# Devimistat

Source: https://onco.cc/drugs/devimistat/  
OnCo record `devimistat` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Devimistat tried to starve pancreatic cancer cells of their energy supply alongside chemotherapy; the phase 3 AVENGER 500 trial found no survival gain.

## Summary

Devimistat (CPI-613) was developed by Rafael Pharmaceuticals, later renamed Cornerstone Pharmaceuticals, as a first-in-class drug against cancer cell metabolism. Early trials combined it with modified FOLFIRINOX in metastatic pancreatic cancer with encouraging response rates.

The phase 3 AVENGER 500 trial randomised patients with untreated metastatic pancreatic adenocarcinoma to modified FOLFIRINOX with or without devimistat. It did not improve overall survival, and a parallel phase 3 in acute myeloid leukaemia (ARMADA 2000) also missed. Development in pancreatic cancer stopped.

## Fields

- Kind: Treatment
- Status: negative
- Last checked: 2026-09-17
- Also known as: CPI-613
- Code: CPI-613
- Modality: Small-molecule inhibitor of mitochondrial metabolism (PDH and KGDH)
- Mechanism: A lipoate analogue that disrupts the tumour's mitochondrial energy metabolism by inhibiting pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase.

## Sources

- ClinicalTrials.gov NCT03504423: https://clinicaltrials.gov/study/NCT03504423

## Connected records

- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- companies: [Cornerstone Pharmaceuticals (formerly Rafael Pharmaceuticals)](https://onco.cc/companies/cornerstone-pharmaceuticals/)
- trials: [AVENGER 500](https://onco.cc/trials/avenger-500/)

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JSON: https://onco.cc/api/v1/entities/devimistat.json