Sponsor: Providence Health & Services (other)
Phase: 2
Start date: Feb. 29, 2024
Planned enrollment: 92
Selvigaltin (GB1211) is an investigational oral drug studied in liver cirrhosis and, with immunotherapy, in non-small-cell lung cancer (NSCLC). Human results are available, but they come from small early-phase studies; clinical benefit has not been established. (pmc.ncbi.nlm.nih.gov)
Selvigaltin is a small-molecule inhibitor of galectin-3, a protein involved in inflammatory and fibrotic processes. Laboratory findings also provide a rationale for testing it alongside immune-checkpoint inhibitors, but that proposed benefit remains unproven in patients. (pmc.ncbi.nlm.nih.gov)
In a published first-in-human study involving 78 healthy participants, no severe or serious treatment-emergent adverse events were reported. In GULLIVER-2, a serious adverse event occurred in one of 15 selvigaltin recipients and none of 15 placebo recipients; investigators did not attribute that event to treatment. In GALLANT-1, serious events at the higher 200-mg twice-daily dose included a grade 4 rash and grade 4 bone-marrow finding, both attributed to the combination of selvigaltin and atezolizumab. These small studies cannot define the drug’s longer-term safety profile. (pmc.ncbi.nlm.nih.gov)
Last updated: Sep 2026
Goal: Determine whether adding the galectin-3 inhibitor GB1211 to pembrolizumab improves imaging-based objective response compared with pembrolizumab alone in advanced melanoma or head and neck squamous cell carcinoma (HNSCC).
Patients: Adults with unresectable or metastatic melanoma, including treatment-naïve patients, or recurrent or metastatic HNSCC that progressed during or after platinum chemotherapy. ECOG performance status must be 0–2. Prior anti-PD-1 or anti-PD-L1 treatment is permitted if the last dose was at least six months earlier and imaging documents progression. Key exclusions include prior galectin antagonist treatment, active autoimmune disease, untreated brain metastases, and a need for steroids above physiologic replacement doses.
Design: Randomized, double-blind, placebo-controlled study. Randomization is stratified by diagnosis and number of prior systemic therapies.
Treatments: Patients receive oral GB1211 400 mg twice daily plus standard pembrolizumab, or a matching oral placebo twice daily plus pembrolizumab. GB1211 (selvigaltin) is an investigational small-molecule inhibitor of galectin-3, a protein implicated in inflammatory and fibrotic processes; its proposed ability to enhance checkpoint blockade remains unproven. In a small, nonrandomized NSCLC study of GB1211 plus atezolizumab, four of 13 patients had partial responses, but the absence of an immunotherapy-only arm prevents attribution of benefit to GB1211. Serious grade 4 events attributed to that combination occurred at a GB1211 dose of 200 mg twice daily; safety at the 400 mg twice-daily dose used here remains uncertain. Pembrolizumab is an anti-PD-1 immunotherapy.
Outcomes: The primary endpoint is imaging-based overall response rate, assessed through up to 63 weeks. Secondary measures include galectin-3 expression in paired biopsies, changes in myeloid-derived suppressor cells and T-cell populations, and the frequency of immune-mediated adverse events.
Burden on patient: Moderate. Pembrolizumab visits and response imaging resemble routine immunotherapy care, but twice-daily oral study medication, paired biopsies at screening and around day 68, and blood-based immune assessments add procedures and potentially extra visits. The provided information does not specify a pharmacokinetic sampling schedule.
Last updated: Sep 2026
Inclusion Criteria:
* Patients with unresectable or metastatic melanoma including unknown primary or mucosal melanomas. Histological confirmation of melanoma will be required by previous biopsy or cytology. Patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) with disease progression during or after platinum-containing chemotherapy are eligible. PD-L1 testing is not needed for OHN cancers.
* Patients who have received anti-PD1 or anti-PD-L1 in the past are eligible if it has been at least 6 months since the last anti-PD-1 or PD-L1 dose, they meet all other eligibility criteria and progression of malignancy has been documented on imaging. Progression for this patient subset is defined as the appearance of one or more new metastatic sites, or a 5% or greater increase in the sum of diameter of target lesions or an unequivocal increase in non-target site. Treatment naïve melanoma patients are eligible.
* Patients must be ≥ 18 years of age.
* ECOG performance status of 0-2.
* Women of childbearing potential must have a serum or urine pregnancy test performed within 72 hours prior to the start of protocol treatment. The results of this test must be negative in order for the patient to be eligible. In addition, women of childbearing potential as well as male patients must agree to take appropriate precautions to avoid pregnancy.
* No active bleeding.
* Anticipated lifespan greater than 12 weeks.
* Patients must sign a study-specific consent document.
Exclusion Criteria:
* Patients who have previously received a galectin antagonist.
* Patients with active autoimmune disease except for autoimmune thyroiditis or vitiligo.
* Patients with history of autoimmune colitis.
* Patients with untreated brain metastases. Patients with treated brain metastases who demonstrate control of brain metastases with follow-up imaging 4 or more weeks after initial therapy are eligible.
* Patients requiring other systemic oncologic therapy, including experimental therapies.
* Patients who have received anti-cancer treatment within 3 weeks or 5 half-lives before first study drug dose.
* Patients with Child-Pugh C hepatic impairment.
* Patients with active infection requiring antibiotics.
* Pregnant or lactating women, as treatment involves unforeseeable risks to the embryo or fetus.
* Need for steroids at greater than physiologic replacement doses. Inhaled corticosteroids are acceptable.
* Laboratory exclusions (to be performed within 28 days of enrollment):
* WBC \< 3.0 x 109/L
* Hgb \< 9.0 g/dL
* AST or ALT \> 1.5 times ULN
* Total bilirubin \> 1.9 g/dL, unless due to Gilbert's Syndrome. If Gilbert's Syndrome is present by clinical history, then direct bilirubin must by \< 3.0 g/dl.
* Active or known history of HIV
* Active or known history of Hepatitis B
* Active or known history of Hepatitis C
* Platelet counts \< 100 x 10E9 / L (100,000/ μL) without transfusion
* INR \> 1.5x ULN
* Inability to give informed consent and comply with the protocol. Patients must be judged able to understand fully the investigational nature of the study and the risks associated with the therapy.
* Any medical condition that in the opinion of the Principal Investigator would compromise the safety or conduct of the study procedures.
* Unresolved immune-mediated pneumonitis, diarrhea, elevation of hepatocellular enzymes or other toxicities requiring greater than physiological replacement doses of steroids.
Portland, Oregon, 97213, United States
[email protected] / 503-215-2691
Status: Recruiting