{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T13:07:05Z","timestamp":1794056825292,"version":"4.8.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Invest New Drugs"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Antiangiogenic drugs may cause vascular normalization and correct hypoxia in tumors, shifting cells to mitochondrial respiration as the primary source of energy. In turn, the addition of an inhibitor of mitochondrial respiration to antiangiogenic therapy holds potential to induce synthetic lethality. This study evaluated the mitochondrial inhibitor ME-344 in combination with bevacizumab in patients with refractory metastatic colorectal cancer (mCRC). Patients were eligible if they had disease progression after standard therapies, adequate hematologic, hepatic and renal function, and no contraindications to bevacizumab. ME-344 was administered intravenously on days 1, 8 and 15 and bevacizumab on days 1 and 15 of 28-day cycles until disease progression or intolerance. The primary efficacy endpoint was progression-free survival (PFS) at week 16. In the 23 patients enrolled, the median age was 58 years, median number of prior lines of therapy was 4, and median interval from last therapy was 3 months. The most common adverse events (all grades\/grade\u2009\u2265\u20093) were fatigue (48%\/13%), abdominal pain (35%\/4%), diarrhea (30%\/4%) and constipation (30%\/0%). No patient had an objective response; 9 patients (39%) achieved stable disease. The 16-week PFS was 30.6% (95% confidence interval [CI]: 12.2\u201351.3), the median PFS was 1.9 months (95% CI: 1.6\u20134.7), and the median overall survival was 6.7 months (95% CI: 3.4-not reached). ME-344 plus bevacizumab was well tolerated. Disease control was limited in this heavily pretreated patient population. Additional investigations in earlier lines are indicated, and extended-release ME-344 formulations may provide longer drug exposure to maximize benefit. (Trial registration number ClinicalTrials.gov NCT05824559. Registration date 22 March 2022).<\/jats:p>","DOI":"10.1007\/s10637-024-01489-1","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T02:21:27Z","timestamp":1735266087000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Phase 1b study of the OxPhos inhibitor ME-344 with bevacizumab in refractory metastatic colorectal cancer"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4213-8847","authenticated-orcid":false,"given":"Patrick M.","family":"Boland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2178-9568","authenticated-orcid":false,"given":"Heinz-Josef","family":"Lenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-5909","authenticated-orcid":false,"given":"Kristen K.","family":"Ciombor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5558-753X","authenticated-orcid":false,"given":"Vaia","family":"Florou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-9041","authenticated-orcid":false,"given":"Michael J.","family":"Pishvaian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5983-980X","authenticated-orcid":false,"given":"Michael","family":"Cusnir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6178-9266","authenticated-orcid":false,"given":"Deirdre","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9212-7954","authenticated-orcid":false,"given":"Jessie Y.","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-8458","authenticated-orcid":false,"given":"Prabhu","family":"Rajagopalan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-2474","authenticated-orcid":false,"given":"Sandra E.","family":"Wiley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6882-8179","authenticated-orcid":false,"given":"Richard G.","family":"Ghalie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0435-061X","authenticated-orcid":false,"given":"Howard S.","family":"Hochster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"1489_CR1","doi-asserted-by":"crossref","unstructured":"Morris VK, Kennedy EB, Baxter NN, Benson AB 3rd, Cercek A, Cho M et al (2023) Treatment of