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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Onvansertib 20 mg + Standard of Care (SOC) | Experimental | Participants 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. |
|
| Onvansertib 30 mg + Standard of Care (SOC) | Experimental | Participants 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. |
|
| Standard of Care (SOC) | Active Comparator | Participants will receive SOC (FOLFIRI + bevacizumab) on Days 1 and 15 of each 28-day cycle. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Onvansertib | Drug | Oral capsule |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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. | Up to approximately 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free Survival (PFS) | Defined from the date of first drug administration to progression or death, whichever occurs first. | Up to approximately 1 year |
| Number of Participants with an Adverse Event (AE) |
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Inclusion Criteria:
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 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
Exclusion Criteria:
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).
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:
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:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic in Arizona - Phoenix Campus | Phoenix | Arizona | 85054 | United States | ||
| Central Arkansas Radiation Therapy Institute - Cancer Center |
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| FOLFIRI | Drug | FOLFIRI (irinotecan + fluorouracil [5-FU] + leucovorin) as intravenous (IV) infusion |
|
| Bevacizumab | Drug | IV infusion |
|
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.
| Up to approximately 1 year |
| Disease Control Rate (DCR) | Defined as CR plus PR plus stable disease (SD). | Up to approximately 1 year |
| Duration of Response (DOR) | Defined from the date of first response (CR or PR) to disease progression (PD) or death, whichever occurs first. | Up to approximately 1 year |
| Overall Survival (OS) | Defined as the time from drug administration to death due to any cause. | Up to approximately 1 year |
| Overall Response (OR) | Defined as CR or PR, PFS, DCR, DOR, and OS associated with a reduction in mutation allele frequency (MAF). | Up to approximately 1 year |
| Maximum Concentration (Cmax) of Onvansertib | 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 | Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days) |
| Trough Concentration (Ctrough) of Onvansertib | Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days) |
| Maximum Concentration (Cmax) of Onvansertib Metabolites | 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 Metabolites | Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days) |
| Trough Concentration (Ctrough) of Onvansertib Metabolites | Day 1 and Day 5 of Cycle 1, and Day 5 of Cycle 3 (cycle is 28 days) |
| Efficacy: Exposure Response Evaluation of Onvansertib | Correlation between onvansertib exposure and overall response rate. | Up to approximately 1 year |
| Safety: Exposure Response Evaluation of Onvansertib | Correlation between onvansertib exposure and the number of participants with an AE. | Up to approximately 1 year |
| Little Rock |
| Arkansas |
| 72205-6523 |
| United States |
| Pacific Cancer Medical Center | Anaheim | California | 92801 | United States |
| Comprehensive Blood and Cancer Center - Bakersfield | Bakersfield | California | 93309 | United States |
| Cancer and Blood Specialty Clinic | Los Alamitos | California | 90720 | United States |
| Norris Comprehensive Cancer Center | Los Angeles | California | 90033 | United States |
| UCI Health - Chao Family Comprehensive Cancer Center | Orange | California | 92868 | United States |
| UCLA Health - Santa Monica Parkside Cancer Care | Santa Monica | California | 90404 | United States |
| Torrance Memorial Physician Network - Cancer Care and Infusion Center | Torrance | California | 90505 | United States |
| PIH Health | Whittier | California | 90602 | United States |
| Mayo Clinic - Jacksonville | Jacksonville | Florida | 32224 | United States |
| Memorial Hospital West | Pembroke Pines | Florida | 33028 | United States |
| Cancer & Hematology Centers of Western Michigan - Lemmen-Holton Cancer Pavilion | Grand Rapids | Michigan | 49503 | United States |
| Mayo Clinic - Rochester | Rochester | Minnesota | 55905 | United States |
| Washington University School of Medicine Center for Advanced Medicine | St Louis | Missouri | 63110 | United States |
| Nebraska Cancer Specialists - Midwest Cancer Center - Legacy | Omaha | Nebraska | 68130 | United States |
| Englewood Health | Englewood | New Jersey | 07631 | United States |
| San Juan Oncology Associates | Farmington | New Mexico | 87401 | United States |
| Manhattan Hematology Oncology Associates | New York | New York | 10016 | United States |
| Gabrail Cancer and Research Center | Canton | Ohio | 44718 | United States |
| Trihealth Kenwood | Cincinnati | Ohio | 45236 | United States |
| University Hospitals Cleveland Medical Center | Cleveland | Ohio | 44106 | United States |
| West Cancer Center - East Campus | Germantown | Tennessee | 38138 | United States |
| University of Texas MD Anderson Cancer Center | Houston | Texas | 77030 | United States |
| Utah Cancer Specialists | Salt Lake City | Utah | 84106 | United States |
| University of Virginia School of Medicine | Charlottesville | Virginia | 22903 | United States |
| Inova Schar Cancer Institute | Fairfax | Virginia | 22031 | United States |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 22, 2026 |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
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| ID | Term |
|---|---|
| C000706408 | onvansertib |
| C480833 | IFL protocol |
| D000068258 | Bevacizumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
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