A Phase 1b, Multi-centre, Open-label, Randomized Study to Evaluate the Safety, Tolerability, and Clinical Activity of Combining Paxalisib with Olaparib or Pembrolizumab/Chemotherapy in Patients with Advanced Breast Cancer

Start Date25 Nov 2024

Sponsor / Collaborator

Kazia Therapeutics Ltd.

NCT06208657 / RecruitingPhase 1/2IIT

Optimal Precision TherapIes to CustoMISE Care in Childhood and Adolescent Cancer

A companion platform trial to test novel targeted agents based on the patient's tumor profile.

Start Date10 Jul 2024

Sponsor / Collaborator

Kazia Therapeutics Ltd.

[+4]

NCT05183204 / RecruitingPhase 2IIT

A Phase 2 Trial of Paxalisib Combined With a Ketogenic Diet and Metformin for Newly Diagnosed and Recurrent Glioblastoma

This study is for patients with newly diagnosed glioblastoma, as well as patients who have recurring glioblastoma. Subjects will be given daily paxalisib and metformin while also maintaining a ketogenic diet.
The purpose of this study is to assess the safety of Paxalisib while maintaining a ketogenic diet (a high fat, low carbohydrate diet) and Metformin (a drug approved by the Food and Drug Administration to treat type 2 diabetes), and to see what effects it has on glioblastoma.

Start Date14 Feb 2022

Sponsor / Collaborator

Weill Medical College of Cornell University

[+1]

100 Clinical Results associated with Paxalisib

100 Translational Medicine associated with Paxalisib

100 Patents (Medical) associated with Paxalisib

Literatures (Medical) associated with Paxalisib

03 May 2024·Neuro-oncology

Rational combination platform trial design for children and young adults with diffuse midline glioma: A report from PNOC

Article

Author: Molinaro, Annette M ; Kline, Cassie ; Franson, Andrea ; Waszak, Sebastian M ; Plasschaert, Sabine L A ; Prados, Michael ; Nazarian, Javad ; Koschmann, Carl ; Mueller, Sabine ; van der Lugt, Jasper

Abstract:

Background Diffuse midline glioma (DMG) is a devastating pediatric brain tumor unresponsive to hundreds of clinical trials. Approximately 80% of DMGs harbor H3K27M oncohistones, which reprogram the epigenome to increase the metabolic profile of the tumor cells.Methods We have previously shown preclinical efficacy of targeting both oxidative phosphorylation and glycolysis through treatment with ONC201, which activates the mitochondrial protease ClpP, and paxalisib, which inhibits PI3K/mTOR, respectively.Results ONC201 and paxalisib combination treatment aimed at inducing metabolic distress led to the design of the first DMG-specific platform trial PNOC022 (NCT05009992).Conclusions Here, we expand on the PNOC022 rationale and discuss various considerations, including liquid biome, microbiome, and genomic biomarkers, quality-of-life endpoints, and novel imaging modalities, such that we offer direction on future clinical trials in DMG.

15 Mar 2024·The Journal of clinical investigation

PI3K/mTOR is a therapeutically targetable genetic dependency in diffuse intrinsic pontine glioma

Article

Author: Hulleman, Esther ; Manning, Elizabeth E ; de Bock, Charles E ; Vilain, Ricardo E ; Germon, Zacary P ; Dayas, Christopher V ; Findlay, Izac J ; Firestein, Ron ; Hua, Susan ; Jackson, Evangeline R ; Beitaki, Tyrone ; Aksu, Michael ; Colino-Sanguino, Yolanda ; Cairns, Murray J ; Parackal, Sarah G ; Kilburn, Lindsay B ; Jamaluddin, M Fairuz B ; Whittle, James R ; Ashley, David M ; Sun, Claire Xin ; Hocke, Emily A ; Murray, Heather C ; McEwen, Holly P ; Laternser, Sandra ; Kiltschewskij, Dylan ; Nixon, Brett ; Dun, Matthew D ; Daniel, Paul ; Koschmann, Carl ; Valvi, Santosh ; Duchatel, Ryan J ; Eisenstat, David D ; Jain, Vaibhav ; Mueller, Sabine ; Wheeler, Helen ; Nazarian, Javad ; Mannan, Abdul ; Gregory, Simon G ; Tsoli, Maria ; Raabe, Eric H ; Thomas, Bryce C ; Persson, Mika L ; Tinkle, Christopher L ; Phoenix, Timothy N ; Valdes-Mora, Fatima ; Douglas, Alicia M ; Skerrett-Byrne, David A ; Ziegler, David S ; Hansford, Jordan R ; Staudt, Dilana E ; Vitanza, Nicholas A ; Kearney, Padraic S ; Alvaro, Frank ; Cain, Jason E ; Verrills, Nicole M

