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RecruitingNCT06998407AVZO-023-1001Updated Aug 10, 2026

ORION-1: Study of AVZO-023 as a Single Agent and in Combination With AVZO-021, and/or Endocrine Therapy in Advanced Solid Tumors

A Phase 1/2 interventional study of AVZO-021 and Fulvestrant in HR+/HER2- Breast Cancer and HR+, HER2-, Advanced Breast Cancer, sponsored by Avenzo Therapeutics, Inc.. Recruiting at 16 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-10.

Sponsored by Avenzo Therapeutics, Inc. · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
380
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study, the first clinical trial of AVZO-023, aims to determine the safety, tolerability, pharmacokinetics (PK), pharmacodynamics, maximum tolerated dose, and anti-tumor effects of AVZO-023 in patients with advanced solid tumors. AVZO-023 is an oral medication that inhibits cyclin-dependent kinase 4 (CDK4).

Read the detailed description

AVZO-023 is an oral, potent, and selective inhibitor of CDK4. AVZO-021 is an oral, potent, and selective inhibitor of CDK2 that is currently being investigated in a global Phase 1/2 study in patients with advanced hormone receptive positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) breast cancer (NCT05867251).

In Phase 1, the safety and tolerability of AVZO-023 in patients with HR+/HER2- locally advanced or metastatic breast cancer (mBC) will be assessed. The goal of Phase 1 is to determine the MTD/preliminary RP2D of AVZO-023 for use as monotherapy and in combination with AVZO-021 with or without endocrine therapy (ET).

Phase 2 will assess the antitumor activity and confirm the RP2D of AVZO-023 in combination therapy in patients with HR+/HER2- locally advanced or mBC.

02

Conditions studied

  • HR+/HER2- Breast Cancer
  • HR+, HER2-, Advanced Breast Cancer
03

Who can participate

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

Eligibility criteria

Key Inclusion Criteria:

  • Male or female aged ≥ 18 years old at screening with Eastern Cooperative Oncology Group (ECOG) 0-1 and life expectancy > 3 months
  • Patients with histologically or cytologically proven advanced malignancies of preferred indications
  • Measurable disease (as assessed by investigator using RECIST v1.1) is preferred in Phase 1 dose escalation, unless otherwise specified in the protocol, and in all patients in Phase 2. Bone only disease is allowed in dose escalation.
  • Agree to provide molecular test report results to confirm eligibility and archival tumor samples and/or fresh biopsy, as applicable
  • Adequate renal, liver, and bone marrow function

Key Exclusion Criteria:

  • Patients should not have received any prior selective investigational CDK (CDK2, CDK4, CDK2/4, CDK2/4/6) inhibitors
  • Has known active brain metastasis (have either previously untreated intracranial CNS metastasis or previously treated intracranial central nervous system (CNS) metastasis with radiologically documented new or progressing CNS lesions) or leptomeningeal disease
  • Other concurrent invasive malignancy or a prior invasive malignancy for which treatment was completed within 3 years before the first dose on study except for adequately treated basal cell or squamous cell skin cancer, carcinoma in situ, or colorectal adenomatous polyps
  • Last anticancer treatment within 2 weeks (4 weeks for biologic, immunotherapy or ADC) or 5 half-lives of the drug, whichever is shorter, prior to first dose on study
  • Major surgery within 4 weeks prior to first dose on study
  • Have received radiotherapy with a limited field of radiation for palliation within 7 days of the first dose of study treatment, except for patients receiving whole brain radiotherapy, which must be completed at least 4 weeks prior to the first dose of study treatment. Patients must have recovered from all radiation-related toxicities, not require corticosteroids, and not have active radiation pneumonitis. Patients who received radiation of >25% of bone marrow are excluded.
  • Strong or moderate CYP3A4 inhibitors or inducers within 2 weeks or 5 half-lives of the drug, whichever is shorter, prior to first dose on study
  • History of serious cardiovascular conditions within 6 months prior to first dose on study
  • Unresolved toxicities from prior therapy greater than Grade 1 (per CTCAE version 5.0) (with exceptions of alopecia, vitiligo, and ≤ Grade 2 peripheral neuropathy) prior to the first dose on study
  • History of drug-induced pneumonitis/interstitial lung disease
  • Confirmed loss of function mutation or deletion of Rb1 gene
  • Previous high-dose chemotherapy requiring stem cell rescue
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
380 participants (estimated)

Study arms

  • Experimental
    Phase 1, monotherapy (Part 1A) and food effect

    Escalating doses of twice daily, oral AVZO-023 in 28-day cycles, with addition of fulvestrant

    Drug: Fulvestrant · Drug: AVZO-023

  • Experimental
    Phase 1, combination (Parts 1B)

    Escalating doses of twice daily, oral AVZO-023 in combination with once daily, oral AVZO-021 in 28-day cycles, with addition of fulvestrant

    Drug: AVZO-021 · Drug: Fulvestrant · Drug: AVZO-023

  • Experimental
    Phase 1, combination (Parts 1C)

    Escalating doses of twice daily, oral AVZO-023 in combination with once daily, oral AVZO-021, with once daily, oral letrozole in 28-day cycles

    Drug: AVZO-021 · Drug: Letrozole · Drug: AVZO-023

  • Experimental
    Phase 2, combination (Cohorts 2A, 2B, 2C, and 2D)

