It targets enzymes (pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase) in the mitochondria of cancer cells that affect cancer cell energy metabolism, resulting in cell apoptosis and/or necrosis.
Trials are currently recruiting in R/R Burkitt lymphoma/leukemia or high-grade B-cell lymphoma with high-risk translocations , high risk myelodysplastic syndrome , locally advanced pancreatic , R/R AML  and metastatic pancreatic . Also, ones are planned in R/R T-cell NHL , advanced unresectable biliary tract , and the company has a compassionate use program .
The drug with gemcitabine and nab-paclitaxel , fully enrolled in one pivotal trial , and past the midpoint in another (again, pivotal) .
An oral form of devimistat (RFL-618) is in development, as are three second generation compounds (RFL-5800/5990/6520). INDs are expected to be filed either this and/or next year.
In the first PhIII (metastatic pancreatic) the company is expecting a data readout by Q3. In the second PhIII (R/R AML), an IA will be conducted by Q2.
Four PhII trials are planned in first-line metastatic pancreatic (dev plus gemcitabine and nab-paclitaxel), metastatic CRC (dev plus FOLFOXIRI and bevacizumab), R/R MDS (dev plus hydroxychloroquine) and R/R TCL (dev plus bendamustine), also a PhI/II in R/R ccSTS (dev plus hydroxychloronquine).