Antagonism of somatostatin subtype receptor 3 (sstr3) has emerged as a potential treatment of Type 2 diabetes. Unfortunately, the development of our first preclinical candidate, MK-4256, was discontinued due to a dose-dependent QTc (QT interval corrected for heart rate) prolongation observed in a conscious cardiovascular (CV) dog model. As the fate of the entire program rested on resolving this issue, it was imperative to determine whether the observed QTc prolongation was associated with hERG channel (the protein encoded by the human Ether-a-go-go-Related Gene) binding or was mechanism-based as a result of antagonizing sstr3. We investigated a structural series containing carboxylic acids to reduce the putative hERG off-target activity. A key tool compound, 3A, was identified from this SAR effort. As a potent sstr3 antagonist, 3A was shown to reduce glucose excursion in a mouse oGTT assay. Consistent with its minimal hERG activity from in vitro assays, 3A elicited little to no effect in an anesthetized, vagus-intact CV dog model at high plasma drug levels. These results afforded the critical conclusion that sstr3 antagonism is not responsible for the QTc effects and therefore cleared a path for the program to progress. KEYWORDS: sstr3, antagonist, Type-2 diabetes, β-tetrahydrocarboline, carboxylic acid, hERG channel, QTc prolongation, cardiovascular dog models S omatostatin receptor 3 (sstr3) is a member of a group of five G-protein coupled somatostatin receptors (sstr1− sstr5). 1 Two different structural classes of selective small molecule sstr3 antagonists have been reported: imidazolyltetrahydro-β-carbolines derived from D-tryptophan (D-Trp) and substituted decahydroisoquinolines. 2−6 Recently, we disclosed that antagonism of sstr3 represents a potential novel mechanism for the treatment of Type-2 diabetes mellitus (T2DM) through the evaluations of compound 1 in both in vitro assays and animal efficacy models (Figure 1). 7 Subsequently, we reported that the optimization of this tetrahydro-β-carboline series led to the discovery of MK-4256 (Figure 1). 8 MK-4256 possesses excellent sstr3 potency and subtype selectivity, a good pharmacokinetic (PK) profile in preclinical species, and superior efficacy in a mouse oGTT assay. Although, MK-4256 was shown to have high protein plasma binding with ∼1% free fractions across several species (Table 1), only a minimal shift (∼2×) was observed from in vitro assays with 20% human serum added (Figure 1). 9 This lack of serum shift on sstr3 was attributed to a slow dissociation rate of MK-4256 from the receptor. More significantly, MK-4256 reduced glucose excursion by 86% in a mouse oGTT assay at a dose as low as 0.1 mg/kg with the maximal plasma concentration of 88 nM. 8 On the other hand, MK-4256 had