    Oral doses of AVZO-023 in 28-day cycles at the RP2D determined in Part 1B/1C, in combination with: 2A) letrozole 2B) fulvestrant 2C) AVZO-021 plus fulvestrant 2D) AVZO-021 plus letrozole

    Drug: AVZO-021 · Drug: Fulvestrant · Drug: Letrozole · Drug: AVZO-023

Interventions

  • DrugAVZO-021

    AVZO-021 is an oral selective CDK2 inhibitor

  • DrugFulvestrant

    Antineoplastic agent, estrogen receptor antagonist

    Also known as: Faslodex

  • DrugLetrozole

    Antineoplastic agent, aromatase inhibitor

    Also known as: Femara

  • DrugAVZO-023

    AVZO-023 is an oral selective CDK4 inhibitor

05

What researchers measure

Primary outcomes

  1. Occurrence of Dose Limiting Toxicities (DLTs) during the first cycle (Phase 1)

    Number of participants with DLTs assessed for severity using CTCAE v5.0 criteria will be summarized by dose level.

    Time frame: Cycle 1 (28 Days)

  2. Number of Participants with Treatment Emergent Adverse Events (TEAEs) and lab abnormalities (Phase 1)

    Time frame: From baseline until end of study treatment or study completion (approximately 2 years)

  3. Determine the Maximum Tolerated Dose (MTD) and/or Recommended Phase 2 Dose (RP2D) (Phase 1)

    Time frame: Approximately 16 months

  4. Objective Response Rate (ORR) (Phase 2)

    Defined as the proportion of patients with a confirmed Complete Response (CR) or Partial Response (PR), as determined by the investigator by radiographic disease assessment according to RECIST v1.1.

    Time frame: From baseline through disease progression or study completion (approximately 2 years)

Secondary outcomes

  1. Objective Response Rate (ORR) (Phase 1)

    Time frame: From baseline through disease progression or study completion (approximately 2 years)

  2. Duration of response (DOR) (Phase 1 and Phase 2)

    Defined as the time from the first confirmed response to radiologic/objective progression.

    Time frame: From baseline through time to event on study or study completion (approximately 2 years)

  3. Progression Free Survival (PFS) (Phase 1 and Phase 2)

    Defined as the time from study drug treatment to death or disease progression, as determined by the investigator by radiographic disease assessment according to RECIST v1.1.

    Time frame: From baseline through time to event on study or study completion (approximately 2 years)

  4. Overall Survival (OS) (Phase 1 and Phase 2)

    Defined as the time from study drug treatment initiation to death from any cause.

    Time frame: Approximately 76 months

  5. Disease control rate (DCR) (Phase 1 and Phase 2)

    Defined as the proportion of patients who achieve tumor relief (CR or PR) and stable disease (SD) after treatment; calculated as the sum of CR, PR, and SD.

    Time frame: From baseline through disease progression or study completion (approximately 2 years)

  6. Clinical benefit rate (CBR) (Phase 1 and Phase 2)

    Defined as the percentage of advanced cancer patients who achieve CR, PR, or at least six months of SD after treatment.

    Time frame: From baseline through disease progression or study completion (approximately 2 years)

  7. PK Parameters: Maximum plasma concentration (Cmax) (Phase 1)

    Time frame: Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)

  8. PK Parameters: Time to maximum plasma concentration (Tmax) (Phase 1)

    Time frame: Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)

  9. PK Parameters: Elimination half-life (t1/2) (Phase 1)

    Time frame: Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)

  10. PK Parameters: Area under the plasma concentration-time curve from time 0 to last measurable concentration (AUC 0-last) (Phase 1)

    Time frame: Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)

  11. Determination of RP2D (Phase 2)

    Time frame: Approximately 16 months

  12. Number of Participants with Treatment Emergent Adverse Events (TEAEs) and lab abnormalities (Phase 2)

    Time frame: From baseline until end of study treatment or study completion (approximately 2 years)

06

Study locations

16 of 16 sites recruiting
  • Avenzo Therapeutics Recruiting Site
    Los Angeles, California 90025, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Los Angeles, California 90095, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    New Haven, Connecticut 06519, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Orlando, Florida 32827, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Sarasota, Florida 34232, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Tampa, Florida 33612, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Boston, Massachusetts 02215, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    New York, New York 10016, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Cleveland, Ohio 44106, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Columbus, Ohio 43221, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Nashville, Tennessee 37203, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Fort Worth, Texas 76104, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Houston, Texas 77030, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    San Antonio, Texas 78229, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Fairfax, Virginia 22031, United States
    • Avenzo Therapeutics · Contact
    Recruiting
  • Avenzo Therapeutics Recruiting Site
    Seattle, Washington 98109, United States
    • Avenzo Therapeutics · Contact
    Recruiting
07

Registry details

Key details

Study ID
NCT06998407
Lead sponsor
Avenzo Therapeutics, Inc.
Responsible party
Sponsor
First posted
May 31, 2025
Start date
Aug 20, 2025
Primary completion
Aug 2028 (estimated)
Completion
Aug 2030 (estimated)
Last update
Aug 10, 2026

Study contacts

Medical Information
Contact
ClinicalTrials@avenzotx.com
(858) 239-2944

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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