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RecruitingNCT07546500ASPENOVAUpdated Aug 12, 2026

A Study of Azenosertib (ZN-c3) Versus Investigator's Choice Chemotherapy in Subjects With Platinum-Resistant High-Grade Serous Ovarian, Primary Peritoneal, or Fallopian Tube Cancers Positive for Cyclin E1 Protein Expression

A Phase 3 interventional study of Investigator's choice of Chemotherapy and Azenosertib in Ovarian Cancer, sponsored by K-Group, Beta, Inc., a wholly owned subsidiary of Zentalis Pharmaceuticals, Inc. Recruiting at 59 sites in 12 countries. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-12.

Sponsored by K-Group, Beta, Inc., a wholly owned subsidiary of Zentalis Pharmaceuticals, Inc · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
420
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

This is a randomized, Phase 3 trial designed to evaluate the efficacy and safety of azenosertib compared to Investigator's choice of chemotherapy in subjects with platinum-resistant ovarian cancer whose tumors are positive for cyclin E1 protein expression.

Read the detailed description

A Phase 3 study to evaluate the efficacy, safety, and overall clinical benefit of azenosertib (ZN-c3) compared with Investigator's choice of chemotherapy in subjects with Platinum-Resistant, High-Grade Serous Ovarian, Fallopian Tube, or Primary Peritoneal Cancer. Azenosertib is a selective and orally bioavailable inhibitor of WEE1. In HGSOC, high Cyclin E1 protein drives replication stress and increases tumor reliance on WEE1-mediated G2/M checkpoint control. Treating tumor cells with azenosertib promotes premature cell cycle progression leading to increased replication stress and accumulation of DNA damage pushing cells to mitotic catastrophe resulting in tumor cell death.

02

Conditions studied

  • Ovarian Cancer

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Keywords

  • Platinum-Resistant Ovarian Cancer (PROC)
  • OvCa
03

Who can participate

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

Inclusion criteria

  1. Female age ≥ 18 years
  2. High-grade serous epithelial ovarian, primary peritoneal, or fallopian tube cancer
  3. Measurable disease per RECIST Version 1.1
  4. Eastern Cooperative Oncology Group (ECOG) performance status score 0-1
  5. The subject's tumor tissue must be positive for cyclin E1 protein expression per the Sponsor's clinically validated cyclin E1 IHC investigational, in vitro diagnostic assay
  6. Prior Therapy:

    1. Subject must have platinum-resistant disease
    2. One to 3 prior lines or regimens are allowed (1 to 4 prior lines are permitted, if prior mirvetuximab)
    3. Prior bevacizumab treatment is required, if eligible per standard of care
    4. Prior PARP inhibitor treatment is required if BRCA 1/2 mutation or HRD, if eligible per standard of care
    5. Prior mirvetuximab treatment is required, if eligible per standard of care
  7. Adequate hematologic and organ function during the screening period

Exclusion criteria

Exclusion Criteria:

  1. History of another malignancy in the previous 2 years, unless cured by surgery alone and continuously disease-free. Exceptions include appropriately treated carcinoma in situ of the cervix, nonmelanoma skin carcinoma, Stage 1 uterine cancer, or other malignancies with an expected curative outcome.
  2. Subjects with primary platinum-refractory disease.
  3. Prior therapy with azenosertib or any other WEE1 inhibitor, ATR inhibitor, CHK1/2 inhibitor, or (PKMYT1) inhibitor for PROC.
  4. A serious illness or medical condition(s) including, but not limited to, the following:

    1. Clinically or radiographically unstable brain metastases or leptomeningeal disease that requires immediate treatment. Subjects with asymptomatic brain metastases are eligible.
    2. Acute kidney injury requiring intervention, or presence of indwelling urinary catheter or percutaneous nephrostomy.
    3. Significant gastrointestinal abnormalities, including an inability to take oral medication, requirement for IV alimentation, active peptic ulcer, chronic diarrhea or vomiting considered to be clinically significant in the judgment of the Investigator, or prior surgical procedures affecting absorption.
    4. Any evidence of small bowel obstruction as determined by air/fluid levels on computed tomography (CT) scan, recent hospitalization for small bowel obstruction within 3 months before randomization, or recurrent paracentesis or thoracentesis within 6 weeks before randomization.
    5. Active, uncontrolled infection. Subjects with an infection receiving treatment (antibiotic, antifungal, or antiviral) must have completed such treatment and the infection must be considered controlled/resolved (and afebrile) by the Investigator for at least 7 days before randomization
    6. Myocardial impairment of any cause resulting in heart failure by New York Heart Association criteria (Class II, III or IV).
    7. Medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or may interfere with the interpretation of study results
  5. Any of the following treatment interventions within the specified time frame before randomization:

