{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:31:51Z","timestamp":1792063911861,"version":"4.4.0"},"reference-count":32,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"31","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Metastatic pancreatic adenocarcinoma (mPC) remains a difficult-to-treat disease. Fluorouarcil, oxaliplatin, irinotecan, and leucovorin (FFX) is a standard first-line therapy for mPC for patients with a favorable performance status and good organ function. In a phase I study, devimistat (CPI-613) in combination with modified FFX (mFFX) was deemed safe and exhibited promising efficacy in mPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      The AVENGER 500 trial (ClinicalTrials.gov identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT03504423\">NCT03504423<\/jats:ext-link>\n                      ) is a global, randomized phase III trial conducted at 74 sites across six countries to investigate the efficacy and safety of devimistat in combination with mFFX (experimental arm) compared with standard-dose FFX (control arm) in treatment-na\u00efve patients with mPC. Treatment, administered in once-every-2-weeks cycles until disease progression or intolerable toxicity, included intravenous devimistat at 500 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      total per day on days 1 and 3 in the experimental arm. The primary end point of the study was overall survival (OS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Five hundred and twenty-eight patients were randomly assigned (266 in the experimental arm and 262 in the control arm). The median OS was 11.10 months for devimistat plus mFFX versus 11.73 months for FFX (hazard ratio [HR], 0.95 [95% CI, 0.77 to 1.18];\n                      <jats:italic>P<\/jats:italic>\n                      = .655) and median progression-free survival was 7.8 months versus 8.0 months, respectively (HR, 0.99 [95% CI, 0.76 to 1.29];\n                      <jats:italic>P<\/jats:italic>\n                      = .94). Grade \u22653 treatment-emergent adverse events with &gt;10% frequency in the devimistat plus mFFX arm versus the FFX arm were neutropenia (29.0%\n                      <jats:italic>v<\/jats:italic>\n                      34.5%), diarrhea (11.2%\n                      <jats:italic>v<\/jats:italic>\n                      19.6%), hypokalemia (13.1%\n                      <jats:italic>v<\/jats:italic>\n                      14.9%), anemia (13.9%\n                      <jats:italic>v<\/jats:italic>\n                      13.6%), thrombocytopenia (11.6%\n                      <jats:italic>v<\/jats:italic>\n                      13.6%), and fatigue (10.8%\n                      <jats:italic>v<\/jats:italic>\n                      11.5%), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Devimistat in combination with mFFX did not improve long- and short-term mPC patient outcomes compared with standard FFX. There were no new toxicity signals with the addition of devimistat.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.23.02659","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T16:02:16Z","timestamp":1722528136000},"page":"3692-3701","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":50,"title":["Devimistat (CPI-613) With Modified Fluorouarcil, Oxaliplatin, Irinotecan, and Leucovorin (FFX) Versus FFX for Patients With Metastatic Adenocarcinoma of the Pancreas: The Phase III AVENGER 500 Study"],"prefix":"10.1200","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct03504423","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6513-3491","authenticated-orcid":false,"given":"Philip A.","family":"Philip","sequence":"first","affiliation":[{"name":"Department of Oncology and Department of Pharmacology, Henry Ford Cancer Institute, Wayne State University School of Medicine, Detroit, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1892-1548","authenticated-orcid":false,"given":"Vaibhav","family":"Sahai","sequence":"additional","affiliation":[{"name":"University of Michigan Rogel Cancer Center, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7317-9118","authenticated-orcid":false,"given":"Nathan","family":"Bahary","sequence":"additional","affiliation":[{"name":"Allegheny Health Network Cancer Institute, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1111-8333","authenticated-orcid":false,"given":"Amit","family":"Mahipal","sequence":"additional","affiliation":[{"name":"University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, 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