Sponsor: Neonc Technologies, Inc. (industry)
Phase: 1/2
Start date: Nov. 1, 2023
Planned enrollment: 134
NEO212 (TMZ-POH carbamate) is an investigational oral conjugate of temozolomide and perillyl alcohol. It has been studied in an open-label phase 1/2 trial involving people with recurrent glioblastoma, IDH-mutant astrocytoma, or brain metastases. Human findings reported so far are preliminary and come from the trial sponsor; they do not establish clinical benefit. (pmc.ncbi.nlm.nih.gov)
NEO212 acts as a DNA-alkylating agent, rather than a drug directed at a single molecular target. Laboratory and animal studies found activity in some temozolomide-resistant tumor models, including models with high levels of the DNA-repair enzyme MGMT. Researchers have also reported effects on endoplasmic-reticulum stress and autophagy in glioma cells. These findings have not yet shown that NEO212 overcomes temozolomide resistance in patients. (pubmed.ncbi.nlm.nih.gov)
In the phase 1 dose-escalation study, the sponsor reported one partial response in a patient with recurrent glioblastoma and described disease control in a patient with a lung-cancer brain metastasis. A reliable overall response rate has not been reported. The small, nonrandomized dose-escalation study was designed primarily to assess dosing and safety, not to determine efficacy. (sec.gov)
The sponsor reported two dose-limiting toxicities at 810 mg daily on days 1–5 of a 28-day cycle, stopping dose escalation and selecting 610 mg as the recommended phase 2 dose. It reported no clinically meaningful bone-marrow-suppression signal or liver or kidney toxicity signal in the phase 1 group. The available sponsor summary does not provide a comprehensive adverse-event rate, so NEO212’s safety profile remains uncertain. (sec.gov)
Last updated: Sep 2026
Goal: Establish the safety, pharmacokinetics and appropriate dose of NEO212, then assess its intracranial activity alone in recurrent IDH-mutant astrocytoma or IDH-wildtype glioblastoma and with standard-of-care therapy in uncontrolled brain metastases.
Patients: Adults with radiographically confirmed progression of IDH-mutant astrocytoma or IDH-wildtype glioblastoma after radiation-based treatment, or selected solid tumors with brain metastases uncontrolled by surgery or radiation. Patients need adequate organ function, stable or decreasing steroids, and KPS ≥60 for primary CNS tumors or ECOG 0–2 for solid tumors. Phase 2b excludes patients with primary CNS tumors who have had more than one recurrence or progression.
Design: Multicenter, open-label, nonrandomized dose-finding and expansion study. Phase 1 uses 3+3 dose escalation to establish a maximum tolerated and recommended phase 2 dose. Phase 2a uses separate 3+3 safety run-ins for combinations with approved regimens; Phase 2b expands the primary CNS tumor and brain-metastasis groups to evaluate efficacy. There is no control arm.
Treatments: NEO212 is self-administered orally on days 1–5 of each 28-day cycle, alone for primary CNS tumors and with selected standard-of-care regimens for brain metastases. It is an investigational conjugate of temozolomide and perillyl alcohol that acts as a DNA-alkylating agent, not a mutation-specific targeted therapy. Preliminary sponsor-reported phase 1 findings include one partial response in recurrent glioblastoma; two dose-limiting toxicities at 810 mg led to selection of 610 mg as the recommended phase 2 dose, but clinical benefit and the full safety profile remain uncertain. Combination regimens include indicated immunotherapies, regorafenib, or chemotherapy-based regimens with or without bevacizumab, according to the underlying solid tumor.
Outcomes: Primary measures are adverse-event incidence and severity and dose selection in phase 1, combination safety in phase 2a, and the six-month intracranial progression-free survival rate in each phase 2b treatment group. Pharmacokinetics and efficacy are also study aims.
Burden on patient: Moderate to high, especially during dose escalation and combination safety run-ins: patients must attend safety assessments and pharmacokinetic sampling, undergo baseline brain MRI and, for solid tumors, body CT, and return for ongoing disease assessments. NEO212 dosing is limited to five days per cycle and can be done at home, but combination therapy may require IV visits every two to three weeks or additional oral treatment. The supplied protocol does not specify the frequency of pharmacokinetic draws or follow-up scans.
Last updated: Sep 2026
Caution: ClinicalTrials.gov appears to have newer eligibility criteria than the version saved here. Review the current criteria in ClinicalTrials.gov.
To be eligible to participate in the study, a patient must meet all of the following inclusion criteria:
* Patient must be ≥ 18yrs of age.
* Patient must have the ability to understand, and the willingness to sign, a written informed consent form.
* Patient has been on a stable or decreasing dose of steroids for at least five days prior to the date of informed consent.
* Any toxicity from prior therapy must be resolved or at maximum Grade 1 prior to initiation of NEO212.
* If progression of disease occurs within 90 days or conformal radiation, the progression/recurrence must be outside of the radiation field or proven by biopsy/resection.
* Patient with Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype must have a Karnofsky Performance Status (KPS) of ≥ 60.
* Patient with select solid tumors (see Appendix 2) must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
* Patient must have an expected survival or at least three months.
* Patient must have a baseline MRI of the brain with gadolinium within 14 days of administration of NEO212.
* Patient with select solid tumors (see Appendix 2) must have a baseline CT scan with IV contrast and oral contrast of neck, chest, abdomen and pelvis within 14 days of administration of NEO212.
* Patients must be able to comply with all study assessments.