Diffuse midline glioma (DMG), including tumors diagnosed in the brainstem (diffuse intrinsic pontine glioma; DIPG), are uniformly fatal brain tumors that lack effective treatment. Analysis of CRISPR/Cas9 loss-of-function gene deletion screens identified PIK3CA and MTOR as targetable molecular dependencies across patient derived models of DIPG, highlighting the therapeutic potential of the blood-brain barrier-penetrant PI3K/Akt/mTOR inhibitor, paxalisib. At the human-equivalent maximum tolerated dose, mice treated with paxalisib experienced systemic glucose feedback and increased insulin levels commensurate with patients using PI3K inhibitors. To exploit genetic dependence and overcome resistance while maintaining compliance and therapeutic benefit, we combined paxalisib with the antihyperglycemic drug metformin. Metformin restored glucose homeostasis and decreased phosphorylation of the insulin receptor in vivo, a common mechanism of PI3K-inhibitor resistance, extending survival of orthotopic models. DIPG models treated with paxalisib increased calcium-activated PKC signaling. The brain penetrant PKC inhibitor enzastaurin, in combination with paxalisib, synergistically extended the survival of multiple orthotopic patient-derived and immunocompetent syngeneic allograft models; benefits potentiated in combination with metformin and standard-of-care radiotherapy. Therapeutic adaptation was assessed using spatial transcriptomics and ATAC-Seq, identifying changes in myelination and tumor immune microenvironment crosstalk. Collectively, this study has identified what we believe to be a clinically relevant DIPG therapeutic combinational strategy.

15 Mar 2024·The Journal of clinical investigation

Just a spoonful of metformin helps the medicine go down

Article

Author: Tzaridis, Theophilos ; Wechsler-Reya, Robert J

Diffuse intrinsic pontine glioma (DIPG) is a devastating brain tumor with a need for novel therapies. So far, monotherapies have failed to prolong survival for these patients, and combinatorial strategies have often shown severe, dose-limiting toxicities. In this issue of the JCI, Duchatel, Jackson, and colleagues address this challenge by introducing a drug combination that mitigates side effects and overcomes resistance. After identifying the PI3K/mTOR pathway as a therapeutic vulnerability, they treated DIPG-bearing mice with paxalisib and saw responses but also observed hyperglycemia as a severe side effect. Combining paxalisib with metformin mitigated this toxicity, but also upregulated protein kinase C (PKC) signaling. To tackle this mechanism of resistance, the authors added the PKC inhibitor enzastaurin to their drug combination and showed that this triple therapy led to improved survival. This approach paves the way for improved outcomes for patients with DIPG and other brain tumors.

News (Medical) associated with Paxalisib

11 Dec 2024

·www.prnewswire.com

Kazia Therapeutics to Present Data Highlighting Synergistic Activity Between Paxalisib and Immunotherapy in Immunotherapy-Resistant Triple Negative Breast Cancer Model at the San Antonio Breast Cancer Symposium

