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Colorectal CancerPhase 2NCT05593328

Study of Onvansertib in Combination With FOLFIRI and Bevacizumab Versus FOLFIRI and Bevacizumab for Second Line Treatment of Metastatic Colorectal Cancer in Participants With a Kirsten Rat Sarcoma Virus Gene (KRAS) or Neuroblastoma-RAS (NRAS) Mutation

A Phase 2 study testing Onvansertib, FOLFIRI and Bevacizumab in people with Colorectal Cancer and Metastatic Colorectal Cancer, run by Cardiff Oncology at 27 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The primary objective of this study is to assess the efficacy of 2 different doses of onvansertib in combination with a chemotherapy regimen of irinotecan, fluorouracil [5-FU], and leucovorin (FOLFIRI) and bevacizumab for treatment of confirmed metastatic and/or unresectable colorectal cancer (CRC) in participants… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Onvansertib, FOLFIRI and Bevacizumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
23 participants
Where
27 sitesUnited States
Study dates
17 Mar 2023to 9 Dec 2024
Phase
Phase 2
Are there results?
None posted in the registry

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

  • Histologically confirmed metastatic and/or unresectable colorectal cancer (CRC).
  • Documentation of a kirsten rat sarcoma virus gene (KRAS) or neuroblastoma-RAS (NRAS) mutation in exon 2, 3, or 4 in primary tumor or metastasis, assessed by a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory.
  • Age ≥ 18 years.
  • Participants with tumors that have progressed on an oxaliplatin/fluoropyrimidine--based regimen with or without bevacizumab.
  • Participants must have had systemic therapy within 180 days of the screening visit.
  • Participants must have, at any time previously, received oxaliplatin-based chemotherapy with or without bevacizumab (≥ 6 weeks in duration).
Show all 13Show fewer
  • Participants who received oxaliplatin/fluoropyrimidine-based neoadjuvant, adjuvant, and/or fluoropyrimidine maintenance or adjuvant therapy and have disease recurrence or progression > 6 months from their last dose of oxaliplatin will be required to have received oxaliplatin/fluoropyrimidine-based therapy with or without bevacizumab as first-line treatment for metastatic disease.
  • Participants who received an oxaliplatin-based regimen in the first-line setting and discontinued oxaliplatin because of toxicity or who received oxaliplatin for maintenance therapy are eligible as long as progression occurred < 6 months after the last dose of oxaliplatin therapy for advanced metastatic disease. It is recommended that these participants be re-challenged (if feasible) with oxaliplatin/fluoropyrimidine therapy and subsequently progress prior to eligibility. Participants with oxaliplatin-related neuropathy or oxaliplatin infusion-related hypersensitivity that cannot be rechallenged with oxaliplatin are eligible.
  • Participants must not have received prior treatment with irinotecan.
  • FOLFIRI therapy is appropriate for the participant as determined by the Investigator.
  • Imaging computed tomography (CT) or magnetic resonance imaging (MRI) of chest/abdomen/pelvis or other scans as necessary to document all sites of disease performed within 28 days prior to the first dose of onvansertib. Only participants with measurable disease as defined per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) are eligible for enrollment. CT is the preferred imaging modality, but MRI is also accepted. All subsequent scans must consistently use the same imaging modality for comparison with the Screening scan throughout the study.
  • Must have acceptable organ function
  • Signed informed consent to provide blood sample(s) for specific correlative assays

