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Carcinoma, Renal CellPhase 1/2NCT05287945

Study of Orellanine in Metastatic Clear-Cell or Papillary Renal Cell Carcinoma

A Phase 1/2 study testing Orellanine in people with Carcinoma, Renal Cell, run by Oncorena AB at 10 sites in 5 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

A phase I/II, open-label, study to determine the safety and preliminary efficacy of orellanine in patients with metastatic clear-cell or papillary renal carcinoma who have failed standard-of-care therapy. All participants must have end-stage kidney disease and be receiving stable chronic hemodialysis. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Carcinoma, Renal Cell
What is being tested?
Orellanine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
75 participants
Where
10 sitesin 5 countries
Study dates
4 Aug 2023to 31 Dec 2027
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Has provided written informed consent.
  • Has a diagnosis of histologically confirmed advanced ccRCC or pRCC. No conventional therapy is available or considered appropriate by the treating physician or is declined by the patient.
  • For patients in the expansion portion of the study only: Measurable disease per RECIST version 1.1 criteria.
  • ECOG performance status of 0 - 2.
  • Age ≥18 years.
  • Life expectancy ≥3 months.
Show all 19Show fewer
  • Has acceptable haematologic laboratory values defined as:
  • Neutrophils ≥1.5 × 10^9/L, without growth factor stimulation within 3 weeks prior to the blood test;
  • Platelets ≥100 × 10^9/L;
  • Haemoglobin ≥5.6 mmol/L (~90 g/L). Use of erythropoietin or blood transfusions are permitted.
  • Has acceptable liver laboratory values defined as:
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 × ULN (≤5 × ULN for patients with liver metastases
  • Total bilirubin ≤1.5 × ULN or direct bilirubin ≤ ULN for patients with total bilirubin levels >1.5 × ULN
  • For patients diagnosed with Gilbert's syndrome, total bilirubin ≤2 × ULN is acceptable.
  • Must be on chronic hemodialysis (on a consistent regimen for the previous three months, with allowance for intermittent treatments as required for volume overload).
  • The patient's treating nephrologist and oncologist agree that the prospect of loss of remaining renal function resulting from this treatment will not significantly change the patient's future and chronic dialysis treatment.
  • Female patients of child-bearing potential and male patients must agree to use 2 forms of highly effective contraception for the duration of study treatment and after the last dose of orellanine for at least 3 months for males and 6 months for females.
  • For females of child-bearing potential, a negative serum pregnancy test at screening.
  • Patients who are willing and able to comply with travel requirements, scheduled visits, treatment schedule, efficacy assessments, laboratory tests, and other study procedures.

Who cannot join

  • Diagnosis of any other malignancy within 2 years prior to enrolment, except for adequately treated basal cell or squamous cell skin cancer, superficial melanoma, or carcinoma in situ of the breast or of the cervix, or low grade (Gleason 7 or below) prostate cancer on surveillance with no plans for treatment intervention (e.g., surgery, radiation, or castration)
  • Radiotherapy within 2 weeks before first dose.
  • Immuno-oncology therapy (IO) given in the last six (6) months prior to enrolment
  • Other systemic anti-cancer therapy within 2 weeks before first dose.
  • Has not recovered from AEs due to prior anti-cancer medications to at least grade 1 by CTCAE version 5.0 (except for alopecia and grade 2 neuropathy).
  • Has received any other investigational product within 4 weeks before first dose.
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  • Pregnant or breastfeeding women.
  • Uncontrolled medical condition including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements, or would, in the opinion of the investigator, place the patient at increased risk.
  • QTc interval at baseline of ≥470 msec.

Trial locations and contacts

10 sites in 5 countries. Contact the study team or a site near you to ask about taking part.

Hanjing Xie, Ph.D. contact

+46737031615

hanjing.xie@oncorena.com

Oncorena Study General Inquiries contact

oncorella1@oncorena.com

10 sites in 5 countries

United States6 sites, 6 recruiting
  • Roswell Park Comprehensive

    Buffalo, New York, 14263

    M.D. 716-845-2300 ext. 8313, Saby.George@roswellpark.org

    Saby George, MD

    Recruiting
  • University of Texas - MD Anderson Cancer Center

    Houston, Texas, 77030

    Nizar Tannir, M.D., 713-563-7265, ntannir@mdanderson.org

    Nizar Tannir, M.D.

    Recruiting
  • University of California Irvine

    Orange, California, 92868

    Nataliya Mar, M.D., 714-456-5153, marn@hs.uci.edu

    Nataliya Mar, M.D.