SYDNEY, Dec. 11, 2024 /PRNewswire/ -- Kazia Therapeutics Limited (NASDAQ: KZIA), an oncology-focused drug development, announced that data from two abstracts will be presented at the San Antonio Breast Cancer Symposium highlighting the activity the Company's lead product candidate, paxalisib, for the potential treatment of immunotherapy-resistant triple negative breast cancer (TNBC) and HER2 positive metastatic breast cancer with active brain metastases. "Immunotherapy-resistant triple negative breast cancer represents one of the most difficult-to-treat areas of breast cancer, with a growing number of patients who have failed standard-of-care immunotherapy and require new treatment options," said John Friend, M.D., President and Chief Executive Officer of Kazia Therapeutics. "These new preclinical data highlight the potential therapeutic synergies between paxalisib and the checkpoint inhibitor, pembrolizumab (KEYTRUDA®), when used in combination in a preclinical model of immunotherapy-resistant triple negative breast cancer. Furthermore, these data also show synergies when paxalisib is combined with the PARP inhibitor, olaparib (LYNPARZA®), which is approved for the treatment of advanced BRCA-mutated HER2 negative metastatic breast cancer. "In a second abstract, clinical investigators presented efficacy and safety data in heavily pretreated patients (median prior 8 lines of therapy) with HER2 positive breast cancer with active brain metastases. Although the primary endpoint of overall response rate (ORR) was not met, patients receiving a combination of paxalisib and trastuzumab (ENHERTU®) had a median overall survival of 16.5 months, which compares favorably versus historical control studies." Presentation Details: Conclusions: The addition of paxalisib to immunotherapy in the 4T1 TNBC mouse model reduced primary tumor burden, lung metastases, and liver inflammation whilst overcoming toxicity complications and resistance associated with standard-of-care immunochemotherapy. Paxalisib in combination with the PARP inhibitor olaparib, but not monotherapy alone, also reduced primary tumor burden and metastases. Moving forward, work is ongoing to elucidate the PI3K-mTOR mechanism of overcoming metastasis and drug resistance as well as the translation of the data into a clinical development program for patients with TNBC and advanced breast cancer. Conclusions: In this heavily pre-treated population of pts with HER2+ active BCBM, the combination of paxalisib 30 mg daily with trastuzumab was feasible, with a toxicity profile consistent with a class effect of PI3K/mTOR inhibitors. However, it was associated with minimal clinical activity. About Kazia Therapeutics Limited Kazia Therapeutics Limited (NASDAQ: KZIA) is an oncology-focused drug development company, based in Sydney, Australia. Our lead program is paxalisib, an investigational brain-penetrant inhibitor of the PI3K / Akt / mTOR pathway, which is being developed to treat multiple forms of brain cancer. Licensed from Genentech in late 2016, paxalisib is or has been the subject of ten clinical trials in this disease. A completed Phase 2 study in glioblastoma reported early signals of clinical activity in 2021, and a pivotal study in glioblastoma, GBM AGILE, has been completed and a Type C meeting with the FDA is scheduled in December 2024. Other clinical trials involving paxalisib are ongoing in brain metastases, diffuse midline gliomas, and primary CNS lymphoma, with several of these trials having reported encouraging interim data. Paxalisib was granted Orphan Drug Designation for glioblastoma by the FDA in February 2018, and Fast Track Designation (FTD) for glioblastoma by the FDA in August 2020. Paxalisib was also granted FTD in July 2023 for the treatment of solid tumour brain metastases harboring PI3K pathway mutations in combination with radiation therapy. In addition, paxalisib was granted Rare Pediatric Disease Designation and Orphan Drug Designation by the FDA for diffuse intrinsic pontine glioma in August 2020, and for atypical teratoid / rhabdoid tumours in June 2022 and July 2022, respectively. Kazia is also developing EVT801, a small-molecule inhibitor of VEGFR3, which was licensed from Evotec SE in April 2021. Preclinical data has shown EVT801 to be active against a broad range of tumour types and has provided evidence of synergy with immuno-oncology agents. A Phase I study has been completed and preliminary data was presented at 15th Biennial Ovarian Cancer Research Symposium in September 2024. For more information, please visit or follow us on X @KaziaTx. Forward-Looking Statements This announcement may contain forward-looking statements, which can generally be identified as such by the use of words such as "may," "will," "estimate," "future," "forward," "anticipate," or other similar words. Any statement describing Kazia's future plans, strategies, intentions, expectations, objectives, goals or prospects, and other statements that are not historical facts, are also forward-looking statements, including, but not limited to, statements regarding: the timing for results and data related to Kazia's clinical and preclinical trials, Kazia's strategy and plans with respect to its programs, including paxalisib and EVT801, the potential benefits of paxalisib as an investigational PI3K/mTOR inhibitor, timing for any regulatory submissions or discussions with regulatory agencies, and the potential market opportunity for paxalisib. Such statements are based on Kazia's current expectations and projections about future events and future trends affecting its business and are subject to certain risks and uncertainties that could cause actual results to differ materially from those anticipated in the forward-looking statements, including risks and uncertainties: associated with clinical and preclinical trials and product development, related to regulatory approvals, and related to the impact of global economic conditions. These and other risks and uncertainties are described more fully in Kazia's Annual Report, filed on form 20-F with the United States Securities and Exchange Commission, or the SEC, and in subsequent filings with the SEC. Kazia undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise, except as required under applicable law. You should not place undue reliance on these forward-looking statements, which apply only as of the date of this announcement. This announcement was authorized for release by Dr John Friend, CEO. SOURCE Kazia Therapeutics Limited WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