* If patient suffers from seizures (s)he must be controlled on a stable dose of anti-epileptics for 14-days prior to the date of informed consent.
* Patient must have adequate organ and marrow function as follows:
* Absolute neutrophil count ≥ 1,500/microliter
* Platelets ≥ 100,000/microliter
* Total bilirubin within normal institutional limits
* AST (SGOT) / ALT (SPGT) ≤ 2.5 x institutional upper limit of normal
* Creatinine clearance (CrCl) of \>60 mL/min (using the Cockcroft-Gault formula or 24- hour urine collection).
* Female patients of child-bearing potential and male patients must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for 30 days prior to the first dose of NEO212, for the duration of study participation, and for 90 days following completion of therapy.
A female of child-bearing potential is any women (regardless of sexual orientation, not having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
* Has not undergone a hysterectomy or bilateral oophorectomy; or
* Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has not had menses at any time in the preceding 12 consecutive months).
* A negative serum pregnancy test will be required of all female patients of child-bearing potential within seven days prior to the receipt of NEO212.
* A serum pregnancy test will be repeated immediately if pregnancy is suspected.
Phase 1: (dose escalation)
* Patient must:
* have radiographically confirmed Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype following previous radiation therapy or treatment with temozolomide and radiation, or
* have select solid tumors (see Appendix 2) with uncontrolled metastases to the brain (confirmed by cranial CT or MRI) that is not controlled by surgery or radiation therapy and receiving one of the protocol approved SOC regimens.
* Patients receiving prior systemic therapy must have a minimum wash-out period (defined as the period prior to receipt of the first dose of NEO212) of:
* 28 days or 5 half-lives (whichever is shorter) elapsed from the administration from any experimental agent;
* 2 weeks from administration of immunotherapies;
* 28 days from administration of cytotoxic agents; and
* 7 days from administration of non-cytotoxic agents (interferon, tamoxifen, thalidomide, cis-retinoic acid, and herbal medicine).
NOTE: No washout is necessary for alternating electrical fields.
Phase 2a: (safety run-in)
* Patient must have select solid tumors (see Appendix 2) with uncontrolled metastases to the brain (confirmed by cranial CT or MRI) that is not controlled by surgery or radiation therapy and receiving one of the protocol approved SOC regimens.
* Patients receiving prior systemic therapy must be receiving one of the protocol approved Standard of Care (SOC) regimens listed on Appendix 1.
* Patient must have measurable/evaluable CNS disease per RANO or RANO-BM criteria.
* Patient must have measurable/evaluable systemic disease per RECIST v1.1 criteria.
Phase 2b: (efficacy)
* Patient must:
* have radiographically confirmed Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype following previous radiation therapy or treatment with temozolomide and radiation, or
* have select solid tumors (see Appendix 2) with uncontrolled metastases to the brain (confirmed by cranial CT or MRI) that is not controlled by surgery or radiation therapy and receiving one of the protocol approved SOC regimens.
* Patients receiving prior systemic therapy must be receiving one of the protocol approved Standard of Care (SOC) regimens listed on Appendix 1.
* Patient must have measurable/evaluable CNS disease per RANO or RANO-BM criteria
* Patient with select solid tumors (see Appendix 2) must have measurable/evaluable systemic disease per RECIST v1.1 criteria.
* Creatinine clearance (CrCl) of \>60 mL/min (using the Cockcroft-Gault formula or 24-hour urine collection). Female patients of child-bearing potential and male patients must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for 30 days prior to the first dose of NEO212, for the duration of study participation, and for 90 days following completion of therapy.
9.2 Exclusion Criteria: (all Phases)
* Patient in Phase 1 concurrently receiving any other antitumor therapy.
* Patient in Phase 2a or 2b who is concurrently receiving any SOC therapy not listed in Appendix 1.
* Patients with metastases to the spinal cord parenchyma.
* Patients with metastases to the meninges.
* Patient has received stereotactic or highly conformal radiotherapy to CNS lesions within 2 weeks before receipt of NEO212.
* Patient with history of known leptomeningeal involvement.
* Patient has prior history or new diagnosis of secondary cancer within five years prior to the date of informed consent, except for basal cell carcinoma or squamous cell carcinoma of the skin.
* Patient has a corrected QT interval (using Fridericia's correction formula) (QTcF) of \>470 msec, a history of additional risk factors for TdP (e.g. heart failure, hypokalemia), and/or the use of concomitant medications that prolong QT/QTc interval.
* Patient had surgery within 7 days prior to the date of informed consent.
* Patient has not recovered to Grade 1 from treatment related adverse events due to chemotherapy, immunotherapy, or radiation therapy.
* Patient had prior treatment with perillyl alcohol.
* Patient has a history of allergic reactions attributed to perillyl alcohol.
* Patients in Phase 2b with Astrocytoma IDH-mutant, or Glioblastoma IDH-wildtype who have had more than one recurrence or progression of his/her primary CNS tumor(s).
Glendale, California, 91203, United States
[email protected] / No phone
Status: Recruiting
Beverly Hills, California, 90212, United States
[email protected] / (424) 777-0708
Status: Recruiting
Los Angeles, California, 90033, United States
[email protected] / (323) 865-3980
Status: Recruiting
Nashville, Tennessee, 37232, United States
No email / No phone
Status: Recruiting
Dallas, Texas, 75246, United States
[email protected] / No phone
Status: Recruiting
Tacoma, Washington, 98405, United States
No email / 253-380-8173
Status: Recruiting