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CompletedNCT02503709Updated Feb 10, 2025

Onalespib and CDKI AT7519 in Treating Patients With Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery

A Phase 1 interventional study of CDK Inhibitor AT7519 and Laboratory Biomarker Analysis in Advanced Malignant Solid Neoplasm, Metastatic Malignant Solid Neoplasm and Unresectable Solid Neoplasm, sponsored by National Cancer Institute (NCI). Completed at 6 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-02-10.

Sponsored by National Cancer Institute (NCI) · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
29
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase I trial studies the side effects and best dose of onalespib and CDKI AT7519 in treating patients with solid tumors that have spread from the primary site (place where they started) to other places in the body (metastatic) or cannot be removed by surgery. Onalespib and CDKI AT7519 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Read the detailed description

PRIMARY OBJECTIVES:

I. To establish the safety, tolerability, and the maximum tolerated dose of the combination of onalespib and AT7519M (CDKI AT7519).

SECONDARY OBJECTIVES:

I. To determine the pharmacokinetics of the combination of onalespib and AT7519M.

II. To assess the pharmacodynamic effect of the combination of onalespib and AT7519M on HSP70 expression and modulation of HSP90 client proteins in peripheral blood mononuclear cells (PBMCs), plasma, and tumor biopsies.

III. To observe and record anti-tumor activity.

OUTLINE: This is a dose-escalation study.

Patients receive onalespib intravenously (IV) over 1 hour on days 1 and 4 (cycle 0 only). Patients then receive onalespib IV over 1 hour and CDKI AT7519 IV over 1 hour on days 1, 4, 8, and 11 (cycle 1 and subsequent cycles thereafter). Cycles repeat every 21 days (7 days for course 0 only) in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up for 30 days.

02

Conditions studied

  • Advanced Malignant Solid Neoplasm
  • Metastatic Malignant Solid Neoplasm
  • Unresectable Solid Neoplasm

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03

In context

Neoplasm Metastasis

3,562 studies on the registry are indexed under Neoplasm Metastasis; 875 are open to participants now.

This study's enrollment of 29 is below the median of 54 across 2,800 interventional studies indexed under Neoplasm Metastasis.

Browse Neoplasm Metastasis studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,554 studies on the registry; 334 are open to participants now.

Of its 407 completed or terminated interventional studies of FDA-regulated products, 370 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients must have histologically confirmed solid tumor that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective
  • Patients must have evaluable disease or disease measurable per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1; measurable disease is defined as at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as >= 20 mm (>= 2 cm) with conventional techniques or as >= 10 mm (>= 1 cm) with spiral computed tomography (CT) scan, magnetic resonance imaging (MRI), or calipers by clinical exam
  • There are no limits on prior lines of therapy; however, patients must have recovered to eligibility levels from prior toxicity or adverse events as a result of previous treatment prior to entering the study (except alopecia)
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Life expectancy of greater than 3 months
  • Absolute neutrophil count >= 1,500/microliters
  • Platelets >= 100,000/microliters
  • Total bilirubin =\< 1.5 X institutional upper limit of normal
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =\< 2.5 X institutional upper limit of normal
  • Creatinine \< 1 X institutional upper limit of normal OR creatinine clearance >= 50 mL/min determined by Cockcroft-Gault formula
  • Creatine phosphokinase =\< institutional upper limit of normal
  • The effects of onalespib and AT7519M on the developing human fetus are unknown; for this reason, women of childbearing potential and male patients with partners of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry, for the duration of study participation, and for 2 months after completion of study; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; women of childbearing potential enrolling on study must have a negative pregnancy test within 72 hours of enrollment in order to be eligible; because there is an unknown but potential risk to nursing infants secondary to treatment of the mother with onalespib and AT7519M, breastfeeding should be discontinued while the mother is treated with onalespib and AT7519M
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion criteria

Exclusion Criteria:

  • Patients who have had chemotherapy or radiotherapy within 3 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study; patients who have had prior onalespib or AT7519M as a monotherapy will not be excluded
  • Patients who are receiving any other investigational agents
  • Patients with known brain metastases or carcinomatous meningitis are excluded from this clinical trial, with the exception of patients with brain metastatic disease that has previously been treated and remained stable on MRI >= 2 months after treatment, without steroids or anti-epileptic medications; these patients may be enrolled at the discretion of the principal investigator
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to onalespib or AT7519M
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements; additionally, patients with other co-morbid disease or metabolic dysfunction that would render the subject at high risk for treatment complications may be excluded at the discretion of the principal investigator in the interest of patient safety
  • The effects of onalespib and AT7519M on the developing human fetus are unknown; for this reason, pregnant women are excluded from this study
  • Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy known to interact with CYP isoenzymes are ineligible; in addition, HIV patients with CD4 count \< 200 cells/uL are ineligible; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated
  • Consistent corrected QT (QTc) > 450 msec for men and > 470 msec for women by Fridericia formula, on 3 separate electrocardiograms (ECGs); patients with a history of long QTc syndrome or personal or family history of ventricular arrhythmias will be excluded
  • Patients with pre-existing retinal disease on ophthalmologic exam will be excluded due to potential eye toxicities known to be associated with onalespib
  • Patients with left ventricular ejection fraction \< 50% on echocardiogram or multigated acquisition scan will be excluded based on known cardiotoxicities associated with onalespib
  • Patients with grade >= 2 peripheral neuropathy will not be permitted on study
05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
29 participants (actual)

Study arms

  • Experimental
    Treatment (onalespib, CDKI AT7519)

    Patients receive onalespib IV over 1 hour on days 1 and 4 (cycle 0 only). Patients then receive onalespib IV over 1 hour and CDKI AT7519 IV over 1 hour on days 1, 4, 8, and 11 (cycle 1 and subsequent cycles thereafter). Cycles repeat every 21 days (7 days for course 0 only) in the absence of disease progression or unacceptable toxicity.

    Drug: CDK Inhibitor AT7519 · Other: Laboratory Biomarker Analysis · Drug: Onalespib · Other: Pharmacological Study

Interventions

  • DrugCDK Inhibitor AT7519

    Given IV

    Also known as: AT-7519, AT7519, AT7519M, CDK inhibitor AT7519M, Cyclin-Dependent Kinase Inhibitor AT7519M

  • OtherLaboratory Biomarker Analysis

    Correlative studies

  • Given IV

    Also known as: AT 13387, AT-13387, AT13387

  • OtherPharmacological Study

    Correlative studies

06

What researchers measure

Primary outcomes

  1. Incidence of adverse events of onalespib and CDKI AT7519

    Scored using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

    Time frame: Up to 30 days after the last dose of study drug

  2. Tolerability of onalespib and CDKI AT7519

    Assessed using the NCI CTCAE version 5.0.

    Time frame: Up to 30 days after the last dose of study drug

  3. Maximum tolerated dose of onalespib and CDKI AT7519

    Defined as =\< 1 out of 6 patients experiencing dose limiting toxicity.

    Time frame: 21 days

Secondary outcomes

  1. Pharmacokinetic parameters of onalespib and CDKI AT7519

    Individual patient plasma concentration-time curves will be analyzed by noncompartmental methods using routines supplied in the WinNonlin Professional Version 4.0.1 software package. Pharmacokinetic parameters and variables will be calculated according to standard equations. Mean values of the pharmacokinetic parameters will be statistically compared using the paired two-tailed t-test of the log-transformed data.

    Time frame: Before infusion, at 30 and 59 minutes of infusion, and at 1.5, 2, 4, 6, 8, and 24 hours at end of infusion on day 1 of course 0 and days 1 and 11 of course 1

  2. Pharmacodynamic (PD) parameters of onalespib and CDKI AT7519

    PD effect of the combination of onalespib and CDKI AT7519 on Hsp70 expression and modulation of Hsp90 client proteins in peripheral blood mononuclear cells (PBMCs) will be assessed. All PD evaluations and comparisons will be done with exploratory intent, using primarily descriptive and non-parametric techniques.

    Time frame: Prior to onalespib administration during course 0, 2-4 hours after completion of onalespib on day 4 of course 0, and 2-4 hours after completion of CDKI AT7519 on day 11 of course 1

  3. Antitumor activity of the combination

    Measured by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v.1.1).

    Time frame: Up to 30 days after the last dose of study drug

07

Study locations

6 sites
  • MedStar Georgetown University Hospital
    Washington D.C., District of Columbia 20007, United States
  • National Cancer Institute Developmental Therapeutics Clinic
    Bethesda, Maryland 20892, United States
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
  • Massachusetts General Hospital Cancer Center
    Boston, Massachusetts 02114, United States
  • Dana-Farber Cancer Institute
    Boston, Massachusetts 02215, United States
  • Ohio State University Comprehensive Cancer Center
    Columbus, Ohio 43210, United States
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Sep 2016 to primary completion in Aug 2020, 46 months.

Of 165 non-industry phase 1 interventional studies under Neoplasm Metastasis, half reached primary completion within 56 months of starting (the median), counting those still running; a quarter within 35 and three quarters within 107. This study's 46 months is below that.

Counting every sponsor, half of 372 studies reached it within 53 months; a quarter within 33 and three quarters within 85.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 20, 2015
First posted
Jul 21, 2015
StartActual
Sep 30, 2016
Primary completionActual
Aug 15, 2020
CompletionActual
Oct 9, 2020
Last update
Feb 10, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 10, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT02503709
Responsible party
Sponsor
First posted
Jul 21, 2015
Start date
Sep 30, 2016
Primary completion
Aug 15, 2020
Completion
Oct 9, 2020
Last update
Feb 10, 2025

Study contacts

Khanh T Do
principal investigator · Dana-Farber - Harvard Cancer Center LAO

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Onalespib

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