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OKI-219

Phase 1

Advanced Cancer | Small molecule | Oncology |OnKure Therapeutics, Inc.|Trials Updated: Jul 6, 2026

OKI-219 development status

Highest phase Phase 1
Registered trials 1 across 1 sponsor since Feb 2024

OKI-219 target and mechanism

Molecular targetPI3Kα
Target classOncogene
ModalitySmall molecule

Success Probability

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Market & Valuation

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Trial Design

RandomizedCONTROLLEDBiomarker
Total Trials1
Total Enrollment200

FDA Designations

No designations recorded

OKI-219 clinical trials

OKI-219 · 1 trial · 4 indications

Phase 1 1
NCT06239467First-in-Human Study of OKI-219 in Advanced Solid Tumors and Advanced Breast CancerAdvanced Cancer
ACTIVE NOT_RECRUITING200 Analytics
PHASE1ACTIVE NOT_RECRUITING
First-in-Human Study of OKI-219 in Advanced Solid Tumors and Advanced Breast Cancer
Advanced CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

Identify maximum tolerated dose (MTD) of OKI-219 in monotherapy
Cycle 1 (First 28 days on treatment)

Frequency of participants experiencing dose-limiting toxicities during the first 28-day cycle

Assess safety of OKI-219 as monotherapy or in combination with other anti-cancer therapies: incidence of SAEs
Through 30 days after last dose, an average of 1 year

Number and type of SAEs experienced by participants during treatment and follow-up

Assess safety of OKI-219 as monotherapy or in combination with other anti-cancer therapies: incidence of Grade 2 or greater treatment emergent adverse events
Through 30 days after last dose, an average of 1 year

Number of treatment-emergent adverse events (TEAEs) equal or greater than Grade 2 experienced during treatment and follow-up

Assess rate of dose modifications during treatment with OKI-219 as monotherapy or in combination with other anti-cancer therapies
Through last study dose, an average of 1 year

rate of dose modifications

Secondary Endpoints

Assess the plasma PK of OKI-219 following single and multiple doses as monotherapy or in combination with other anti-cancer therapies: maximum plasma concentration (Cmax)
Through cycle 6 of treatment (up to 28 weeks)
Assess the plasma PK of OKI-219 following single and multiple doses as monotherapy or in combination with other anti-cancer therapies: time of maximum plasma concentration (Tmax)
Through cycle 6 of treatment (up to 28 weeks)
Assess the plasma PK of OKI-219 following single and multiple doses as monotherapy or in combination with other anti-cancer therapies: area under the plasma concentration-time curve (AUC)
Through cycle 6 of treatment (up to 28 weeks)
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelSEQUENTIAL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Phase 1a: Part A Dose EscalationEXPERIMENTALOKI-219 Monotherapy Dose Escalation in participants with advanced solid tumors with the PI3KαH1047R mutation
Phase 1b: Part B Dose EscalationEXPERIMENTALOKI-219 + Fulvestrant Dose Escalation in participants with HR+/HER2- locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part B Dose OptimizationEXPERIMENTALOKI-219 + Fulvestrant Dose Optimization in participants with HR+/HER2- locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part C Dose EscalationEXPERIMENTALOKI-219 + Tucatinib + Trastuzumab Dose Escalation in participants with HR±/HER2+ locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part C Dose ExpansionEXPERIMENTALOKI-219 + Tucatinib + Trastuzumab Dose Expansion in participants with HR±/HER2+ locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part D Dose EscalationEXPERIMENTALOKI-219 + Fulvestrant + Atirmociclib Dose Escalation in participants with HR+/HER2- locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part D Dose ExpansionEXPERIMENTALOKI-219 + Fulvestrant + Atirmociclib Dose Escalation in participants with HR+/HER2- locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part E Dose EscalationEXPERIMENTALOKI-219 + Fulvestrant + Ribociclib Dose Escalation in participants with HR+/HER2- locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation
Phase 1b: Part E Dose ExpansionEXPERIMENTALOKI-219 + Fulvestrant + Ribociclib Dose Expansion in participants with HR+/HER2- locally advanced, unresectable or metastatic breast cancer with the PI3KαH1047R mutation

Interventions

NameTypeDescription
OKI-219DRUGOral twice daily
FulvestrantDRUGIntramuscular injection
TrastuzumabDRUGIntravenous (IV)
TucatinibDRUGOral twice daily
AtirmociclibDRUGOral twice daily
RibociclibDRUGOral once daily continuous for 21-days followed by 7 days off
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites33

Key Inclusion Criteria: * Participants with advanced solid tumors with documented evidence of a PI3KαH1047R mutation in tumor tissue and/or blood (ie, ctDNA). * Eastern Cooperative Oncology Group (ECOG) Performance status score of to 1. * Life expectancy \> 12 weeks for Part A and \> 6 months for P...

Countries:United StatesBelgiumFranceItalySouth KoreaSpain
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Competitive Landscape -Cancer 7 trials (matched to "Advanced Cancer")

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Frequently asked questions about OKI-219

What is OKI-219?

OKI-219 is an investigational small molecule developed by OnKure Therapeutics, Inc. for the treatment of advanced cancer. It is being studied in a first-in-human Phase 1 clinical trial in patients with advanced solid tumors and advanced breast cancer, including tumors with PI3K gene mutations.

What is OKI-219 used for in advanced cancer?

OKI-219 is being evaluated for the treatment of advanced solid tumors and advanced breast cancer, including cases with PI3K gene mutations. It is an investigational therapy and has not been approved for any indication. The Phase 1 study enrolls adults 18 years and older.

What does OKI-219 target?

OKI-219 targets PI3K alpha, a lipid kinase encoded by the PIK3CA gene that is classified as an oncogene. PI3K alpha is frequently altered in cancer, and OKI-219 is designed as a small molecule directed at this target. The Phase 1 trial includes patients with PI3K gene mutations.

Who is developing OKI-219?

OKI-219 is being developed by OnKure Therapeutics, Inc., which trades under the ticker OKUR. The company is running the first-in-human Phase 1 study of the drug in advanced solid tumors and advanced breast cancer across sites in the United States, Belgium, France, Italy, South Korea, and Spain.

What phase is OKI-219 in?

OKI-219 is in Phase 1 clinical development. It is investigational and has not been approved by the FDA or any other regulatory agency. The single ongoing Phase 1 trial is a first-in-human study that is currently active but not recruiting, with a planned enrollment of 200 patients.

What clinical trials is OKI-219 in?

OKI-219 is being studied in one active Phase 1 trial, NCT06239467, titled First-in-Human Study of OKI-219 in Advanced Solid Tumors and Advanced Breast Cancer. The trial is controlled, includes biomarker-selected patients with PI3K gene mutations, and has a planned enrollment of 200 participants.