Orphan DrugFast TrackClinical ResultImmunotherapyPhase 1

23 Sep 2024

·www.prnewswire.com

Kazia Therapeutics Announces Presentation of EVT801 Clinical Data at 15th Biennial Ovarian Cancer Research Symposium

SYDNEY, Sept. 23, 2024 /PRNewswire/ -- Kazia Therapeutics Limited (NASDAQ: KZIA), an oncology-focused drug development company, is pleased to announce the presentation of data highlighting promising clinical activity of EVT801 in high grade serous (HGS) Ovarian Cancer at the 15th Biennial Ovarian Cancer Research Symposium, co-presented by American Association of Cancer Research (AACR) and the Rivkin Center for Ovarian Cancer Research on Saturday, September 21, 2024 in Seattle Washington. Dr. John Friend, CEO Kazia Therapeutics presented preliminary data from a Phase 1 first-in-human clinical trial evaluating the safety and tolerability of EVT801, a highly selective small molecule VEGFR3 inhibitor targeting tumour angiogenesis. The Phase 1 study met its primary objectives, with the maximal tolerated dose identified at 500mg twice a day (BID). The Phase 1 study also identified the recommended Phase 2 dose starting at 400mg BID. It was observed that EVT801 was tolerated across all doses, with the majority of toxicities being mild to moderate and transient in nature. Key points of the presentation included: A total of 26 patients were treated across 6 dosing cohorts ranging from 50mg once daily (QD) to 500mg twice daily (BID) Patients with eleven different cancer types (ex. colon, renal cell, pancreatic) were enrolled in the study, with heavily pretreated advanced ovarian cancer being the most prevalent indication (11 patients) Biomarkers have shown strong VEGFR3 expression in multiple indications, including ovarian cancer Encouraging clinical activity in High Grade Serous ovarian cancer patients with forty-six percent (46%) having stable disease or for at least three cycles, including two patients who received 9 cycles One patient had a partial response (-39% decrease) after 2 cycles of EVT801 therapy Dr John Friend, CEO of Kazia Therapeutics, commented: "I was honored to participate at the Ovarian Cancer Research Symposium and present our findings to fellow clinicians and ovarian cancer researchers from around the globe. Ovarian cancer is often diagnosed at late stages with poor patient prognosis, so the data from the Phase 1 study is extremely encouraging and gives us confidence that we could potentially have a first-in-class VEGFR-3 inhibitor with EVT801." Abstract: Phase I study of EVT801, a VEGFR-3 inhibitor, shows promising clinical activity in HGS ovarian cancer September 21, 2024 – 11:30am-1:30pm About Kazia Therapeutics Limited Kazia Therapeutics Limited (NASDAQ: KZIA) is an oncology-focused drug development company, based in Sydney, Australia. Our lead program is paxalisib, an investigational brain-penetrant inhibitor of the PI3K / Akt / mTOR pathway, which is being developed to treat multiple forms of brain cancer. Licensed from Genentech in late 2016, paxalisib is or has been the subject of ten clinical trials in this disease. A completed Phase 2 study in glioblastoma reported early signals of clinical activity in 2021, and a pivotal study in glioblastoma, GBM AGILE, has