    Recruiting
  • Stanford

    Palo Alto, California, 94304

    Sandhya Srinivas, M.D., 650-498-6000, sandysri@stanford.edu

    Sandhya Srinivas, MD

    Recruiting
  • University of California San Francisco

    San Francisco, California, 94158

    Arpita Desai, M.D., 415-476-4616, arpita.desai@ucsf.edu

    Arpita Desai, M.D.

    Recruiting
  • Washington University in St. Louis

    St Louis, Missouri, 63130

    Melissa Reimers, M.D., 314-273-3713, mreimers@wustl.edu

    Melissa Reimers, MD

    Recruiting

Other trials in United States

France1 site, 1 recruiting
  • Institut de Cancerologie Gustave-Roussy

    Villejuif, 94805

    Christophe Massard, M.D., Ph.D, +33142114211, Christophe.massard@gustaveroussy.fr

    Christophe Massard, M.D., Ph.D.

    Recruiting

Other trials in France

Portugal1 site, 1 recruiting
  • START Lisbon - Hospital de Santa Maria Av

    Lisbon, 1649-035

    Andre Mansinho, M.D., +351 210 405 907, andre.mansinho@startlisbon.com

    Andre Mansinho, M.D.

    Recruiting

Other trials in Portugal

Spain1 site, 1 recruiting
  • Clinica Mi Nova Alianca

    Lleida, 25004

    Santiago Viteri, M.D., Ph.D., + 34 932287445, santiago.viteri@pratia.com

    Santiago Viteri, M.D.

    Recruiting

Other trials in Spain

Sweden1 site, 1 recruiting
  • Karolinska University Hospital

    Stockholm

    Jeffrey Yachnin, +46812370000, jeffrey.yachnin@regionstockholm.se

    Jeffrey Yachnin

    Recruiting

Other trials in Sweden

About this study

Official title: A Phase I/II, Open-Label, Single-Arm Study on Safety, Tolerability and Anti-Tumour Efficacy of Orellanine Treatment in Patients With Metastatic Clear-Cell or Papillary Renal Cell Carcinoma

A phase I/II, open-label, study to determine the safety and preliminary efficacy of orellanine in patients with metastatic clear-cell or papillary renal carcinoma who have failed standard-of-care therapy. All participants must have end-stage kidney disease and be receiving stable chronic hemodialysis.

Read the detailed description

This is an open, non-controlled, phase I/II study evaluating the safety, tolerability, and anti-tumor efficacy of orellanine treatment in patients with metastatic clear-cell or papillary renal carcinoma. The study will include up to 75 patients and is conducted in 3 parts. The study will consist of 3 parts: Part A - an intra-patient dose escalation part, followed by a dose exposure (Part B), followed by a dose expansion (Part C).

Part A, which is now closed, used an intra patient dose escalation design to evaluate safety across multiple dose levels.

The study is currently in Part B, an exposure based dose escalation phase. Patients may be enrolled into either a 24 hour or a 72 hour exposure cohort. Exposure duration is defined by the timing of hemodialysis, as elimination of orellanine occurs primarily through dialysis initiated after infusion. The starting dose for Part B is 0.38 mg/kg, and the total dose per treatment cycle is limited to 2.5 mg/kg, including any replacement doses. A minimum of three patients will be enrolled in each cohort, and escalation to longer exposure durations occurs only after safety evaluation.

Part C is a planned dose expansion phase to further characterize safety and explore preliminary antitumor activity at the selected dose and exposure level.

Being tested
Orellanine
Keywords
Renal cancer, Kidney cancer, Metastatic, Dialysis, Hemodialysis, Clear-cell renal cell carcinoma (ccRCC), Metastatic renal cell carcinoma (mRCC), Papillary renal cell carcinoma (pRCC), End stage Kidney Disease, Advanced renal cell carcinoma, Investigational drug kidney cancer, ONC175, Oncorena
Medical subject headings
Carcinoma, Renal Cell, Kidney Neoplasms, Neoplasm Metastasis, Kidney Failure, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • OrellanineDrug

    Orellanine administered intravenously

Study groups in NCT05287945
Study groupRoleWhat they receive
Part B - 24-Hour Exposure CohortExperimentalParticipants receive orellanine (ONC175) as a 30 minute intravenous infusion once during each 28 day treatment cycle. Hemodialysis is performed the day before the infusion and again approximately 24 hours after the infusion to define the exposure period, as orellanine is eliminated primarily through dialysis. Participants will continue their regular hemodialysis schedule throughout the cycle.
Receives: Drug: Orellanine
Part B - 72 Hour Exposure CohortExperimentalParticipants receive orellanine (ONC175) as a 30 minute intravenous infusion once during each 28 day treatment cycle. In this cohort, hemodialysis is performed on the morning of the infusion, and additional hemodialysis sessions occur on the following days. Replacement doses of orellanine may be administered on the days after the initial infusion, depending on the assigned dose level. Hemodialysis is performed approximately 72 hours after the initial infusion to define the extended exposure period, as orellanine is eliminated primarily through dialysis.
Receives: Drug: Orellanine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Adverse events and laboratory abnormalities as graded by NCI CTCAE v5.0.

