{"entity":{"id":"devimistat","kind":"drug","name":"Devimistat","aka":["CPI-613"],"tldr":"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.\n\nThe 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.","status":"negative","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT03504423","url":"https://clinicaltrials.gov/study/NCT03504423"}],"tags":[],"related":[],"cancers":["pancreatic"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":[],"drugs":[],"companies":["cornerstone-pharmaceuticals"],"institutions":[],"pathways":[],"terms":[],"trials":["avenger-500"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/devimistat/","neighbours":{"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"company":[{"id":"cornerstone-pharmaceuticals","kind":"company","name":"Cornerstone Pharmaceuticals (formerly Rafael Pharmaceuticals)","route":"/companies/cornerstone-pharmaceuticals/"}],"trial":[{"id":"avenger-500","kind":"trial","name":"AVENGER 500","route":"/trials/avenger-500/"}]}}