Who cannot join

  • Concomitant KRAS or NRAS and BRAF-V600 mutation or Microsatellite Instability High/Deficient Mismatch Repair (MSI-H/dMMR).
  • Anti-cancer chemotherapy or biologic therapy administered within 28 days prior to the first dose of study drug. The exception is a single dose of radiation up to 8 Gray (equal to 800 RAD) with palliative intent for pain control up to 14 days before enrollment, provided it is not the target lesion.
  • More than 1 prior chemotherapy regimen administered in the metastatic setting.
  • Major surgery within 6 weeks prior to enrollment.
  • Untreated or symptomatic brain metastasis.
  • Gastrointestinal (GI) disorder(s) that, in the opinion of the Investigator, would significantly impede the absorption of an oral agent (e.g., intestinal occlusion, active Crohn's disease, ulcerative colitis, extensive gastric and small intestine resection).
Show all 27Show fewer
  • Unable or unwilling to swallow study drug.
  • Known hypersensitivity to fluoropyrimidine or leucovorin.
  • Known hypersensitivity to irinotecan.
  • Abnormal glucuronidation of bilirubin; known Gilbert's syndrome.
  • QT interval:
  • Fridericia's correction (QTcF) > 470 milliseconds. The QTcF should be calculated as the arithmetic mean of the QTcF on triplicate electrocardiograms (ECGs). In the case of potentially correctible causes of QT prolongation that are readily corrected (e.g., medications, hypokalemia), the triplicate ECG may be repeated once during Screening and that result may be used to determine eligibility.
  • Planned concomitant use of medications known to prolong the QT/QTc interval according to institutional guidelines.
  • Presence of risk factors for torsade de pointes, including family history of Long QT Syndrome or uncorrected hypokalemia.
  • Use of strong cytochrome P450 3A4 (CYP3A4) or cytochrome P450 2C19 (CYP2C19) inhibitors or strong CYP3A4 inducers. Participants currently receiving these agents who can be switched to alternate therapy are not excluded. Inhibitors should be stopped at least 1 week prior to the first dose of protocol therapy and inducers should be stopped at least 2 weeks prior to initiation of protocol therapy.
  • The following are exclusion criteria for bevacizumab:
  • History of cardiac disease: Congestive heart failure (CHF) Class II or higher according to the New York Heart Association (NYHA); active coronary artery disease, myocardial infarction within 6 months prior to study entry; unevaluated new onset angina within 3 months or unstable angina (angina symptoms at rest) or cardiac arrhythmias requiring anti-arrhythmic therapy, with the exception of participants who have been receiving therapy and are deemed by the Investigator to have stable/controlled disease.
  • Current uncontrolled hypertension (systolic blood pressure >150 mmHg or diastolic blood pressure >90 mmHg despite optimal medical management) and prior history of hypertensive crisis or hypertensive encephalopathy.
  • History of arterial thrombotic or embolic events (within 6 months prior to study entry).
  • Significant vascular disease (eg, aortic aneurysm, aortic dissection, symptomatic peripheral vascular disease).
  • Evidence of bleeding diathesis or clinically significant coagulopathy.
  • Major surgical procedure (including open biopsy, significant traumatic injury, etc) within 28 days, or anticipation of the need for major surgical procedure during the study, and minor surgical procedure (excluding placement of a vascular access device) within 7 days prior to study enrollment.
  • Proteinuria at Screening as demonstrated by urinalysis with proteinuria ≥2+ (participants discovered to have ≥2+ proteinuria on dipstick urinalysis at baseline should undergo a 24-hour urine collection and must demonstrate ≤1 g of protein in 24 hours to be eligible).
  • Abdominal fistula, gastrointestinal perforation, peptic ulcer, or intra-abdominal abscess within the past 6 months.
  • Ongoing serious, non-healing wound, ulcer, or bone fracture
  • Known hypersensitivity to any component of bevacizumab
  • History of reversible posterior leukoencephalopathy syndrome

Trial locations and contacts

27 sites in 1 country.

27 sites in 1 country

United States27 sites
  • Pacific Cancer Medical Center

    Anaheim, California, 92801

  • Comprehensive Blood and Cancer Center - Bakersfield

    Bakersfield, California, 93309

  • Gabrail Cancer and Research Center

    Canton, Ohio, 44718

  • University of Virginia School of Medicine

    Charlottesville, Virginia, 22903

  • Trihealth Kenwood

    Cincinnati, Ohio, 45236

  • University Hospitals Cleveland Medical Center

    Cleveland, Ohio, 44106

  • Englewood Health

    Englewood, New Jersey, 07631

  • Inova Schar Cancer Institute

    Fairfax, Virginia, 22031

  • San Juan Oncology Associates

    Farmington, New Mexico, 87401

  • West Cancer Center - East Campus

    Germantown, Tennessee, 38138

  • Cancer & Hematology Centers of Western Michigan - Lemmen-Holton Cancer Pavilion

    Grand Rapids, Michigan, 49503

  • University of Texas MD Anderson Cancer Center

    Houston, Texas, 77030

  • Mayo Clinic - Jacksonville

    Jacksonville, Florida, 32224

  • Central Arkansas Radiation Therapy Institute - Cancer Center

    Little Rock, Arkansas, 72205-6523

  • Cancer and Blood Specialty Clinic

    Los Alamitos, California, 90720

  • Norris Comprehensive Cancer Center

    Los Angeles, California, 90033

  • Manhattan Hematology Oncology Associates

    New York, New York, 10016

  • Nebraska Cancer Specialists - Midwest Cancer Center - Legacy

    Omaha, Nebraska, 68130

  • UCI Health - Chao Family Comprehensive Cancer Center

    Orange, California, 92868

  • Memorial Hospital West

    Pembroke Pines, Florida, 33028

  • Mayo Clinic in Arizona - Phoenix Campus

    Phoenix, Arizona, 85054

  • Mayo Clinic - Rochester

    Rochester, Minnesota, 55905

  • Utah Cancer Specialists

    Salt Lake City, Utah, 84106

  • UCLA Health - Santa Monica Parkside Cancer Care

    Santa Monica, California, 90404

  • Washington University School of Medicine Center for Advanced Medicine

    St Louis, Missouri, 63110

  • Torrance Memorial Physician Network - Cancer Care and Infusion Center

    Torrance, California, 90505

  • PIH Health

    Whittier, California, 90602

Other trials in United States

About this study

Official title: A Phase 2, Randomized, Open-label Study of Onvansertib in Combination With FOLFIRI and Bevacizumab Versus FOLFIRI and Bevacizumab for Second Line Treatment of Metastatic Colorectal Cancer in Patients With a KRAS or NRAS Mutation

The primary objective of this study is to assess the efficacy of 2 different doses of onvansertib in combination with a chemotherapy regimen of irinotecan, fluorouracil [5-FU], and leucovorin (FOLFIRI) and bevacizumab for treatment of confirmed metastatic and/or unresectable colorectal cancer (CRC) in participants with a kirsten rat sarcoma virus gene (KRAS) or neuroblastoma-RAS (NRAS) mutation who have progressed on an oxaliplatin/fluoropyrimidinebased regimen in the first-line setting.

