Overview

NCI Definition [1]:
A selective inhibitor of the eukaryotic translation initiation factor 4A (eIF4A), with potential antineoplastic activity. Upon administration of zotatifin, this agent targets and binds to elF4A, and promotes eIF4A binding to mRNA with specific polypurine motifs within their 5'-untranslated region (5'-UTR), leading to the formation of a stable sequence-specific ternary complex with eIF4A and mRNA (elF4A- zotatifin-mRNA). This results in the translational repression of key oncogenes and anti-apoptotic proteins involved in tumor cell proliferation, survival and metastasis, such as KRAS, Myc, myeloid cell leukemia-1 (Mcl-1), B-cell lymphoma 2 (Bcl-2), cyclin-dependent kinase (CDK) 4 and 6, cyclin D, fibroblast growth factor receptor (FGFR) 1 and 2, human epidermal growth factor receptor 2 (HER2; ERBB2), and beta-catenin. The inhibition of the expression of these oncogenes leads to the inhibition of various oncogenic signal transduction pathways. This inhibits proliferation and induces apoptosis in tumor cells. eIF4A, a RNA helicase and the rate-limiting component of the eukaryotic translation initiation complex, catalyzes the ATP-dependent unwinding of RNA duplexes and facilitates 43S ribosome scanning within the 5'-UTR. elF4A is activated by various oncogenic signaling pathways, including RAS/mitogen-activated protein kinase (MAPK) and phosphatidylinositide 3-kinase (PI3K)/AKT pathways, and regulates the translation of oncogenes and tumor survival factors with complex secondary structures within the 5'-UTRs that are required for tumor cell proliferation, survival and metastasis.

Zotatifin has been investigated in 1 clinical trial, of which 1 is open and 0 are closed. Of the trial investigating zotatifin, 1 is phase 1/phase 2 (1 open).

ERBB2 Amplification, ERBB2 Fusion, and ERBB2 Mutation are the most frequent biomarker inclusion criteria for zotatifin clinical trials.

Malignant solid tumor and pancreatic adenocarcinoma are the most common diseases being investigated in zotatifin clinical trials [2].

Top Biomarker Inclusion Criteria for Open Clinical Trials Investigating Zotatifin
This graph displays the 20 most frequently occurring biomarkers curated on clinical trials investigating zotatifin and the cancer types associated with these biomarkers. These numbers are derived from a set of 5,956 clinical trials for which biomarker status defines treatment.

Drug Details

Synonyms [2]:
4-((5ar,6s,7s,8r,8as)-7-((dimethylamino)methyl)-8,8a-dihydroxy-1,3-dimethoxy-6-phenyl-6,7,8,8a-tetrahydro-5ah-cyclopenta(4,5)furo(3,2-c)pyridin-5a-yl)benzonitrile, eft 226, eft-226, eft226
Drug Target(s) [2]:
EIF4A1
NCIT ID [1]:
C165746

References

1. National Cancer Institute. NCI Thesaurus Version 18.11d. https://ncit.nci.nih.gov/ncitbrowser/. [2018-07-30] [2018-08-02].

2. All assertions and clinical trial landscape data are curated from primary sources. You can read more about the curation process here.