Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Onvansertib · 8 trials · 20 indications
The proportion of patients having either a complete response (CR) or partial response (PR) (as best response), per RECIST 1.1. Complete Response (CR): Disappearance of all target lesions. For non-target lesions, CR is the disappearance of all non-target lesions and normalization of tumor marker level. Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD.
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.
Disease control was defined as lack of prostate-specific antigen (PSA) progression per Prostate Cancer Working Group 3 (PCWG3) criteria: not having an increase in PSA from Baseline or nadir ≥ 25% and ≥ 2 ng/mL during the first 12 weeks of PSA assessments. Participants that do not have 12 weeks of PSA assessments were considered not to have demonstrated PSA progression control in this analysis. If a participant achieved disease control prior to Week 12, but relapsed at, or before Week 12, disease control was still considered achieved. The 90% confidence intervals were calculated using Wilson Confidence Interval.
DLTs will be defined as toxicities that are considered at least possibly related to the study regimen and that fit one or more of the criteria defined per protocol
All grade 3 or higher adverse events (AE) with treatment attribution of possibly, probably or definite based on CTCAEv5 as reported on case report forms were counted. Incidence is the number of patients experiencing at least one treatment-related grade 3 or higher AE of any type during the time of observation.
The objective response rate (ORR) was defined as the proportion of participants achieving complete response (CR) or partial response (PR) based on RECIST 1.1 criteria on treatment. Per RECIST 1.1 for target lesions: CR is complete disappearance of all target lesions and PR is at least a 30% decrease in the sum of longest diameter (LD) of target lesions, taking as reference baseline sum LD. PR or better overall response assumes at a minimum incomplete response/stable disease (SD) for the evaluation of non-target lesions and absence of new lesions
DLTs were defined as a Grade 4 hematologic adverse events (AEs), Grade ≥ 3 non-hematologic AEs that were considered related to the study drug and that did not resolve within 14 days following presentation with standard management and care, Grade ≥ 3 thrombocytopenia with bleeding, neutropenic fever, any death not clearly due to the underlying disease or extraneous causes, or any change in liver function that met Hy's Law criteria of a DLT.
AEs were defined as any untoward medical occurrence associated with the use of a drug in humans. TEAEs are defined as any AE that started on or after the first day of study treatment and within 30 days of the last administration of study treatment, or that worsened on or after the first day of study treatment. AE severity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 on a scale from Grade 1 (mild) to Grade 5 (death). An AE was considered "serious" if it resulted in death, life-threatening AE, hospitalization or prolongation of hospitalization, persistent or significant incapacity, or congenital anomaly/birth defect. The Investigator determined relatedness to the use of onvansertib. Clinically significant changes in vital signs, laboratory parameters, electrocardiograms, physical examinations, weight, and Eastern Cooperative Oncology Group (ECOG) performance status were reported as AEs.
ORR was defined as the percentage of participants documented to have a confirmed complete response (CR) or partial response (PR) using the Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1). Two-sided 95% confidence interval (CI) was calculated using the exact binomial Clopper-Pearson method. CR: disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have had a reduction in short axis to \< 10 mm. All lymph nodes must have been non-pathological in size (\< 10mm short axis). PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the Baseline sum diameters.
Dose-limiting toxicities were defined as events related to onvansertib that were considered an adverse reaction or suspected adverse reaction during the first cycle of therapy and that fulfilled one of the following: Hematologic (persistent pancytopenia resistant to current standards of care that continues for ≥42 days and is not related to leukemic infiltration or another cause unrelated to study therapy) or Non-Hematologic (any Grade 3 abnormalities that persist \>7 days without decreasing in severity despite standards of care, are clinically significant, or that are Grade 4 and symptomatic).
ECOG performance status was determined using 6-point scale from 0-5, with 0 meaning a participant was fully active/able to carry on all pre-disease activities without restriction and 5 meaning the participant was deceased.
Complete Response also includes Complete Response with Incomplete Blood Count Recovery (CRi). Complete response is defined by the following criteria: Morphologic leukemia-free state plus: * Subject is independent of transfusions * Absolute neutrophil count of \>1000/mm3 * Platelets of ≥100,000/mm3 Complete response with incomplete blood count recovery meets all criteria for CR except for either neutropenia (ANC \<1000/mm3) or thrombocytopenia (\<100,000/mm3) but must include transfusion independence.
