Study of Onvansertib in Combination With FOLFIRI and Bevacizumab or FOLFOX and Bevacizumab Versus FOLFIRI and Bevacizumab or FOLFOX and Bevacizumab for First-Line Treatment of Metastatic Colorectal Cancer in Adult Participants With a KRAS or NRAS Mutation
- Conditions
- CRCMetastatic Colorectal CancerKRAS/NRAS Mutation
- Interventions
- Registration Number
- NCT06106308
- Lead Sponsor
- Cardiff Oncology
- Brief Summary
The purpose of this study is to assess 2 different doses of onvansertib to select the lowest dose that is maximally effective, and to assess the safety, efficacy, pharmacokinetics, and pharmacodynamics of onvansertib in combination with FOLFIRI + bevacizumab or FOLFOX + bevacizumab in patients with KRAS or NRAS-mutated metastatic colorectal cancer (CRC) in the first-line setting.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 113
- Histologically confirmed metastatic colorectal cancer.
- Documented KRAS or NRAS mutation.
- No previous systemic therapy in the metastatic setting.
- Participants must be willing to submit archival tissue or undergo fresh biopsy.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Women of childbearing potential must use contraception or take measures to avoid pregnancy.
- Imaging computed tomography (CT) or magnetic resonance imaging (MRI) of chest/abdomen/pelvis and other scans as necessary to document all sites of disease performed within 28 days prior to the first dose of onvansertib.
- Must have acceptable organ function
- Concomitant KRAS or NRAS and BRAF-V600 mutation or microsatellite instability high/deficient mismatch repair.
- Prior treatment with a VEGF inhibitor, including bevacizumab or biosimilars.
- Previous oxaliplatin treatment within 12 months prior to randomization, when arm open.
- Known dihydropyrimidine dehydrogenase (DPD) deficiency.
- Anticancer chemotherapy or biologic therapy administered within 28 days prior to the first dose of study drug.
- Untreated or symptomatic brain metastasis.
- Gastrointestinal (GI) disorder(s) that would significantly impede the absorption of an oral agent.
- Unable or unwilling to swallow study drug.
- Uncontrolled intercurrent illness.
- Known hypersensitivity to fluoropyrimidine or leucovorin, irinotecan, or oxalipatin.
- Abnormal glucuronidation of bilirubin; known Gilbert's syndrome.
- Use of strong CYP3A4 or CYP2C19 inhibitors or strong CYP3A4 inducers.
- QTc >470
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Standard of Care (SOC) Bevacizumab Participants will receive FOLFIRI/Bev on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 30 mg + Standard of Care Onvansertib Participants will receive 30 mg onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFOX on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 30 mg + Standard of Care FOLFOX Participants will receive 30 mg onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFOX on Day 1 and Day 15 of each 28-day treatment cycle. Standard of Care (SOC) FOLFIRI Participants will receive FOLFIRI/Bev on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 20 mg + Standard of Care FOLFOX Participants will receive 20 mg of onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFOX on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 20mg + Standard of Care Onvansertib Participants will receive 20 mg of onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFIRI/BEV on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 20mg + Standard of Care Bevacizumab Participants will receive 20 mg of onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFIRI/BEV on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 30 mg + Standard of Care (SOC) FOLFIRI Participants will receive 30 mg of onvansertib + on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFIRI on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 20mg + Standard of Care FOLFIRI Participants will receive 20 mg of onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFIRI/BEV on Day 1 and Day 15 of each 28-day treatment cycle. Standard of Care FOLFOX Participants will receive FOLFOX/Bev on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 30 mg + Standard of Care Bevacizumab Participants will receive 30 mg onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFOX on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 30 mg + Standard of Care (SOC) Onvansertib Participants will receive 30 mg of onvansertib + on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFIRI on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 30 mg + Standard of Care (SOC) Bevacizumab Participants will receive 30 mg of onvansertib + on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFIRI on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 20 mg + Standard of Care Onvansertib Participants will receive 20 mg of onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFOX on Day 1 and Day 15 of each 28-day treatment cycle. Onvansertib 20 mg + Standard of Care Bevacizumab Participants will receive 20 mg of onvansertib on Days 1 to 5 and Days 15 to 19 of each 28-day treatment cycle + FOLFOX on Day 1 and Day 15 of each 28-day treatment cycle. Standard of Care Bevacizumab Participants will receive FOLFOX/Bev on Day 1 and Day 15 of each 28-day treatment cycle.
- Primary Outcome Measures
Name Time Method Objective Response Rate (ORR) Up to approximately 1 year ORR defined as the proportion of participants who achieved a best overall Response (BOR) of CR or PR per RECIST Version 1.1 from randomization until disease progression, or death due to any cause, as determined by blinded independent central review.
- Secondary Outcome Measures
Name Time Method Overall Response (OR) Up to approximately 1 year Defined as CR or PR, PFS, DCR, DOR, and OS associated with a reduction in circulating tumor DNA (ctDNA) mutation allele frequency (MAF).