Metastatic Colorectal Cancer: ASCO Guideline. J Clin Oncol 41(3):678\u2013700","DOI":"10.1200\/JCO.22.01690"},{"issue":"23","key":"1489_CR2","doi-asserted-by":"publisher","first-page":"2405","DOI":"10.1001\/jama.2021.6027","volume":"325","author":"LH Biller","year":"2021","unstructured":"Biller LH, Schrag D (2021) A Review of the Diagnosis and Treatment of Metastatic Colorectal Cancer-Reply. JAMA 325(23):2405","journal-title":"JAMA"},{"issue":"9863","key":"1489_CR3","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/S0140-6736(12)61900-X","volume":"381","author":"A Grothey","year":"2013","unstructured":"Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M et al (2013) Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 381(9863):303\u2013312","journal-title":"Lancet"},{"issue":"10395","key":"1489_CR4","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S0140-6736(23)00772-9","volume":"402","author":"A Dasari","year":"2023","unstructured":"Dasari A, Lonardi S, Garcia-Carbonero R, Elez E, Yoshino T, Sobrero A et al (2023) Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. Lancet 402(10395):41\u201353","journal-title":"Lancet"},{"issue":"20","key":"1489_CR5","doi-asserted-by":"publisher","first-page":"1909","DOI":"10.1056\/NEJMoa1414325","volume":"372","author":"RJ Mayer","year":"2015","unstructured":"Mayer RJ, Van Cutsem E, Falcone A, Yoshino T, Garcia-Carbonero R, Mizunuma N et al (2015) Randomized trial of TAS-102 for refractory metastatic colorectal cancer. N Engl J Med 372(20):1909\u20131919","journal-title":"N Engl J Med"},{"issue":"18","key":"1489_CR6","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1056\/NEJMoa2214963","volume":"388","author":"GW Prager","year":"2023","unstructured":"Prager GW, Taieb J, Fakih M, Ciardiello F, Van Cutsem E, Elez E et al (2023) Trifluridine-Tipiracil and Bevacizumab in Refractory Metastatic Colorectal Cancer. N Engl J Med 388(18):1657\u20131667","journal-title":"N Engl J Med"},{"issue":"6","key":"1489_CR7","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/S1470-2045(15)70156-7","volume":"16","author":"J Li","year":"2015","unstructured":"Li J, Qin S, Xu R, Yau TC, Ma B, Pan H et al (2015) Regorafenib plus best supportive care versus placebo plus best supportive care in Asian patients with previously treated metastatic colorectal cancer (CONCUR): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 16(6):619\u2013629","journal-title":"Lancet Oncol"},{"issue":"2","key":"1489_CR8","first-page":"689","volume":"5","author":"SC Lim","year":"2015","unstructured":"Lim SC, Carey KT, McKenzie M (2015) Anti-cancer analogues ME-143 and ME-344 exert toxicity by directly inhibiting mitochondrial NADH: ubiquinone oxidoreductase (Complex I). Am J Cancer Res 5(2):689\u2013701","journal-title":"Am J Cancer Res"},{"issue":"16","key":"1489_CR9","doi-asserted-by":"publisher","first-page":"4072","DOI":"10.1158\/0008-5472.CAN-18-3503","volume":"79","author":"L Zhang","year":"2019","unstructured":"Zhang L, Zhang J, Ye Z, Manevich Y, Ball LE, Bethard JR et al (2019) Isoflavone ME-344 Disrupts Redox Homeostasis and Mitochondrial Function by Targeting Heme Oxygenase 1. Cancer Res 79(16):4072\u20134085","journal-title":"Cancer Res"},{"issue":"7","key":"1489_CR10","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1002\/cncr.29155","volume":"121","author":"JC Bendell","year":"2015","unstructured":"Bendell JC, Patel MR, Infante JR, Kurkjian CD, Jones SF, Pant S et al (2015) Phase 1, open-label, dose escalation, safety, and pharmacokinetics study of ME-344 as a single agent in patients with refractory solid tumors. Cancer 121(7):1056\u20131063","journal-title":"Cancer"},{"issue":"5","key":"1489_CR11","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1007\/s10637-017-0444-1","volume":"35","author":"JR Diamond","year":"2017","unstructured":"Diamond JR, Goff B, Forster MD, Bendell JC, Britten CD, Gordon MS et al (2017) Phase Ib study of the mitochondrial inhibitor ME-344 plus topotecan in patients with previously treated, locally advanced or