Phase 3 Trial of eRapa in Patients With Familial Adenomatous Polyposis (SERENTA)

May 20, 2026 updated by: Rapamycin Holdings Inc.

A Phase 3, Multi-Site, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial of eRapa to Improve Clinical Outcomes in Patients With Familial Adenomatous Polyposis

The main goal of this clinical trial is to learn if the drug eRapa works to slow down the progression of disease in patients diagnosed with Familial Adenomatous Polyposis (FAP). Researchers will compare eRapa to Placebo. The questions to be answered by this trial are:

  • Does taking eRapa help to slow down the progression of the disease in patients with FAP?
  • Is eRapa a safe treatment for patients diagnosed with FAP?
  • What is the effect of eRapa on the number of polyps found in GI tract of patients diagnosed with FAP?
  • How does treatment with eRapa affect a patient's quality of life?

Participants will:

  • Take eRapa or placebo once per day every other week until disease progresses (gets worse), stops taking part in the trial or dies.
  • Visit the clinic once every 3 months for check ups and tests.
  • Have an endoscopy at the start of the trial and then every 6 months to check on whether the disease is getting better or worse.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This is a Phase 3, multi-site, prospective, randomized, double-blind, placebo-controlled trial of eRapa administered to patients with FAP who are at high risk of disease progression. 168 patients with FAP will be enrolled in the trial and randomized 2:1 to receive 0.5 mg eRapa or matching placebo orally, once a day (QD) every other week. There is no minimum treatment duration as this is an event-driven trial; however, the intervention period will continue until disease progression, participant withdrawal from treatment, or until the overall trial endpoint is reached. Participant eligibility is restricted to patients under active surveillance for genetic or clinically diagnosed FAP and who have an intact colon; who are postcolectomy/subtotal colectomy and have documented residual polyps in the rectum/sigmoid or who are post-proctocolectomy with ileal-pouch anal anastomosis and documented polyps in the pouch. Eligible participants will undergo a baseline endoscopy and subsequent endoscopic procedures performed every 6 months to monitor for disease progression.

Randomized patients will be stratified based on the following disease characteristics:

  • Intact colon versus post-surgical resection with retained rectum/sigmoid or pouch, and
  • Duodenal polyposis (current Spigelman stage score ≤2 versus Spigelman stage score ≥3) For the purposes of this trial, high-risk for disease progression is defined as meeting one of the following:
  • Patients who have intact colons and have >100 polyps but ≤500 polyps
  • Patients who have retained rectum/sigmoid or ileal-pouch-anal anastomosis and have ≥10 polyps that are ≥3 mm in diameter, or
  • Patients who have a history of duodenal polyposis Spigelman stage score of 3 or 4 with at least 1 duodenal polyp that has been removed within 18 months of screening.

Trial assessments should be conducted as per the Schedule of Activities with a visit occurring about once every 3 months.

Assessment of Spigelman stage will not require a biopsy unless the lesion has an abnormal appearance and/or is ≥10 mm.

Study Type

Interventional

Enrollment (Estimated)

168

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Denmark
  • Germany
  • Netherlands
  • Puerto Rico
      • Rio Piedras, Puerto Rico, 00935
  • Spain
      • Barcelona, Spain
        • Recruiting
        • Hospital Clinic De Barcelona
        • Contact:
      • Inca, Spain
        • Not yet recruiting
        • Hospital Comarcal de Inca
        • Contact:
      • Valencia, Spain
  • United States
    • California
      • Arcadia, California, United States, 91007
    • Connecticut
      • New Haven, Connecticut, United States, 06520
    • District of Columbia
      • Washington D.C., District of Columbia, United States, 20057
    • Florida
      • Orlando, Florida, United States, 32825
        • Recruiting
        • Digestive & Liver Center of Florida
        • Contact:
      • Weston, Florida, United States, 33331
        • Recruiting
        • Cleveland Clinic Florida
        • Contact:
    • Illinois
    • Kansas
      • Kansas City, Kansas, United States, 66160
        • Recruiting
        • University of Kansas Medical Center
        • Contact:
    • Maryland
      • Baltimore, Maryland, United States, 21205
    • Massachusetts
      • Boston, Massachusetts, United States, 02115
    • Michigan
      • Ann Arbor, Michigan, United States, 48109
        • Recruiting
        • University of Michigan
        • Contact:
    • Missouri
      • St Louis, Missouri, United States, 63110
        • Recruiting
        • Department of Surgery, Section of Colon Rectal and Surgery
        • Contact:
    • Ohio
      • Cleveland, Ohio, United States, 44195
        • Recruiting
        • Cleveland Clinic
        • Contact:
      • Columbus, Ohio, United States, 43210
        • Recruiting
        • Ohio State University
        • Contact:
    • Pennsylvania
      • Danville, Pennsylvania, United States, 17822
        • Recruiting
        • Geisinger Medical Center
        • Contact:
      • Pittsburgh, Pennsylvania, United States, 15213
        • Recruiting
        • University of Pittsburgh Medical Center
        • Contact:
    • Texas
      • Houston, Texas, United States, 77030
        • Recruiting
        • The University of Texas MD Anderson Cancer Center
        • Contact:
    • Washington
      • Seattle, Washington, United States, 98101
      • Seattle, Washington, United States, 98195
        • Recruiting
        • University of Washington - Fred Hutchinson
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Participant must be ≥18 years of age inclusive.
  2. Participant must have documented FAP, confirmed by adenomatous polyposis coli genotype mutation testing.
  3. Participant must have at least 1 of the following high-risk features: >100 polyps but ≤500 polyps in the colon, or ≥10 polyps in the retained rectum/sigmoid or ileal pouch (≥3 mm in size), or Spigelman stage 3 or 4 with at least 1 polyp ≥10 mm to be removed at baseline or on endoscopy performed within 18 months of screening.
  4. Contraceptive use by participants or participant partners until at at least 12 weeks after stopping study treatment.
  5. Agree not to donate gametes for the purpose of reproduction until at at least 12 weeks after stopping study treatment.
  6. Willing to undergo endoscopic evaluation.

