Cipargamin is an experimental synthetic antimalarial molecule belonging to the spiroindolone class. It possesses both the potency (average IC50 of 550 pM against asexual blood-stage P. falciparum) and favorable pharmacokinetics (elimination half-life of ~24 hours in humans) needed for a single-dose cure, a feature that could help slow the onset of parasite resistance and that is not shared by existing, approved antimalarial drugs. KAE609 is also unique in its ability to block transmission to mosquitoes. Cipargamin is a parasite P-type ATPase4 inhibitor. Cipargamin in phase II clinical trials for the treatment of acute, uncomplicated malaria due to plasmodium falciparum monoinfection. Nausea was the most common reported adverse effect. The adverse events were generally mild and did not lead to any discontinuations of the drug.

Cannabidivarin is a homolog of cannabidiol, with a well-established antiepileptiform profile in preclinical studies, both in vitro and in vivo animal models of epilepsy. The oral bioavailability of cannabidivarin is very low (about 6%) due to erratic absorption and first pass metabolism. After oral administration, the maximum plasma concentration of Cannabidivarin is rising in about three hours and the drug has a large volume of distribution, because of his link to protein plasma, being highly liposoluble, so CBDV can penetrate well to the brain. Cannabidivarin is also metabolized in the liver to 7-COOH and 6-OH metabolites, but the mechanism is also unknown. There is an ongoing phase II double-blind, placebo-controlled trial that is assessing the efficacy and safety of cannabidivarin in Children With Autism Spectrum Disorder (ASD).

SN38 (7-ethyl-10-hydroxy camptothecin) is a prominent and efficacious anticancer agent. It is poorly soluble in both water and pharmaceutically approved solvents; therefore, the direct formulation of SN38 in solution form is limited. SN38 is formed via hydrolysis of irinotecan by carboxylesterases and metabolized via glucuronidation by UGT1A1. Currently, the water soluble prodrug of SN38, irinotecan (CPT-11), is formulated as a low pH solution and is approved for chemotherapy. SN38 causes the strongest inhibition of DNA topoisomerase I, followed by CPT and then CPT-11. CPT-11 dose dependently shifts the position of relaxed DNA in the direction of nicked DNA, but SN38 and CPT shows no effect on the position of relaxed DNA. SN38 dose-dependently and time-dependently inhibit DNA synthesis. Respective IC50 values of SN38, in DNA synthesis is 0.077 uM.

PQR-309 is an orally bioavailable pan inhibitor of phosphoinositide-3-kinases (PI3K) and inhibitor of the mammalian target of rapamycin (mTOR), with potential antineoplastic activity. PI3K/mTOR kinase inhibitor PQR-309 inhibits the PI3K kinase isoforms alpha, beta, gamma and delta and, to a lesser extent, mTOR kinase, which may result in tumor cell apoptosis and growth inhibition in cells overexpressing PI3K/mTOR. By inhibiting mTOR to a lesser extent than PI3K, PQR-309 does not interfere with the mTOR-mediated negative feedback loop on PI3K signaling. Blocking the negative feedback loop would potentially increase PI3K signaling and decrease therapeutic efficacy. PQR-309 is in phase II clinical trial for the treatment of glioblastoma, head and neck cancer, lymphoma and breast cancer. Common adverse events included fatigue, hyperglycemia, nausea, diarrhea, constipation, rash, anorexia and vomiting.

Mapreg is developing pregnenolone methyl ether (MAP4343), an injectable neurosteroid stimulator of the tubulin polymerisation and neurite growth stimulator. The synthetic pregnenolone-derivative MAP4343 (3β-methoxy-preg-nenolone) binds in vitro to microtubule-associated-protein 2 (MAP2), stimulates the polymerization of tubulin, enhances the extension of neurites and protects neurons against neurotoxic agents. MAP4343 has been selected after screening of a large library ofnatural and synthetic steroids. MAP4343 has similar in vitro activity as pregnenolone; it cannot be converted into metabolites with hormonal activities, and has been shown to have in vivo beneficial effects in rat models of spinal cord injury. MAP4343 has an interesting pharmacological profile because no in vitro affinity for any CNS neurotransmitter receptor was found. MAP4343 has been shown to have antidepressant efficacy in rats. In the rat isolation-rearing model of depression, administration of MAP4343 showed persistent efficacy in recovering recognition memory deficit, stronger and more rapid anxiolytic activity, and more rapid rescue of passive coping behavior compared with FLX. The behavioral effects of MAP4343 correlated with changes in α-tubulin isoforms in the hippocampus, amygdala, and pre-frontal cortex (PFC). Its efficacy was also assessed in vivo with the most commonly used thoracic spinal cord compression/contusion models in rats. In the three models used, the post-traumatic subcutaneous injection of MAP4343 significantly improved the recovery of locomotor function after spinal cord injury, as shown by an earlier and more complete recovery compared to vehicle-treated rats. The results obtained in three different rat models of spinal cord injury demonstrate the beneficial effects of this therapeutic strategy and identify MAP4343 as a potential treatment for acute spinal cord injury. MAP4343 received EU Orphan Drug designation for spinal cord injury. MAP4343 is in phase II clinical trials by Mapreg for the treatment of depression and in phase I clinical trials for the treatment of spinal cord injury and traumatic brain injury.

Sulfatinib (previously known as HMPL-012) was developed as a small-molecule inhibitor targeting vascular endothelial growth factor receptors 1 and 3, fibroblast growth factor receptor 1 and colony-stimulating factor 1 receptor with potential antineoplastic and anti-angiogenic activities. Sulfatinib has shown encouraging antitumor activity and manageable toxicities in patients with advanced neuroendocrine tumors (NET). The drug is participating in two ongoing phases III studies, validating the efficacy of surufatinib in patients with NETs. In addition, in November 2018, Hutchison MediPharma completed a phase II trial of sulfatinib, for the treatment of patients with biliary tract cancer. This drug is also participating in the phase II trial that is currently in recruiting status in treating advanced medullary thyroid carcinoma.