Recursion's Phase 2 Sycamore Trial

REC-994 is being developed by Recursion Pharmaceuticals specifically for the treatment of symptomatic cerebral cavernous malformations.

The Phase I trial of REC-994, using healthy volunteers, was completed in late 2020. A Phase II trial testing the safety and tolerability of the medicine in patients with CCM enrolled its first patient in March 2022. The Phase 2 trial is currently enrolling and will include 60 patients who will be randomized into three groups: a high-dose group, a low-dose group, and a placebo group. The patient eligibility criteria and sites for the trial are below. Please check to learn more.

Phase 2 enrollment information

Who can participate?  Please scroll down for complete inclusion and exclusion criteria. The Phase 2 trial will enroll 60 adults with symptomatic CCM. Symptoms must be caused by an active brain lesion and can include seizure, headache, neurological deficits, or other issues that are not solely from a prior hemorrhage or surgery.  REC-994 is meant to address symptoms that can be reduced.

What is involved?  This trial involves 7 visits to the study site over a 15 month period. Three of these visits will include MRI, but gadolinium is not used in this study.  In addition to taking the medicine, you will also use an app to record headaches and seizures daily.

Where are the study sites and who should I contact?  There will be at least 12 sites around the US once all are up and running. We will list the new sites here when they come online.



Xenoscience/21st Century Neurology
Principal Investigator: Dr. Stephen Flitman
Study Contact:
Mona Dever
Clinical Research Coordinator
(602) 274-9500

Stanford University
Principal Investigator: Dr. Gary Steinberg
Study Contacts:
Sasha Alexander:
Guiping Qui

Principal Investigator: Dr. Anthony Wong
Study Contact:
Melissa Arevalo

Baptist Health
Principal Investigator: Dr. Ricardo Hanel
Study Contact:
LaNaya Lewis
Ph: 904-202-7013

New Jersey
Valley Hospital, Ridgewood
Principal Investigator: Dr. Dorothea Altschul
Study Contact:
Kimberly Michel

New York
Columbia University Medical Center
Principal Investigator: Dr. Sander Connolly
Study Contact:
Angela Velazquez

Penn Medicine
Principal Investigator: Dr. Jan Karl Burkhardt
Study Contact:
Leah Coghlan

Thomas Jefferson University
Principal Investigator: Dr. Pascal Jabbour
Study Contact:
Contact: Nadirah Jones
Contact: Chris Gahm

University of Pittsburgh
Principal Investigator: Dr. Zenonos
Study Contact:
Maegan Johnson
P: 412-677-0243

The University of Texas Southwestern Medical Center
Principal Investigator: Dr. Jonathan White
Study Contact:
Tash Mupambo

University of Virginia
Principal Investigator: Dr. Ryan Kellogg
Study Contact:
Judy Beenhakker, MS, CCRC
P: 434-982-1856



Ages Eligible for Study: 18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study: All
Accepts Healthy Volunteers: No

Inclusion criteria:
  1. 18 years of age or older with anatomic CCM lesions demonstrated by brain MRI
  2. Have symptomatic CCM
  3. Have provided written informed consent to participate in the study
  4. Have NOT participated in a clinical trial utilizing an investigational agent within 28 days or within 6 half-lives of the investigational drug (whichever is longer) prior to Screening

Exclusion Criteria:

  1. Symptoms deemed by the study Investigator to be caused exclusively by irreversible neuronal damage from prior stroke or neurosurgical instrumentation
  2. History of cranial irradiation or surgical/radio-surgical treatment of the primary symptomatic CCM lesion
  3. Pregnant or breastfeeding
  4. Unable or unwilling to participate in MRI assessments (eg, claustrophobia, metal implant, implanted cardiac pacemaker). This trial does not use contrast.
  5. Liver dysfunction or active liver disease as defined by baseline serum transaminases >2x upper limit of normal (ULN)
  6. Have severely impaired renal function (eGFR <60ml/min) or active renal disease
  7. Have had a previous diagnosis of skeletal muscle disorders (myopathy) of any cause or have a baseline creatine kinase level > 5x ULN
  8. History of alcohol or substance abuse within 1 year prior to screening
  9. Clinically significant laboratory abnormality
  10. Have had an intracerebral hemorrhage within 3 months of screening or any brain surgery within 6 months of screening

More background

REC-994 is the first industry-sponsored trial of a medicine developed specifically for CCM.  The following webinar offers more information about its unique history.


In this blog post, Recursion’s CEO Chris Gibson shares the origin story of REC-994 beginning in graduate school at the University of Utah.


Updated 08.25.22