Any clinically significant change in electrocardiogram (ECG), physical examination findings, body weight, vital signs, and laboratory parameters were recorded as Adverse Events.
| Arm | Type | Description |
|---|---|---|
| Single Treatment Arm | EXPERIMENTAL | Onvansertib |
| Onvansertib 20mg + Standard of Care | EXPERIMENTAL | 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) | EXPERIMENTAL | 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. |
| Standard of Care (SOC) | ACTIVE_COMPARATOR | Participants will receive FOLFIRI/Bev on Day 1 and Day 15 of each 28-day treatment cycle. |
| Onvansertib 20 mg + Standard of Care | EXPERIMENTAL | 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 30 mg + Standard of Care | EXPERIMENTAL | 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 | ACTIVE_COMPARATOR | Participants will receive FOLFOX/Bev on Day 1 and Day 15 of each 28-day treatment cycle. |
| 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. |
| Safety Lead-in: Onvansertib + nal-IRI + leucovorin + 5-FU | EXPERIMENTAL | The first 3 participants will be administered onvansertib orally once a day at a dosing schedule of 12 mg/m\^2 on Day 1 to Day 10 for two cycles, where each cycle is 2 weeks. Depending on the number of dose limiting toxicities (DLTs) experienced in the first 3 participants, additional participants may receive different dosing schedules, determining the dosing schedule to be used in the treatment period. Onvansertib will be administered in combination with 70 mg/m\^2 nanoliposomal irinotecan (nal-IRI), 400 mg/m\^2 leucovorin and 2400 mg/m\^2 fluorouracil (5-FU). |
| Treatment Period: Onvansertib + nal-IRI + leucovorin + 5-FU | EXPERIMENTAL | Participants will be administered onvansertib at the dosing schedule selected based on the results of the safety lead-in, in cycles of 2 weeks. Onvansertib will be administered in combination with 70 mg/m\^2 nanoliposomal irinotecan (nal-IRI), 400 mg/m\^2 leucovorin and 2400 mg/m\^2 fluorouracil (5-FU). |
| Arm A: onvansertib + abiraterone and prednisone | EXPERIMENTAL | On Day 1 of each cycle, onvansertib will be administered orally (PO) once daily (QD) at a dose of 24 mg/m\^2 for 5 days (Day 1 through Day 5) out of a 21-day cycle. Beginning on Day 1 and continuing uninterrupted throughout each cycle, participants will also receive abiraterone and prednisone. This arm was discontinued. |
| Arm B: onvansertib + abiraterone and prednisone | EXPERIMENTAL | On Day 1 of each cycle, onvansertib will be administered orally (PO) once daily (QD) at a dose of 24 mg/m\^2 for 5 days (Day 1 through Day 5) out of a 14-day cycle. Beginning on Day 1 and continuing uninterrupted throughout each cycle, participants will also receive abiraterone and prednisone. |
| Arm C: onvansertib + abiraterone and prednisone | EXPERIMENTAL | On Day 1 of each cycle, onvansertib will be administered orally (PO) once daily (QD) at a dose of 12 mg/m\^2 for 14 days (Day 1 through Day 14) out of a 21-day cycle. Beginning on Day 1 and continuing uninterrupted throughout each cycle, participants will also receive abiraterone and prednisone. |
| DOSE ESCALATION ONVANSERTIB + PACLITAXEL | EXPERIMENTAL | In the phase 1b, dose escalation/de-escalation will be managed using a BOIN design to identify the RP2D. The study is divided into three time periods: a screening period; a treatment period; and a post-treatment follow-up period. The names of the study interventions involved in this study are: * Onvansertib * Paclitaxel |
| DOSE EXPANSION RP2D ONVANSERTIB + PACLITAXEL | EXPERIMENTAL | The study is divided into three time periods: a screening period; a treatment period; and a post-treatment follow-up period. The names of the study interventions involved in this study are: * Onvansertib * Paclitaxel |
| Onvansertib + FOLFIRI + Bevacizumab | EXPERIMENTAL | Phase 1b: Onvansertib escalating starting dose of 12 mg/m\^2 orally Day 1 through Day 5 and Day 15 through Day 19 of each 28-day cycle in combination with FOLFIRI (180 mg/m\^2 irinotecan, 400 mg/m\^2 leucovorin, 400 mg/m\^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m\^2 continuous intravenous infusion 5-FU + 5 mg/kg bevacizumab. This Phase 1b portion of the study has been completed. Phase 2: Onvansertib Recommended Phase 2 Dose (RP2D) of 15 mg/m\^2 orally Day 1 through Day 5 and Day 15 through Day 19 of every 28-day cycle in combination with FOLFIRI (180 mg/m\^2 irinotecan, 400 mg/m\^2 leucovorin, 400 mg/m\^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m\^2 continuous intravenous infusion 5-FU + 5 mg/kg bevacizumab, with treatment modifications or delays based on unresolved toxicity experienced during a previous cycle. |