    Measured: Through study completion, approximately 1 year

  2. Changes in arterial blood pressure measurements

    Measured: Through study completion, approximately 1 year

  3. Changes in pulse rate measurements

    Measured: Through study completion, approximately 1 year

  4. Changes in respiratory rate measurements

    Measured: Through study completion, approximately 1 year

  5. Changes in temperature measurements

    Measured: Through study completion, approximately 1 year

  6. Changes in physical examination findings

    Measured: Through study completion, approximately 1 year

  7. Maximum tolerable dose of orellanine

    Measured: Through study completion, approximately 1 year

Secondary outcomes (10)
  1. Efficacy of orellanine based on time to tumor response

    Measured: Through study completion, approximately 1 year.

  2. Efficacy of orellanine based on best overall response

    Measured: Through study completion, approximately 1 year.

  3. Area under the curve extrapolated to infinity

    Measured: Through study completion, approximately 1 year.

  4. Terminal half-life

    Measured: Through study completion, approximately 1 year.

  5. Partial area under the curve

    Measured: Through study completion, approximately 1 year.

  6. Dose proportionality

    Measured: Through study completion, approximately 1 year.

  7. Time to maximum plasma concentration

    Measured: Through study completion, approximately 1 year.

  8. Maximum plasma concentration

    Measured: Through study completion, approximately 1 year.

  9. Total body clearance

    Measured: Through study completion, approximately 1 year.

  10. Volume of distribution

    Measured: Through study completion, approximately 1 year.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2022
  2. Study start4 Aug 2023
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
75 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05287945
Sponsor's protocol ID
ONC001-CL-001
Status last verified
Sep 2026
First submitted
24 May 2021
Last updated
1 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Pursuant to relevant data protection and privacy legislation, patients will authorize the collection, use and disclosure of their study data by the investigator and by those persons who need that information for the purposes of the study.

Publications

  • Buvall L, Hedman H, Khramova A, Najar D, Bergwall L, Ebefors K, Sihlbom C, Lundstam S, Herrmann A, Wallentin H, Roos E, Nilsson UA, Johansson M, Tornell J, Haraldsson B, Nystrom J. Orellanine specifically targets renal clear cell carcinoma. Oncotarget. 2017 Jul 25;8(53):91085-91098. doi: 10.18632/oncotarget.19555. eCollection 2017 Oct 31.

    PubMed 29207627
  • Dy GW, Gore JL, Forouzanfar MH, Naghavi M, Fitzmaurice C. Global Burden of Urologic Cancers, 1990-2013. Eur Urol. 2017 Mar;71(3):437-446. doi: 10.1016/j.eururo.2016.10.008. Epub 2016 Oct 28.

    PubMed 28029399
  • Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009 Jan;45(2):228-47. doi: 10.1016/j.ejca.2008.10.026.

    PubMed 19097774
  • Hedman H, Holmdahl J, Molne J, Ebefors K, Haraldsson B, Nystrom J. Long-term clinical outcome for patients poisoned by the fungal nephrotoxin orellanine. BMC Nephrol. 2017 Apr 3;18(1):121. doi: 10.1186/s12882-017-0533-6.

    PubMed 28372584
  • Merza H, Bilusic M. Current Management Strategy for Metastatic Renal Cell Carcinoma and Future Directions. Curr Oncol Rep. 2017 Apr;19(4):27. doi: 10.1007/s11912-017-0583-8.

    PubMed 28303494
  • Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649-55. No abstract available.

    PubMed 7165009
  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018 Jan;68(1):7-30. doi: 10.3322/caac.21442. Epub 2018 Jan 4.

    PubMed 29313949

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Orellanine in people with Carcinoma, Renal Cell, run by Oncorena AB at 10 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 19 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 1 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in United States, France, Portugal, Spain, Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hanjing Xie, Ph.D. (+46737031615, hanjing.xie@oncorena.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Adverse events and laboratory abnormalities as graded by NCI CTCAE v5.0. (time frame: Through study completion, approximately 1 year). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05287945, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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