Being tested
Onvansertib, FOLFIRI, Bevacizumab
Keywords
Colorectal Cancer, Metastatic Colorectal Cancer, KRAS Mutation, NRAS Mutation, Onvansertib, FOLFIRI, Bevacizumab
Medical subject headings
Colorectal Neoplasms

What participants receive

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

  • OnvansertibDrug

    Oral capsule

  • FOLFIRIDrug

    FOLFIRI (irinotecan + fluorouracil [5-FU] + leucovorin) as intravenous (IV) infusion

  • BevacizumabDrug

    IV infusion

Study groups in NCT05593328
Study groupRoleWhat they receive
Onvansertib 20 mg + Standard of Care (SOC)ExperimentalParticipants will receive 20 mg of onvansertib on Days 1 to 5 and 15 to 19 of a 28-day treatment cycle and SOC (FOLFIRI + bevacizumab) on Days 1 and 15 of each 28-day cycle.
Receives: Drug: Onvansertib; Drug: FOLFIRI; Drug: Bevacizumab
Onvansertib 30 mg + Standard of Care (SOC)ExperimentalParticipants will receive 30 mg of onvansertib on Days 1 to 5 and 15 to 19 of a 28-day treatment cycle and SOC (FOLFIRI + bevacizumab) on Days 1 and 15 of each 28-day cycle.
Receives: Drug: Onvansertib; Drug: FOLFIRI; Drug: Bevacizumab
Standard of Care (SOC)Active comparatorParticipants will receive SOC (FOLFIRI + bevacizumab) on Days 1 and 15 of each 28-day cycle.
Receives: Drug: FOLFIRI; Drug: Bevacizumab

What is being measured

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

  1. Overall Response Rate

    Defined as complete response (CR) or partial response (PR) as determined according to the Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) by an independent central review.

    Measured: Up to approximately 1 year

Secondary outcomes (14)
  1. Progression-free Survival (PFS)

    Defined from the date of first drug administration to progression or death, whichever occurs first.

    Measured: Up to approximately 1 year

  2. Number of Participants with an Adverse Event (AE)

    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), physical examinations, weight, and Eastern Cooperative Oncology Group (ECOG) performance status will be recorded as AEs.

    Measured: Up to approximately 1 year

  3. Disease Control Rate (DCR)

    Defined as CR plus PR plus stable disease (SD).

    Measured: Up to approximately 1 year

  4. Duration of Response (DOR)

    Defined from the date of first response (CR or PR) to disease progression (PD) or death, whichever occurs first.

    Measured: Up to approximately 1 year

  5. Overall Survival (OS)

    Defined as the time from drug administration to death due to any cause.

    Measured: Up to approximately 1 year

  6. Overall Response (OR)

    Defined as CR or PR, PFS, DCR, DOR, and OS associated with a reduction in mutation allele frequency (MAF).

    Measured: Up to approximately 1 year

  7. Maximum Concentration (Cmax) of Onvansertib

    Measured: Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)

  8. Area Under The Plasma Concentration Curve (AUC) of Onvansertib

    Measured: Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)

  9. Trough Concentration (Ctrough) of Onvansertib

    Measured: Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)

  10. Maximum Concentration (Cmax) of Onvansertib Metabolites

    Measured: Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)

  11. Area Under The Plasma Concentration Curve (AUC) of Onvansertib Metabolites

    Measured: Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)

  12. Trough Concentration (Ctrough) of Onvansertib Metabolites

    Measured: Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days)

  13. Efficacy: Exposure Response Evaluation of Onvansertib

    Correlation between onvansertib exposure and overall response rate.

    Measured: Up to approximately 1 year

  14. Safety: Exposure Response Evaluation of Onvansertib

    Correlation between onvansertib exposure and the number of participants with an AE.

    Measured: Up to 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 posted25 Oct 2022
  2. Study start17 Mar 2023
  3. Primary completion9 Dec 2024
  4. Study completion9 Dec 2024

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
23 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05593328
Sponsor's protocol ID
CRDF-003
Status last verified
Jan 2025
First submitted
20 Oct 2022
Last updated
10 Jan 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Onvansertib, FOLFIRI and Bevacizumab in people with Colorectal Cancer and Metastatic Colorectal Cancer, run by Cardiff Oncology at 27 sites in United States.

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 13 inclusion and 27 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: finished, as of the sponsor's last update on 10 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 27 sites in United States. 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 phase mean?

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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Response Rate (time frame: Up to approximately 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 10 Jan 2025.

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