| Phase 1b: Onvansertib + low-dose cytarabine | EXPERIMENTAL | Onvansertib, administered in escalating doses orally Day 1 through Day 5 every 28 days (1 cycle) in combination with cytarabine, which will be administered in all cohorts as 20 mg/m\^2 subcutaneously, once daily on Day 1 through Day 10 every 28 days (1 cycle). Onvansertib administration, in combination with cytarabine, will be initiated at a starting dose of 12 mg/m\^2 orally, daily for 5 days. Onvansertib dose will be escalated in successive cohorts until the recommended phase 2 dose is achieved. |
| Phase 1b: Onvansertib + decitabine | EXPERIMENTAL | Onvansertib will be administered in escalating doses orally, Day 1 through Day 5 every 28 days (1 cycle) in combination with decitabine, administered consistently in all cohorts as 20 mg/m\^2 intravenously over 1 hour on Day 1 through Day 5 every 28 days (1 cycle). Onvansertib administration, in combination with decitabine, will be initiated at a starting dose of 12 mg/m\^2 orally, daily for 5 days (Day 1 through Day 5). Onvansertib dose will be escalated in successive cohorts until the recommended phase 2 dose is achieved. |
| Phase 2: Onvansertib + decitabine | EXPERIMENTAL | Onvansertib recommended phase 2 dose, orally Day 1 through Day 5 every 28 days (1 cycle) and decitabine, administered consistently as 20 mg/m\^2 intravenously over 1 hour on Day 1 through Day 5 every 28 days (1 cycle), with treatment modifications or delays based on return of hematopoietic function to baseline or Grade ≤1 toxicity for optimal subject management. |
| Name | Type | Description |
|---|---|---|
| Onvansertib | DRUG | Onvansertib at a dose of 15 mg/m2 orally on Days 1-14 of a 21-day cycle. Treatment will continue until disease progression or intolerable toxicity. |
| FOLFIRI | DRUG | FOLFIRI (irinotecan + fluorouracil \[5-FU\] + leucovorin) as intravenous (IV) infusion |
| Bevacizumab | DRUG | IV Infusion |
| FOLFOX | DRUG | FOLFOX (leucovorin + fluorouracil \[5-FU\] + oxaliplatin) as intravenous (IV) infusion |
| Nanoliposomal irinotecan | DRUG | Intravenous infusion |
| Leucovorin | DRUG | Intravenous infusion |
| Fluorouracil | DRUG | Intravenous infusion |
| Abiraterone | DRUG | Abiraterone orally |
| Prednisone | DRUG | Prednisone orally |
| Paclitaxel | DRUG | once a week into your vein (by intravenous infusion) over about 30 minutes. This will continue for 3 weeks of every cycle |
| Cytarabine | DRUG | subcutaneously |
| Decitabine | DRUG | intravenously |
Inclusion Criteria: 1. Patients must have histologically or cytologically confirmed small cell lung cancer 2. Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and sh...
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Onvansertib is an investigational small molecule being studied for multiple cancers, including pancreatic ductal adenocarcinoma, colorectal cancer, metastatic castration-resistant prostate cancer, small-cell lung cancer, acute myeloid leukemia, and breast cancer. It is not approved by the FDA and remains in clinical development.
Onvansertib is a small molecule that targets polo-like kinase 1 (PLK1), a protein involved in cell division. By inhibiting PLK1, it aims to disrupt cancer cell proliferation. This mechanism is being evaluated across several oncology indications in clinical trials.
Onvansertib is being developed by Cardiff Oncology, Inc., a biopharmaceutical company traded on NASDAQ under the ticker CRDF. The company is conducting clinical trials to evaluate the drug's safety and efficacy in various cancer types.
Onvansertib is in Phase 1 and Phase 2 clinical trials. It is an investigational drug and has not received FDA approval. The trials are assessing its use alone or in combination with other therapies for cancers such as acute myeloid leukemia, metastatic castration-resistant prostate cancer, colorectal cancer, and breast cancer.
Onvansertib has been studied in several clinical trials, including NCT03303339 (Phase 1, AML, completed), NCT03414034 (Phase 2, metastatic castration-resistant prostate cancer, completed), NCT05383196 (Phase 1, breast cancer, active not recruiting), and NCT05593328 (Phase 2, metastatic colorectal cancer, completed).
Onvansertib is also known by its chemical name and is sometimes referred to as NMS-1286937. It is not the same as other PLK1 inhibitors; it is a distinct investigational compound developed by Cardiff Oncology.