)

Bacterial Infections and MycosesInfections

Study Officials

  • Alison Kuchta, MD

    Basilea Pharmaceutica International Ltd, Allschwil

    STUDY DIRECTOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: An open-label, 2-cohort study
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR
Expanded Access
Yes

Study Record Dates

First Submitted

March 27, 2025

First Posted

April 13, 2025

Study Start

August 26, 2025

Primary Completion (Estimated)

February 1, 2028

Study Completion (Estimated)

February 1, 2028

Last Updated

April 22, 2026

Record last verified: 2026-04

Locations