been completed with presentation of paxalisib arm data expected later in 2024 at a major medical conference. Other clinical trials involving paxalisib are ongoing in brain metastases, diffuse midline gliomas, and primary CNS lymphoma, with several of these trials having reported encouraging interim data. Paxalisib was granted Orphan Drug Designation for glioblastoma by the FDA in February 2018, and Fast Track Designation (FTD) for glioblastoma by the FDA in August 2020. Paxalisib was also granted FTD in July 2023 for the treatment of solid tumour brain metastases harboring PI3K pathway mutations in combination with radiation therapy. In addition, paxalisib was granted Rare Pediatric Disease Designation and Orphan Drug Designation by the FDA for diffuse intrinsic pontine glioma in August 2020, and for atypical teratoid / rhabdoid tumours in June 2022 and July 2022, respectively. Kazia is also developing EVT801, a small-molecule inhibitor of VEGFR3, which was licensed from Evotec SE in April 2021. Preclinical data has shown EVT801 to be active against a broad range of tumour types and has provided evidence of synergy with immuno-oncology agents. A Phase I study has been completed and preliminary data was presented at 15th Biennial Ovarian Cancer Research Symposium in September 2024. For more information, please visit or follow us on X @KaziaTx. Forward-Looking Statements This announcement may contain forward-looking statements, which can generally be identified as such by the use of words such as "may," "will," "estimate," "future," "forward," "anticipate," or other similar words. Any statement describing Kazia's future plans, strategies, intentions, expectations, objectives, goals or prospects, and other statements that are not historical facts, are also forward-looking statements, including, but not limited to, statements regarding: the timing for results and data related to Kazia's clinical and preclinical trials, Kazia's strategy and plans with respect to its programs, including paxalisib and EVT801, the potential benefits of EVT801 as a VEGFR3 inhibitor and the potential market opportunity for EVT801. Such statements are based on Kazia's current expectations and projections about future events and future trends affecting its business and are subject to certain risks and uncertainties that could cause actual results to differ materially from those anticipated in the forward-looking statements, including risks and uncertainties: associated with clinical and preclinical trials and product development, related to regulatory approvals, and related to the impact of global economic conditions. These and other risks and uncertainties are described more fully in Kazia's Annual Report, filed on form 20-F with the SEC, and in subsequent filings with the United States Securities and Exchange Commission. Kazia undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise, except as required under applicable law. You should not place undue reliance on these forward-looking statements, which apply only as of the date of this announcement. This announcement was authorized for release by Dr John Friend, CEO. SOURCE Kazia Therapeutics Limited WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

