Abstract Our goal is to conduct a Phase I clinical trial of CMS121, a small molecule that has shown efficacy in multiple mouse models of Alzheimer's Disease (AD) and which affords a different therapeutic approach for treatment of AD in humans. There are currently no drugs or other therapeutic interventions that can reverse or halt the progression of Alzheimer's disease (AD). The need for a fundamental rethinking of the way clinical candidates for AD are chosen and tested is exemplified by the large number of clinical trial failures for potential AD therapeutics. An effective AD drug will have to demonstrate powerful effects against multiple pathological processes. A truly disease-modifying drug with long-term therapeutic benefits and immediate cognitive benefits would be a tremendous benefit to the millions affected by AD. CMS121 was derived from a different approach to an AD therapeutic and does not directly interact with the targets of the failed drug candidates, thereby providing an altogether new AD drug candidate. The product was developed in conjunction with Salk Institute scientists for treatment of Alzheimer's Disease (AD). The parent compound, identified from a broad screen of compounds for neuroprotective activity, was modified to obtain a series of derivatives with vastly superior protective and pharmacologic characteristics. The derivative, CMS121, prevents and reverses a number of the symptoms associated with AD in both genetic and sporadic mouse models of AD. Studies of the mechanism of action show CMS121 affects multiple, specific regulators of lipid synthesis and metabolism, resulting in reduction of fatty acid synthesis and lipid peroxidation. Both of these features are elevated in AD brains with the increased levels associated with neuroinflammation. Inhibition or removal of these regulators of lipid synthesis and metabolism has been shown to be beneficial in mouse models of AD. Currently, the IND-enabling studies are in the final stages. Large scale GMP manufacture has been completed and sufficient product is ready for clinical trial. The product has been tested for stability under a variety of conditions, genotoxicity, absorption, distribution, metabolism and excretion. The last toxicology and pharmacology studies in rats and dogs are nearing completion. The FDA has been notified of our intent to file an IND application and has assigned Virogenics an IND number for CMS121. Submission of the IND application is on target for the fourth quarter 2020. The clinical trial proposed in this application is the next step in evaluating CMS121 as a drug candidate for treatment of AD.