Exclusion Criteria:

  1. Participant has unresected or incompletely resected high-grade dysplasia or cancer within the duodenum, colon, rectum, or ileal pouch at screening endoscopy.
  2. Participant has any polyps ≥8 mm in the duodenum, colon, rectum, or ileal pouch remaining after screening endoscopy (polyps ≥8 mm are to be resected during screening endoscopy).
  3. Participant has had surgery within 6 weeks of the trial.
  4. Participant has active malignancy or history of malignancy diagnosed within 24 months of first dose of trial intervention.
  5. Participant has a history of, or currently has, an acquired or primary (congenital) immunodeficiency.
  6. Participant has active and clinically significant tuberculosis (positive Quantiferon Gold test), bacterial, fungal, or viral infection, including human immunodeficiency virus (HIV).
  7. Participant has any medical or social condition that, in the opinion of the Investigator, might increase participant risk if enrolled, prevent participant compliance to trial procedures, or present an unacceptable confound to safety or clinical trial data.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: eRapa
0.5 mg eRapa once a day (QD) every other week
Drug: eRapa (encapsulated rapamycin)
0.5 mg capsules for oral use; white opaque capsule filled with off-white powder; Trial intervention will be provided in 28-count round high-density polyethylene bottles with a polypropylene child-resistant screw cap and foil induction seal.
Placebo Comparator: Placebo
Placebo once a day (QD) every other week
Drug: Placebo
Capsules in 28-count round high-density polyethylene bottles with a polypropylene child-resistant screw cap and foil induction seal.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Progression-free survival (PFS) in high-risk patients with FAP treated with eRapa versus placebo.
Time Frame: 3 years
  • Death from any cause
  • Cancer/high-grade dysplasia
  • Major FAP-related surgery (e.g., colectomy, proctectomy, total proctocolectomy with ileal pouch anal anastomosis [IPAA], pouch resection, ileostomy, duodenectomy, or surgical ampullectomy)
  • Advancement of Spigelman stage (not related solely to increase in polyp number)
  • Meets criteria for surgery (consistent with United States [US] and European Union [EU] practice guidelines) (Yang, Gurudu et al. 2020, Zaffaroni, Mannucci et al.2024)
  • Retained rectum/sigmoid or pouch (≥10 polyps ≥3 mm in size at baseline)
  • Duodenum (Stage 3/4 and at least 1 polyp ≥10 mm removed in last 18 months)
3 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The safety and tolerability of eRapa in patients with FAP
Time Frame: 3 years

-Frequency of all grades (as per the Common Terminology Criteria for Adverse Events [CTCAE] version [v] 5.0) treatment-emergent adverse events (TEAEs) in participants receiving eRapa;

  • Frequency of Grade 3 and higher (as per the CTCAE v5.0) TEAEs in participants receiving eRapa
  • Percentage of participants discontinuing eRapa treatment due to adverse drug reactions (ADRs)
3 years
The effect of eRapa treatment on GI polyposis in patients with FAP
Time Frame: 3 years
  • Percent change from baseline in the PB (i.e., the sum of the diameters of all polyps >3 mm) at 6, 12, 18, 24, 30, and 36 months as observed by surveillance endoscopy Note: The total PB will be based on polyps observed in the upper GI tract (duodenum) and the lower GI tract (colon, retained rectum/sigmoid or pouch)
  • Percent change from baseline in the PB in the upper GI tract (duodenum) at 6, 12, 18, 24, 30, and 36 months as observed by upper endoscopy
  • Percent change from baseline in the PB in the lower GI tract (colon, retained rectum/ sigmoid or pouch) at 6, 12, 18, 24, 30, and 36 months as observed by lower endoscopy
3 years
The effect of eRapa treatment on Spigelman stage score in patients with FAP
Time Frame: 3 years
Change from baseline in Spigelman stage score at 6, 12, 18, 24, 30, and 36 months
3 years
The effect of eRapa treatment on quality-of-life measures, assessed by the 5 level EuroQoL-5 Dimension (EQ-5D-5L)
Time Frame: 3 years
-Change from baseline in EQ-5D-5L score at 6, 12, 18, 24, 30, and 36 months;
3 years
Determine the immunomodulating effect of eRapa treatment in patients with FAP
Time Frame: 3 years
• Change from baseline in T cell phenotypes and function at 12, 24, and 36 months
3 years
The effect of eRapa treatment on quality-of-life measures, assessed by EORTC-30
Time Frame: 3 years
-Change from baseline in EORTC-30 score at 6, 12, 18, 24, 30, and 36 months;
3 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Rapamycin Holdings Inc.

Collaborators

Biodexa Pharmaceuticals

Investigators

  • Study Director: Gary Shangold, MD, Biodexa

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 18, 2025

Primary Completion (Estimated)

July 1, 2030

Study Completion (Estimated)

January 1, 2031

Study Registration Dates

First Submitted

April 10, 2025

First Submitted That Met QC Criteria

April 24, 2025

First Posted (Actual)

April 30, 2025

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 20, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • MTX230-301

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Familial Adenomatous Polyposis (FAP)

Clinical Trials on eRapa (encapsulated rapamycin)

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in South Korea

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe