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Azenosertib

Phase 2

Uterine Serous Carcinoma | Small molecule | Oncology |Zentalis Pharmaceuticals, Inc.|Last Updated: Jul 1, 2026

Success Probability
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Market & Valuation
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Trial Design
UNCONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment117
FDA Designations
FAST_TRACK
Clinical trial landscape

Azenosertib · 8 trials · 17 indications

Phase 2 3Phase 1 5
NCT06369155Azenosertib in Uterine Serous Carcinoma: Biomarker StudyUterine Serous Carcinoma
RECRUITING25 Analytics
NCT05128825A Study of Azenosertib (ZN-c3) in Subjects With Platinum-Resistant High-Grade Serous Ovarian, Fallopian Tube or Primary Peritoneal CancerHigh-Grade Serous Ovarian, Fallopian Tube or Primary Peritoneal Cancer
RECRUITING310 Analytics
NCT04814108A Study of Azenosertib (ZN-c3) in Women With Recurrent or Persistent Uterine Serous CarcinomaUterine Serous Carcinoma
COMPLETED92 Analytics
PHASE2RECRUITING
Azenosertib in Uterine Serous Carcinoma: Biomarker Study
Uterine Serous CarcinomaUnlock trial analytics
PHASE2RECRUITING
A Study of Azenosertib (ZN-c3) in Subjects With Platinum-Resistant High-Grade Serous Ovarian, Fallopian Tube or Primary Peritoneal Cancer
High-Grade Serous Ovarian, Fallopian Tube or Primary Peritoneal CancerUnlock trial analytics
PHASE2COMPLETED
A Study of Azenosertib (ZN-c3) in Women With Recurrent or Persistent Uterine Serous Carcinoma
Uterine Serous CarcinomaUnlock trial analytics
Study Endpoints
Primary Endpoints
Percentage Change in Replication Fork Speed in Overall Response
Up to 7 months

Replication fork speed assessed by DNA fiber assays in PDO models. Responder defined as participants achieving complete response (CR) or partial response (PR) based on RECISTv1.1 criteria. Wilcoxon rank sum tests will be used to compare the percentage change in replication fork speed with exposure to WEE1 inhibition in co-clinical models between overall response responder and non-responder.

Percentage Change in Replication Fork Speed in 6 Month Progression Free Survival (PFS6)
At 6 months

Replication fork speed assessed by DNA fiber assays in PDO models. PFS6 is a binary endpoint where patients that are alive and progression free (per RECIST 1.1) at 6 months are considered responders. All other patients (those that died or progressed prior to 6 months or those with less than 6 months of follow-up for progression) are considered non-responders. Wilcoxon rank sum tests will be used to compare the percentage change in replication fork speed with exposure to WEE1 inhibition in co-clinical models between overall response responder and non-responder.

Objective Response Rate (ORR) defined by RECIST v1.1 [Part 2]
Up to approximately 12 months from the enrollment of the last subject

Participants who achieve partial response (PR) or complete response (CR) per RECIST v1.1 criteria.

Frequency and severity of TEAEs
2 years

To determine the safety and tolerability of ZN-c3 in subjects with recurrent or persistent USC.

Objective Response Rate as defined by the revised RECIST v1.1 as assessed by ICR
2 years

To investigate the antitumor activity of ZN-c3 in subjects with recurrent or persistent USC

Number of Participants Experiencing Dose Limiting Toxicity (DLT)
Up to 3 weeks

Detailed DLT consideration outline in protocol section 5.4. Toxicities are to be assess according to the CTCAE v5. Management and dose modifications associated with the above adverse events outlined in protocol section 6.

Maximum Tolerated Dose (MTD)
Up to 3 weeks

The MTD is defined as the highest dose level with ≤1 DLT in a cohort of 6 participants. See previous primary outcome measure for the DLT definition. If 0 out of 3 participants experience DLT, next dose level will be proceeded. If \>=1 out of the group suffer DLT, dose escalation will be stopped and 3 additional participants will be entered at the next lowest dose level. If \<=1 out of 6 DLTs, this dose level is considered as MTD.

Objective Response Rate (ORR)
Up to 6 months

ORR was defined as the proportion of participants achieving complete response (CR) or partial response (PR) on treatment based on RECIST 1.1 criteria. 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.

To investigate the safety and tolerability of ZN-c3 in combination with niraparib, including identification of the MTD and RP2D
6 months

Incidence and severity of Dose Limiting Toxicities (DLTs) in DLT-evaluable subjects during Cycle 1

To determine the safety and tolerability of ZN-c3 monotherapy
12 months

Frequency and severity of AEs and dose modifications

To investigate the antitumor activity of ZN-c3 monotherapy
12 months

ORR as defined by the revised RECIST Guideline version 1.1 and assessed by ICR.

Incidence of dose-limiting toxicities (DLT) in DLT evaluable subjects and the incidence and severity of adverse events.
Through Cycle 1 (21 days) Phase 1
Event-free survival (EFS) at 18 weeks per RECIST (Response Evaluation Criteria in Solid Tumors) Guideline version 1.1.
During phase 2, at 18 weeks

EFS at 18 weeks is defined as time from study enrollment until date of disease progression, or detection of disease at a previously uninvolved site, or date of death of the subjects at 18 weeks.

Part 1: To investigate the safety and tolerability of azenosertib in combination with PLD, carboplatin, paclitaxel, or gemcitabine
Through study completion, an average of 1 year

Incidence and severity of adverse events (AEs)

Part 1: To identify the maximum tolerated dose (MTD)/recommended Phase 2 dose (RP2D) of azenosertib in combination with PLD, carboplatin, paclitaxel, or gemcitabine
Through Cycle 1 (cycle is 28 days for PLD or paclitaxel, and 21 days for carboplatin, or gemcitabine)

Incidence and severity of dose-limiting toxicities (DLTs)

Part 2: To estimate the safety/tolerability of azenosertib in combination with bevacizumab
Through study completion, an average of 1 year

Incidence and severity of adverse events (AEs) Incidence of dose interruptions, reductions, and discontinuations due to treatment-related AEs

Part 2: To identify the recommended dose for Part 2 Dose Expansion
Through Cycle 1 (21 days)
Dose Escalation
Through completion, average of 1 year

To investigate the safety and tolerability of single agent ZN-c3, including identification of the maximum tolerated dose (MTD)/recommended Phase 2 dose (RP2D), based on the incidence and severity of adverse events (AEs) and dose-limiting toxicities (DLTs) in DLT-evaluable subjects.

Food Effect Cohort
Through completion, approx 6 months

To characterize and compare the PK (Cmax.) of ZN-c3 following a single dose of ZN-c3 under fed and fasting conditions.

Dose Expansion
Through completion, approximately 43 month

To investigate the clinical activity of WEE1 inhibition based on the objective response rate (ORR) as defined by the revised Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Secondary Endpoints
Overall Response Rate (ORR)
Up to 7 months
6-month Progression-Free Survival (PFS6)
At 6 months
Clinical Benefit Rate (CBR)
Up to 7 months
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
AzenosertibEXPERIMENTAL25 participants will be enrolled and will complete study procedures as follows: * Baseline visit with assessments and CT or MRI scan. * CT or MRIs scans every 2 cycles. * Cycle 1 through End of Treatment: --Days 1 through 5, 8 through 12, and 15 through 19: Predetermined dose of Azenosertib 1x daily. * End of Treatment visit.
Part 1a/1b (Completed Enrollment)EXPERIMENTALAzenosertib 400mg administered once daily on a 5 days on, 2 days off intermittent schedule.
Part 2a: Arm 1 (Completed Enrollment)EXPERIMENTALAzenosertib 400mg administered once daily on a 5 days on, 2 days off intermittent schedule
Part 2a: Arm 2 (Completed Enrollment)EXPERIMENTALAzenosertib 300mg administered once daily on a 5 days on, 2 days off intermittent schedule
Part 2bEXPERIMENTALAzenosertib 400mg administered once daily on a 5 days on, 2 days off intermittent schedule
Part 2cEXPERIMENTALAzenosertib 400mg administered once daily on a 5 days on, 2 days off intermittent schedule
Azenosertib Single AgentEXPERIMENTALAzenosertib (ZN-c3) taken orally with food
Phase 1: Dose Escalation ArmEXPERIMENTALParticipants will be enrolled in a standard 3+3 dose-escalation scheme to establish a Maximum Tolerated dose (MTD) of Azenosertib, starting at Dose Level 0, de-escalating to Dose Level -1, and escalating to Dose Levels 1 and 2. * Baseline visit with CT or MRI scan. * CT or MRI scan every 9 weeks until 27 weeks then every 12 weeks. * Cycle 1 through End of Treatment: * Days 1 through 5, 8 through 12, and 15 through 19 of 21 Day Cycle: Predetermined dose of Azenosertib 1 x daily. * Day 1 of 21 Day Cycle: Predetermined dose of Pembrolizumab 1x daily. * Days 1 and 8 of 21 Day Cycle: Predetermined dose of Carboplatin 1x daily. * End of Treatment visit * Follow up: every 6 months * Dose de-escalation and escalation will follow dose-limiting toxicities specifications (DLTs) per the protocol. The MTD is the highest dose level with ≤1 DLT in a cohort of 6 participants and the study will proceed to Phase 2.
Phase 2: AZENOSERTIB + PEMBROLIZUMAB + CARBOPLATINEXPERIMENTALParticipants will complete: * Baseline visit with CT or MRI scan and tumor biopsy. * CT or MRI scan every 9 weeks until 27 weeks then every 12 weeks. * Cycle 1 through End of Treatment: * Days 1 through 5, 8 through 12, and 15 through 19 of 21 Day Cycle: Predetermined dose of Azenosertib 1x daily. * Day 1 of 21 Day Cycle: Predetermined dose of Pembrolizumab 1x daily. * Days 1 and 8 of 21 Day Cycle: Predetermined dose of Carboplatin 1x daily. * Tumor biopsy during Cycle 2. * End of Treatment visit * Follow up: every 6 months
Azenosertib and NiraparibEXPERIMENTALAzenosertib in combination with Niraparib
Azenosertib in combination with GemcitabineEXPERIMENTALAzenosertib (ZN-c3) in combination with Gemcitabine
Part 1: Azenosertib + carboplatinEXPERIMENTALAzenosertib in combination with carboplatin
Part 1: Azenosertib + PLDEXPERIMENTALAzenosertib in combination with pegylated liposomal doxorubicin (PLD)
Part 1: Azenosertib + paclitaxelEXPERIMENTALAzenosertib in combination with paclitaxel
Part 1: Azenosertib + gemcitabineEXPERIMENTALAzenosertib in combination with gemcitabine
Part 2: Azenosertib + bevacizumabEXPERIMENTALAzenosertib in combination with bevacizumab
Single Agent Dose EscalationEXPERIMENTALSubjects with solid tumors with advanced or metastatic disease who are refractory or ineligible to standard therapy(ies) or for whom no standard therapy is available.
Single Agent Food Effect CohortEXPERIMENTALSubjects with solid tumors with advanced or metastatic disease who are refractory or ineligible to standard therapy(ies) or for whom no standard therapy is available. This cohort will give subjects the option to continue treatment after PK assessments are completed.
Single Agent Dose ExpansionEXPERIMENTALSubjects with recurrent, platinum-resistant HGSOC; histologically confirmed USC; or either CCNE1-amplified/cyclinE1-positive solid tumors; or subjects who roll over from ZN-c3 pharmacology studies.
Interventions
NameTypeDescription
AzenosertibDRUGWee1 inhibitor, 25mg and 100mg tablets, taken orally per protocol.
CarboplatinDRUGPlatinum coordination compound, 5-, 15-, 45-, and 60-mL vials, via intravenous (into the vein) infusion per institutional standards.
PembrolizumabDRUGHumanized immunoglobulin G4 monoclonal antibody, 4-mL vials, via intravenous (into the vein) infusion per protocol.
NiraparibDRUGNiraparib
GemcitabineDRUGGemcitabine is an approved drug
Pegylated liposomal doxorubicinDRUGPegylated liposomal doxorubicin (PLD) is an approved drug
PaclitaxelDRUGPaclitaxel is an approved drug
BevacizumabBIOLOGICALBevacizumab is an approved drug
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Eligibility Criteria
Age Range18 Years to N/A
SexFEMALE
Healthy VolunteersNo
Study Sites2

Inclusion Criteria: * Participants must have histologically or cytologically confirmed recurrent or persistent uterine serous carcinoma. For the purposes of this study, uterine carcinomas (with the exception of carcinosarcomas) that have any component that is considered serous will be considered a ...

Countries:United StatesAustraliaBelgiumFranceItalyPolandSouth KoreaSpainCanadaGeorgiaBosnia and HerzegovinaBulgariaSerbia
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Recent Changes (Last 90 Days)
LOWJul 2, 2026NCT05128825lastUpdatePostDate: changed
LOWJul 2, 2026NCT05128825lastUpdatePostDate: changed
LOWJul 2, 2026NCT05128825lastUpdatePostDate: changed
LOWJul 2, 2026NCT05128825lastUpdatePostDate: changed
MEDIUMMay 26, 2026NCT04516447Enrollment: 140 → 172
LOWMay 26, 2026NCT05128825Enrollment: 170 → 310
LOWMay 24, 2026NCT06369155studyFirstPostDate: changed
LOWMay 24, 2026NCT04516447studyFirstPostDate: changed
LOWMay 24, 2026NCT05128825studyFirstPostDate: changed
LOWMay 24, 2026NCT06351332studyFirstPostDate: changed
MEDIUMMay 21, 2026NCT04833582TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT04814108TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT04158336TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT05198804TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT04814108TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT04833582TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT04158336TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT05198804TRIAL_REMOVED: changed