Overall Survival (OS) Up to approximately 1 year OS defined as the time from drug administration to death due to any cause.
Maximum Concentration (Cmax) of Onvansertib and metabolites in combination w/FOLFIRI and bevacizumab or FOLFOX and bevacizumab Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days) Area Under the Plasma Concentration Curve (AUC) of Onvansertib and metabolites in combination w/FOLFIRI and bevacizumab or FOLFOX and bevacizumab Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days) Efficacy: Exposure Response Evaluation of Onvansertib Up to approximately 1 year Progression Free Survival (PFS) Up to approximately 1 year PFS defined as the time from the date of randomization to the earliest documented disease progression per RECIST version 1.1, or death due to any cause, as determined by blinded independent central review.
Number of Participants with an Adverse Event (AE) Up to approximately 1 year Type, incidence, causality and severity of AEs based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0. Clinically significant changes from baseline in vital signs, laboratory parameters, electrocardiograms (ECGs), weight, and Eastern Cooperative Oncology Group (ECOG) performance status will be recorded as AEs.
Disease Control Rate (DCR) Up to approximately 1 year DCR defined as CR plus PR plus stable disease (SD), as determined by independent central review.
Duration of Response (DOR) Up to approximately 1 year DOR defined as the time from the date of first documentation of objective tumor response (CR or PR) to the earliest documented disease progression per RECIST version 1.1, or death due to any cause, as determined by blinded independent central review.
Safety: Exposure Response Evaluation of Onvansertib Up to approximately 1 year Trough Concentration (Ctrough) of Onvansertib and metabolites in combination w/FOLFIRI and bevacizumab or FOLFOX and bevacizumab Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)
Trial Locations
- Locations (41)
Mayo Clinic - Arizona
🇺🇸Phoenix, Arizona, United States
The University of Arizona Cancer Center
🇺🇸Tucson, Arizona, United States
St. Bernards Medical Center
🇺🇸Jonesboro, Arkansas, United States
Highlands Oncology Group
🇺🇸Springdale, Arkansas, United States
Pacific Cancer Medical Center
🇺🇸Anaheim, California, United States
Comprehensive Blood and Cancer Center - Bakersfield
🇺🇸Bakersfield, California, United States
Orange Coast Memorial Medical Center
🇺🇸Fountain Valley, California, United States
UC San Diego Moores Cancer Center
🇺🇸La Jolla, California, United States
Norris Comprehensive Cancer Center
🇺🇸Los Angeles, California, United States
UCLA Department of Medicine-Hematology/Oncology
🇺🇸Los Angeles, California, United States
Sharp Memorial Hospital
🇺🇸San Diego, California, United States
Oncology Consultants, PA
🇺🇸Houston, Texas, United States
Torrance Memorial Physician Network - Cancer Care and Infusion Center
🇺🇸Torrance, California, United States
PIH Health
🇺🇸Whittier, California, United States
Memorial Cancer Institute
🇺🇸Hollywood, Florida, United States
Mayo Clinic - Florida
🇺🇸Jacksonville, Florida, United States
Cleveland Clinic Martin Health
🇺🇸Stuart, Florida, United States
Kaiser Permanente
🇺🇸Honolulu, Hawaii, United States
Fort Wayne Medical Oncology and Hematology
🇺🇸Fort Wayne, Indiana, United States
The University of Kansas Cancer Center - Westwood
🇺🇸Westwood, Kansas, United States
Cancer Center of Kansas
🇺🇸Wichita, Kansas, United States
Cancer & Hematology Centers of Western Michigan - Lemmen-Holton Cancer Pavilion
🇺🇸Grand Rapids, Michigan, United States
Mayo Clinic Cancer Center
🇺🇸Rochester, Minnesota, United States
Saint Luke's Hospital
🇺🇸Kansas City, Missouri, United States
Washington University School of Medicine Center for Advanced Medicine
🇺🇸Saint Louis, Missouri, United States
CCCN
🇺🇸Las Vegas, Nevada, United States
Manhattan Hematology Oncology (MHO) Research Foundation, Inc.
🇺🇸New York, New York, United States
Trihealth Kenwood
🇺🇸Cincinnati, Ohio, United States
University Hospitals Cleveland Medical Center
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
The Ohio State University Wexner Medical Center
🇺🇸Columbus, Ohio, United States
Oregon Health and Science University
🇺🇸Portland, Oregon, United States
Lehigh Valley Health Network
🇺🇸Allentown, Pennsylvania, United States
West Cancer Clinic
🇺🇸Germantown, Tennessee, United States
MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
Utah Cancer Specialists
🇺🇸Salt Lake City, Utah, United States
University of Virginia
🇺🇸Charlottesville, Virginia, United States
Inova Schar Cancer Institute
🇺🇸Fairfax, Virginia, United States
VCU Massey Cancer Center
🇺🇸Richmond, Virginia, United States
Virginia Mason Medical Center
🇺🇸Seattle, Washington, United States
ThedaCare Regional Cancer Center
🇺🇸Appleton, Wisconsin, United States