ClinicalTrials.gg
RecruitingNCT06925321Updated Oct 28, 2026

A Phase 3 Efficacy and Safety Study of Fosmanogepix for the Treatment of Adult Patients With Invasive Mold Infections.

A Phase 3 interventional study of Fosmanogepix IV infusion and Standard of care antifungal therapy in Invasive Mold Infections, sponsored by Basilea Pharmaceutica. Recruiting at 90 sites in 15 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-28.

Sponsored by Basilea Pharmaceutica · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2025; still recruiting 1 year 2 months later.
Updated Oct 28, 20267 sites added1 site removedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
234
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study 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.

02

Conditions studied

  • Invasive Mold Infections

Browse trials for

Keywords

  • Fungal infection
  • Antifungal
  • Mold infection
  • Rare molds
  • Multidrug resistant mold
  • Aspergillus spp.
  • Fusarium spp.
  • Lomentospora prolificans
  • Mucorales fungi
  • Scedosporium spp.
03

In context

Mycoses

260 studies on the registry are indexed under Mycoses; 37 are open to participants now.

This study's planned enrollment of 234 is above the median of 68 across 164 interventional studies indexed under Mycoses.

Browse Mycoses studies →

Lead sponsor

Basilea Pharmaceutica is the lead sponsor of 60 studies on the registry; 7 are open to participants now.

Of its 22 completed or terminated interventional studies of FDA-regulated products, 15 (68%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

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. hematologic .
  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 Performance Status \< 20 at Screening.
  6. Requirement, or anticipated requirement, for hemodialysis, peritoneal dialysis, or hemofiltration.
  7. Patients with known 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 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 to fosmanogepix, manogepix, or any of their .
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
234 participants (estimated)

Study 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.

    Drug: Fosmanogepix IV infusion · Drug: Fosmanogepix oral tablet

  • Active comparator
    Cohort A: Comparator Antifungal Treatment

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

    Drug: Standard of care antifungal therapy

  • Experimental
    Cohort B

    Patients will receive the study drug. Fosmanogepix will be administered as an Intravenous (IV) infusion or in oral form.

    Drug: Fosmanogepix IV infusion · Drug: Fosmanogepix oral tablet

Interventions

  • Fosmanogepix will be administered IV

  • DrugStandard 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 will be administered orally.

06

What researchers measure

Primary outcomes

  1. Day 42 all-cause mortality rate

    Time frame: Day 42

Secondary outcomes

  1. Proportion of patients with overall response of treatment success

    Time frame: Day 42, Day 84 and up to 180 days

  2. Proportion of patients with clinical response of treatment success

    Time frame: Day 42, Day 84 and up to 180 days

  3. Proportion of patients with mycological response of eradication or presumed eradication

    Time frame: Day 42, Day 84 and up to 180 days

  4. Proportion of patients with radiological response of complete response or partial response

    Time frame: Day 42, Day 84 and up to 180 days

  5. All-cause mortality rate at Day 84

    Time frame: Day 84

  6. Incidence of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), treatment-related AEs, adverse events of special interest (AESI), and AEs leading to discontinuation

    Time frame: Screening up to follow-up 6 weeks after EOST (target duration approximately up to 8 months)

  7. Number of patients with clinically significant laboratory abnormalities

    Time frame: Up to follow-up 6 weeks after EOST (target duration approximately up to 8 months)

  8. Number of patients with abnormal neurological examination findings

    Time frame: Up to follow-up 6 weeks after EOST (target duration approximately up to 8 months)

  9. Assessment of 12-lead electrocardiogram corrected QT (Fridericia method) Interval (ECG QTcF Interval)

    Time frame: Up to follow-up 6 weeks after EOST (target duration approximately up to 8 months)

  10. Plasma concentrations versus time of fosmanogepix (prodrug) and manogepix (active moiety) following IV administration

    Time frame: Pre-dose, 3,6, and 9 hours post-start of the 3-hour IV infusion on Day 3, and at 24 hours (prior to Day 4 dosing)

  11. Plasma concentrations versus time of fosmanogepix (prodrug) and manogepix (active moiety) following oral administration

    Time frame: On days 7, 14, 28, and 42. Post-dose plasma samples will also be collected: 72 hrs and 192 hrs after last dose.

07

Study locations

89 of 90 sites recruiting
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Aug 2025 (actual). Primary completion is estimated for Feb 2028, 30 months after the start.

Of 15 phase 3 interventional studies under Mycoses, half reached primary completion within 68 months of starting (the median), counting those still running; a quarter within 36 and three quarters within 81. This study's planned 30 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 27, 2025
First posted
Apr 13, 2025
StartActual
Aug 26, 2025
Primary completionEst.
Feb 2028
CompletionEst.
Feb 2028
Last update
Oct 28, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Sites
7 sites added, 1 site removed
Show 7 added (3 Canada, 1 Australia, 1 Belgium, 1 France, 1 Israel)
  • Sir Charles Gairdner Hospital · Nedlands, Australia
  • General Hospital Saint-Jan · Bruges, Belgium
  • London Health Sciences Center - University Hospital · London, Canada
  • Toronto General Hospital, The Transplant Infectious Diseases Clinic · Toronto, Canada
  • Princess Margaret Cancer Centre · Toronto, Canada
  • Strasbourg University Hospitals - Civil Hospital · Strasbourg, France
  • Shamir Medical Center, Department of Infectious Diseases · Tsrifin, Israel
Show 1 removed
  • Shamir Medical Center, Department of Infectious Diseases · Ẕerifin, Israel
Oct 28, 2026
Show all 1 update
  1. Oct 28, 2026
    7 sites added, 1 site removed
    Show 7 added (3 Canada, 1 Australia, 1 Belgium, 1 France, 1 Israel)
    • Sir Charles Gairdner Hospital · Nedlands, Australia
    • General Hospital Saint-Jan · Bruges, Belgium
    • London Health Sciences Center - University Hospital · London, Canada
    • Toronto General Hospital, The Transplant Infectious Diseases Clinic · Toronto, Canada
    • Princess Margaret Cancer Centre · Toronto, Canada
    • Strasbourg University Hospitals - Civil Hospital · Strasbourg, France
    • Shamir Medical Center, Department of Infectious Diseases · Tsrifin, Israel
    Show 1 removed
    • Shamir Medical Center, Department of Infectious Diseases · Ẕerifin, Israel
    + 2 other changes: identifiers and verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT06925321
Collaborators
Biomedical Advanced Research and Development Authority
Responsible party
Sponsor
First posted
Apr 13, 2025
Start date
Aug 26, 2025
Primary completion
Feb 2028 (estimated)
Completion
Feb 2028 (estimated)
Last update
Oct 28, 2026

Study contacts

Alison Kuchta, MD
Contact
kuchtaa@basileapharma.com
+41616061243
Marc Engelhardt, MD
Contact
marc.engelhardt@basilea.com
+41797010551
Alison Kuchta, MD
study director · Basilea Pharmaceutica International Ltd, Allschwil

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Fosmanogepix

Start the discussion