Anthracyclines like doxorubicin are among oncology’s most enduring drugs — but their power comes with a limit. Beyond a certain cumulative dose, the risk of irreversible heart damage rises sharply, forcing oncologists to cap or abandon otherwise effective treatments.
Race Oncology Ltd (ASX:RAC, OTC:RAONF) is trying to change that equation. Its lead candidate RC220 is being developed as both an anticancer and a cardioprotective therapy — a combination that could allow patients to receive doxorubicin for longer, or at higher doses, without the same risk of cardiac injury.
The company’s goal is to overcome the cardiotoxic limits that have long constrained anthracycline use.
Clinical trial progress: Tackling two questions at once
Race’s ongoing Phase 1 trial (RAC-010) is designed to explore both the safety and therapeutic potential of RC220, a proprietary formulation of (E,E)-bisantrene. The study is testing the drug both as a single agent and in combination with doxorubicin in patients with advanced solid tumours.
Two patients have already been treated in Australia — one with RC220 alone and one in combination — and recruitment is now expanding internationally. Hong Kong sites are active, with regulatory approval secured from the region’s Department of Health, while Korea’s Ministry of Food and Drug Safety has approved an Investigational New Drug (IND) application, paving the way for recruitment across four sites.
Read more: Race Oncology wins Korean approval to commence RC220 Phase 1 trial
That broader footprint should accelerate patient enrolment and provide data on RC220’s dual promise — anticancer efficacy and potential protection against doxorubicin-induced cardiotoxicity.
The mechanism behind the cardio-oncology angle
Race’s recent research shows that (E,E)-bisantrene doesn’t behave like a traditional chemotherapy agent. Instead, it acts by binding to G-quadruplex (G4) DNA and RNA structures — regulatory sequences that influence cancer-driving genes such as MYC.
By stabilising these G4 structures, RC220 can suppress oncogenic activity and inhibit pathways including telomerase and topoisomerase II. Race presented the findings at the European Society of Medical Oncology (ESMO) Congress in October, linking the discovery to its cardio-oncology ambitions.
If the trial confirms that RC220 preserves cardiac function at useful doxorubicin doses, it could redefine how oncologists use anthracyclines in solid tumours such as breast cancer and sarcoma.
Operational footing and financial position
The September quarter placed Race on solid operational ground. The company closed the period with $11.27 million in cash and equivalents, with more than three-quarters of expenditure directed towards research, development and manufacturing.
Early option conversions added a further $3.6 million post-quarter, extending Race’s funding runway into calendar 2026.
CEO Dr Daniel Tillett highlighted the “extraordinary perseverance” of the clinical team as the multi-site trial expanded into Asia, noting that the study’s complexity is central to demonstrating RC220’s dual activity profile.
Read more: Race Oncology extends patent protection and advances Phase 1 RC220 trial in September quarter
Extending protection — in the lab and on the balance sheet
Alongside its clinical progress, Race made an intellectual property breakthrough during the quarter. The company discovered that “bisantrene” exists as three photo-isomers with distinct biological properties, and that the active (E,E) form is responsible for the therapeutic activity.
Race has filed three composition-of-matter patents covering the manufacture, formulation and use of the (E,E)-bisantrene isomer — protection that could extend exclusivity for up to 20 years. For potential partners, that’s a significant shift, strengthening the company’s patent position and commercial clarity.
Read more: Race Oncology moves to secure IP protection for ‘breakthrough' bisantrene discovery
From AML to solid tumours
Race’s earlier work in acute myeloid leukaemia (AML) continues to support the underlying efficacy of bisantrene. Peer-reviewed results published this year showed a 40% response rate in a Phase II salvage study, including one patient who remains disease-free two years after treatment.
The company’s focus is increasingly turning towards solid tumours, where combining RC220 with doxorubicin could deliver meaningful early results.
What’s next
Over the next two quarters, investors will be watching three key indicators:
- Recruitment pace across Australian, Hong Kong and Korean sites, which will determine how quickly safety and pharmacokinetic data accumulate.
- Cardiac biomarker signals such as troponin or echocardiographic changes that could indicate protective effects.
- Mechanistic biomarkers tied to the G4/MYC pathway, which may help identify patient subgroups most likely to benefit.
With funding secured and the Phase 1 trial expanding internationally, Race is positioned to generate the data needed to validate its cardio-oncology thesis.
If RC220 can extend the utility of doxorubicin without extending its cardiac risk, Race could carve out a distinctive niche — not by replacing a cornerstone chemotherapy, but by making it safer to use.