Recruiting
Phase 3

Fosmanogepix

Sponsor:

Basilea Pharmaceutica

Code:

NCT06925321

Conditions

Invasive Mold Infections

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Fosmanogepix IV infusion

Standard of care antifungal therapy

Fosmanogepix oral tablet

Study Details

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.

Conditions

Invasive Mold Infections

Study ID

NCT06925321

Start date

Aug 26, 2025

Status verified date

Aug, 2026

Completion date

Feb, 2028

Anticipated

Primary completion date

Feb, 2028

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

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.

Study Design

Enrollment

234 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Cohort A: Experimental Treatment

Patients will receive the study drug.

Fosmanogepix will be administered as an Intravenous (IV) infusion or in oral form.

active comparator: Cohort A: Comparator Antifungal Treatment

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

experimental: Cohort B

Patients will receive the study drug.

Fosmanogepix will be administered as an Intravenous (IV) infusion or in oral form.

Interventions

Fosmanogepix IV infusion

Fosmanogepix will be administered IV

Standard of care antifungal therapy

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

Fosmanogepix oral tablet

Fosmanogepix will be administered orally.

Primary outcome measure

  • Day 42 all-cause mortality rate [ Time Frame: Day 42 ]

Central Contacts and Locations

Central contacts

Locations

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

Recruiting

Birmingham, Alabama, United States, 35294-0006

City of Hope

Recruiting

Duarte, California, United States, 91010

David Geffen School of Medicine at UCLA

Recruiting

Los Angeles, California, United States, 90095-1690

UC Davis Medical Center

Recruiting

Sacramento, California, United States, 95817

Memorial Healthcare System

Recruiting

Hollywood, Florida, United States, 33021

Rush University Medical Center, Division of Infectious Diseases

Recruiting

Chicago, Illinois, United States, 60612

University of Kentucky Medical Center, Division of Infectious Diseases

Recruiting

Lexington, Kentucky, United States, 40506

Johns Hopkins Hospital

Recruiting

Baltimore, Maryland, United States, 21231

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

Recruiting

Ann Arbor, Michigan, United States, 48109-5000

University of Minnesota, M Health Fairview Medical Center

Recruiting

Minneapolis, Minnesota, United States, 55455

Washington University School of Medicine, Infectious Diseases Clinical Research Unit

Recruiting

St Louis, Missouri, United States, 63110

Weill Cornell Medical College - NewYork-Presbyterian Hospital

Recruiting

New York, New York, United States, 10021

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

Recruiting

New York, New York, United States, 10065

University of North Carolina at Chapel Hill

Recruiting

Chapel Hill, North Carolina, United States, 27514

Duke University Medical Center, Duke Infectious Diseases

Recruiting

Durham, North Carolina, United States, 27710

University of Pennsylvania School of Medicine

Recruiting

Philadelphia, Pennsylvania, United States, 19104-6243

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

Recruiting

Houston, Texas, United States, 77030

UT MD Anderson Cancer Center

Recruiting

Houston, Texas, United States, 77030

University of Texas Health Science Center at San Antonio

Recruiting

San Antonio, Texas, United States, 78229

University of Alberta

Recruiting

Edmonton, Alberta, Canada, T6G 2R3

Juravinski Hospital - Hamilton Health Sciences

Recruiting

Hamilton, Ontario, Canada, L8V 1C3

Ottawa Hospital

Recruiting

Ottawa, Ontario, Canada, K1H 8L6

Vancouver Coastal Health Research Institute (VCHRI)

Recruiting

Vancouver, Canada, V5Z 1M9

More Information

Sponsor

Basilea Pharmaceutica

Last update posted

Aug 17, 2026

Last verified

Aug, 2026

Keywords

  • Fungal infection
  • Antifungal
  • Mold infection
  • Rare molds
  • Multidrug resistant mold
  • Aspergillus spp.
  • Fusarium spp.
  • Lomentospora prolificans
  • Mucorales fungi
  • Scedosporium spp.

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-08. This information was provided to ClinicalTrials.gov by Basilea Pharmaceutica on 2026-08-17.