Phase 1Orphan DrugFast TrackClinical Result

11 Jul 2024

·www.biospace.com

Kazia Offers Secondary OS Data to Build FDA Case for Glioblastoma Drug

Pictured: 3D illustration of a tumor on a brain/iStock, wildpixel Kazia Therapeutics on Wednesday unveiled additional data from the Phase II/III GBM-AGILE study, picking out secondary efficacy signals as it eyes an FDA accelerated approval pathway for its investigational glioblastoma treatment paxalisib. GBM-AGILE is a large global study designed to test several investigational glioblastoma treatments versus current standard of care. In the case of paxalisib, the study used chemotherapy with temozolomide for newly diagnosed patients and with lomustine for those with recurrent disease. The primary outcome of interest was overall survival (OS). Paxalisib showed no signs of efficacy in the recurrent disease setting. Median OS in treated patients was 8.05 months, which was nearly two months shorter than the 9.69-month median OS in comparators treated with lomustine. The Australian biotech is currently conducting deeper analysis of these data “to elucidate potential signs for further consideration.” Kazia is focused on the subset of patients who were newly diagnosed with glioblastoma. In this population, paxalisib led to a median OS of 14.77 months, slightly longer than that in temozolomide counterparts, who survived for a median of 13.84 months. The biotech further zoomed in on a smaller slice of control patients who were enrolled into GBM-AGILE concurrently with paxalisib’s inclusion into the study. In this concurrent population, median OS for paxalisib grew to 15.54 months while that for comparators dipped to 11.89 months. Kazia CEO John Friend pointed to this survival difference, saying that the biotech is “excited to have shown a 3.8-month improvement in overall survival, an approximate 33% improvement, for newly diagnosed unmethylated patients with GBM compared to the concurrent standard-of-care arm.” “Having comparable [OS] data across two independent studies in a compelling outcome in this difficult to treat population,” Friend noted, adding that the biotech will bring these findings to the FDA to discuss “possible approaches” to an accelerated approval for paxalisib. The market reacted favorably to Kazia’s readout, with its stocks surging 142% on Wednesday, according to SeekingAlpha. Initially invented by Genentech, paxalisib works by inhibiting the action of PI3K, a key player in cell growth and division which are highly dysregulated in several cancers. Unlike most other PI3K blockers, paxalisib can cross the blood-brain barrier making it a promising candidate for malignancies of the central nervous system. In August 2022, Kazia reported that paxalisib failed to reach the pre-defined criteria for moving to the second phase of GBM-AGILE. However, at the time, the biotech was still blinded to the study’s results and could not fully understand the failure. Tristan Manalac is an independent science writer based in Metro Manila, Philippines. Reach out to him on LinkedIn or email him at tristan@tristanmanalac.com or tristan.manalac@biospace.com.

Accelerated ApprovalClinical ResultDrug Approval

100 Deals associated with Paxalisib

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KEGG	Wiki	ATC	Drug Bank
D11869	-	-	DB15186

R&D Status

10 top R&D records.

to view more data

Indication	Highest Phase	Country/Location	Organization	Date
Glioblastoma Multiforme	Phase 3	US	Bayer AG	30 Jul 2019
Glioblastoma Multiforme	Phase 3	US	Vigeo Therapeutics, Inc.	30 Jul 2019
Glioblastoma Multiforme	Phase 3	US	Kazia Therapeutics Ltd.	30 Jul 2019
Glioblastoma Multiforme	Phase 3	US	Biohaven Pharmaceuticals, Inc.	30 Jul 2019
Glioblastoma Multiforme	Phase 3	US	Kintara Therapeutics, Inc.	30 Jul 2019
Glioblastoma Multiforme	Phase 3	US	Polaris Group	30 Jul 2019
Glioblastoma Multiforme	Phase 3	AU	Bayer AG	30 Jul 2019
Glioblastoma Multiforme	Phase 3	AU	Polaris Group	30 Jul 2019
Glioblastoma Multiforme	Phase 3	AU	Biohaven Pharmaceuticals, Inc.	30 Jul 2019
Glioblastoma Multiforme	Phase 3	AU	Kintara Therapeutics, Inc.	30 Jul 2019

Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05009992 (SNO2023) Manual	Phase 2	Diffuse Midline Glioma	68	ONC201+paxalisib	dgqhkbrune(iodxrivqkl) = xtpbkqyiyk ydaojeswue (kvocsgxjaj, lower 11.6) View more	Positive	10 Nov 2023
NCT04906096 (PRNewswire) Manual	Phase 2	Primary Central Nervous System Lymphoma	14	Paxalisib	lmnjlqaxzt(bojeidumog) = preliminarily observed in enrolled patients, including partial responses and stable disease ltodhppbze (ropjalxdxf ) View more	Positive	01 Nov 2023
NCT04192981 (Corporate Publications) Manual	Phase 1	Brain metastases PIK3CA Mutation	12	radiotherapy+paxalisib	vlapylylmv(ghsifbmpib) = Paxalisib 45mg daily in combination with radiotherapy dqgwpfrwpu (dhqmujxkfg )	Positive	08 Aug 2022
NCT01547546 (Pubmed \| Clin Cancer Res) Manual	Phase 1	Malignant glioma of brain	47	GDC-0084	lzyksuceer(oesnjngrdn) = tvyequhhvj zyownvjpha (kpdhtduhww ) View more	Positive	15 Apr 2020

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