metastatic small cell lung, ovarian and cervical cancers. Invest New Drugs 35(5):627\u2013633","journal-title":"Invest New Drugs"},{"issue":"5706","key":"1489_CR12","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1126\/science.1104819","volume":"307","author":"RK Jain","year":"2005","unstructured":"Jain RK (2005) Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science 307(5706):58\u201362","journal-title":"Science"},{"issue":"17","key":"1489_CR13","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1200\/JCO.2012.46.3653","volume":"31","author":"RK Jain","year":"2013","unstructured":"Jain RK (2013) Normalizing tumor microenvironment to treat cancer: bench to bedside to biomarkers. J Clin Oncol 31(17):2205\u20132218","journal-title":"J Clin Oncol"},{"issue":"12","key":"1489_CR14","doi-asserted-by":"publisher","first-page":"2705","DOI":"10.1016\/j.celrep.2016.05.052","volume":"15","author":"P Navarro","year":"2016","unstructured":"Navarro P, Bueno MJ, Zagorac I, Mondejar T, Sanchez J, Mouron S et al (2016) Targeting Tumor Mitochondrial Metabolism Overcomes Resistance to Antiangiogenics. Cell Rep 15(12):2705\u20132718","journal-title":"Cell Rep"},{"issue":"1","key":"1489_CR15","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1158\/1078-0432.CCR-19-2023","volume":"26","author":"M Quintela-Fandino","year":"2020","unstructured":"Quintela-Fandino M, Morales S, Cortes-Salgado A, Manso L, Apala JV, Munoz M et al (2020) Randomized Phase 0\/I Trial of the Mitochondrial Inhibitor ME-344 or Placebo Added to Bevacizumab in Early HER2-Negative Breast Cancer. Clin Cancer Res 26(1):35\u201345","journal-title":"Clin Cancer Res"},{"issue":"3","key":"1489_CR16","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.cmpb.2010.01.007","volume":"99","author":"Y Zhang","year":"2010","unstructured":"Zhang Y, Huo M, Zhou J, Xie S, PKSolver (2010) An add-in program for pharmacokinetic and pharmacodynamic data analysis in Microsoft Excel. Comput Methods Programs Biomed 99(3):306\u2013314","journal-title":"Comput Methods Programs Biomed"},{"issue":"1","key":"1489_CR17","doi-asserted-by":"publisher","first-page":"5857","DOI":"10.1038\/s41467-024-50157-8","volume":"15","author":"T Lan","year":"2024","unstructured":"Lan T, Arastu S, Lam J, Kim H, Wang W, Wang S et al (2024) Glucose-6-phosphate dehydrogenase maintains redox homeostasis and biosynthesis in LKB1-deficient KRAS-driven lung cancer. Nat Commun 15(1):5857","journal-title":"Nat Commun"},{"issue":"1","key":"1489_CR18","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1186\/s12967-023-04604-7","volume":"21","author":"Y Yang","year":"2023","unstructured":"Yang Y, Wang Z, Li X, Lv J, Zhong R, Gao S et al (2023) Profiling the metabolic disorder and detection of colorectal cancer based on targeted amino acids metabolomics. J Transl Med 21(1):824","journal-title":"J Transl Med"},{"issue":"21","key":"1489_CR19","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1056\/NEJM197111182852108","volume":"285","author":"J Folkman","year":"1971","unstructured":"Folkman J (1971) Tumor angiogenesis: therapeutic implications. N Engl J Med 285(21):1182\u20131186","journal-title":"N Engl J Med"},{"issue":"10043","key":"1489_CR20","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/S0140-6736(15)01088-0","volume":"388","author":"GC Jayson","year":"2016","unstructured":"Jayson GC, Kerbel R, Ellis LM, Harris AL (2016) Antiangiogenic therapy in oncology: current status and future directions. Lancet 388(10043):518\u2013529","journal-title":"Lancet"},{"issue":"1","key":"1489_CR21","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1158\/1078-0432.CCR-22-1366","volume":"29","author":"SA Patel","year":"2023","unstructured":"Patel SA, Nilsson MB, Le X, Cascone T, Jain RK, Heymach JV (2023) Molecular Mechanisms and Future Implications of VEGF\/VEGFR in Cancer Therapy. Clin Cancer Res 29(1):30\u201339","journal-title":"Clin Cancer Res"},{"key":"1489_CR22","doi-asserted-by":"crossref","unstructured":"Lopes-Coelho F, Martins F, Pereira SA, Serpa J (2021) Anti-Angiogenic Therapy: Current Challenges and Future Perspectives. Int J Mol Sci.;22(7)","DOI":"10.3390\/ijms22073765"},{"issue":"10","key":"1489_CR23","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1038\/nri3064","volume":"11","author":"GT Motz","year":"2011","unstructured":"Motz GT, Coukos G (2011) The parallel lives of angiogenesis and immunosuppression: cancer and other tales. Nat Rev Immunol 11(10):702\u2013711","journal-title":"Nat Rev Immunol"},{"key":"1489_CR24","doi-asserted-by":"crossref","unstructured":"Tarpgaard LS, Winther SB, Pfeiffer P (2023) Treatment Options in Late-Line Colorectal Cancer: Lessons Learned from Recent Randomized Studies. Cancers (Basel).;16(1)","DOI":"10.3390\/cancers16010126"},{"issue":"12","key":"1489_CR25","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1200\/JCO.2006.09.6305","volume":"25","author":"BJ Giantonio","year":"2007","unstructured":"Giantonio BJ, Catalano PJ, Meropol NJ, O\u2019Dwyer PJ, Mitchell EP, Alberts SR et al (2007) Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 25(12):1539\u20131544","journal-title":"J Clin Oncol"}],"container-title":["Investigational New Drugs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10637-024-01489-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10637-024-01489-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10637-024-01489-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T03:08:17Z","timestamp":1735268897000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10637-024-01489-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,27]]},"references-count":25,"alternative-id":["1489"],"URL":"https:\/\/doi.org\/10.1007\/s10637-024-01489-1","relation":{},"ISSN":["0167-6997","1573-0646"],"issn-type":[{"value":"0167-6997","type":"print"},{"value":"1573-0646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,27]]},"assertion":[{"value":"6 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the ethical principles that have their origin in the Declaration of Helsinki, and the ICH Harmonised Tripartite Guideline for GCP and all applicable regulations. This study and all pertinent documents were reviewed and approved by the Institutional Review Board of each participating institution.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants provided written informed consent to participate in the study prior to the initiation of any study-specific procedures.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Patrick M. Boland is on the advisory board of AbbVie, Bristol Myers Squib, BeiGene and Taiho and has a research grant from CARIS. Kristen K. Ciombor is a consultant\/advisory board for Pfizer, Incyte, Exelixis, Bayer, ALX, Tempus, Taiho, Agenus, Merck, Beigene, and has received research grants from BMS, Array, Incyte, Daiichi Sankyo, Nucana, Merck, Pfizer, Calithera, Genentech, Seagen, and Syndax. Vaia Florou is a consultant\/advisory board member of Deciphera, Springwork Therapeutics, and Aadi Biosciences. Michael J. Pishvaian is a consultant\/ad hoc advisory board for Astra Zeneca, Ideaya, Seattle Genetics, Merus, Merck, Moderna, Pfizer, Novartis, Astellas, and Serna Bio. He is on the Steering Committee\/Advisory Board for Astellas and Merck. He has received travel, accommodations and expenses support from Astellas and RenovoRx. He owns equity in Perthera. He has received institutional research funding from Tesaro, Arcus Bio, Ideaya, Repare Tx, Novartis, Pfizer, Merck, Tizonia, Biomed Valley Discoveries, Amgen, RenovoRx, Boerhinger Ingelheim, Astellas, Hutchinson Medipharma, Takeda, Actuate, MEI Pharma, Elevation Oncology, and Recursion Pharma. Min Tang and Prabu Rajagopalan are consultants to MEI Pharma. Sandy E. Wiley and Richard G. Ghalie are employed by and hold equity in MEI Pharma. Howard S. Hochster is consultant to GSK, AstraZeneca, Processa and Compass Therapeutics, and is expert witness for Guardant. Heinz-Josef Lenz, Michael Cusnir, Dierdre Cohen, and Jessie Y. Guo have no conflicts to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}