    1. Hospitalization within 14 days
    2. Major surgery within 28 days
    3. Any chemotherapy or targeted tumor therapy within 21 days or 5 half-lives (whichever is shorter)
    4. Radiation therapy within 21 days
    5. Autologous or allogeneic stem cell transplant within 3 months
    6. Current use of any other investigational drug therapy \< 28 days or 5 half-lives (whichever is shorter)
  6. Inability to discontinue treatment with prescription or nonprescription drugs that are prohibited per protocol.
  7. Inability to discontinue consumption of food and herbal supplements that are prohibited per protocol
  8. Prior wide-field radiotherapy affecting ≥ 20% of the bone marrow.
  9. Unresolved toxicity of Grade > 1 attributed to any prior therapies (excluding Grade ≤ 2 neuropathy, alopecia, or skin pigmentation).
  10. Subjects who are immunocompromised or HIV-positive on highly active anti-retroviral therapy
  11. Subjects with known active hepatitis B or hepatitis C infection
  12. Individuals who are judged by the Investigator to be unsuitable as study subjects
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
420 participants (estimated)

Study arms

  • Experimental
    Arm A Azenosertib 400 mg administered daily on a 5 days on, 2 days off intermittent schedule

    Drug: Azenosertib

  • Active comparator
    Experimental: Arm C Investigator's choice of chemotherapy at the dose defined by the protocol

    Drug: Investigator's choice of Chemotherapy

Interventions

  • DrugInvestigator's choice of Chemotherapy

    The investigator will select the chemotherapy in accordance with the protocol defined requirements. The possible choices as defined by the protocol: * Paclitaxel * Gemcitabine * Pegylated liposomal doxorubicin (PLD) * Topotecan The selected chemotherapy will be administered intravenously

  • DrugAzenosertib

    Azenosertib 400 mg will be administered orally.

    Also known as: ZN-c3

05

What researchers measure

Primary outcomes

  1. Progression free survival (PFS) per RECIST v1.1 as assessed by Investigator

    Time from randomization to the first documented tumor progression (per RECIST v1.1) or death from any cause, whichever occurs first.

    Time frame: Up to approximately 24 months from the enrollment of the last subject

Secondary outcomes

  1. Overall survival

    Time from randomization until death due to any cause

    Time frame: Up to approximately 24 months from the enrollment of the last subject

  2. PFS per RECIST 1.1 as assessed by blinded independent central review (ICR)

    Time from randomization to the first documented tumor progression (per RECIST v1.1) or death from any cause, whichever occurs first.

    Time frame: Up to approximately 24 months from the enrollment of the last subject

  3. Objective Response Rate (ORR) per RECIST v1.1 and assessed by Investigator

    Proportion of patients who attain a partial response (PR) or complete response (CR) per RECIST v1.1

    Time frame: Up to approximately 24 months from the enrollment of the last subject

  4. Change from baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire score (EORTC QLQ)-Core 30 (C30) at each post baseline visit

    Assess changes over time in cancer-specific and patient-reported outcome instruments assessing global health status/quality of life, functional domains, and symptom burden.

    Time frame: Up to approximately 24 months from the enrollment of the last subject

  5. Change from baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire score (EORTC QLQ)-OV28 at each post baseline visit

    Assess changes over time in cancer-specific and patient-reported outcome instruments assessing global health status/quality of life, functional domains, and symptom burden.

    Time frame: Up to approximately 24 months from the enrollment of the last subject

  6. Change from baseline in EQ-5D-5L score at each post baseline visit

    Assess changes over time in cancer-specific and patient-reported outcome instruments assessing global health status/quality of life, functional domains, and symptom burden.

    Time frame: Up to approximately 24 months from the enrollment of the last subject

  7. Number of Subjects experiencing treatment emergent adverse events (TEAEs)

    Assess adverse events occurring for the first time or worsening of a pre-existing event during the treatment period until 30 days after the last dose of study drug

    Time frame: Up to approximately 24 months and 30 days from the enrollment of the last subject

06

Study locations

7 of 59 sites recruiting
  • Site 0107
    Phoenix, Arizona 85016, United States
    Not yet recruiting
  • Site 0110
    Antioch, California 94531, United States
    Not yet recruiting
  • Site 0104
    Beverly Hills, California 90212, United States
    Recruiting
  • Site 0115
    San Francisco, California 94109, United States
    Not yet recruiting
  • Site 0101
    Torrance, California 90505, United States
    Recruiting
  • Site 0111
    Camden, New Jersey 08103, United States
    Not yet recruiting
  • Site 0108
    Columbus, Ohio 43026, United States
    Not yet recruiting
  • Site 0105
    Portland, Oregon 97210, United States
    Not yet recruiting
  • Site 0109
    Philadelphia, Pennsylvania 19104, United States
    Not yet recruiting
  • Site 0113
    Philadelphia, Pennsylvania 19111, United States
    Not yet recruiting
  • Site 0114
    Willow Grove, Pennsylvania 19090, United States
    Not yet recruiting
  • Site 0112
    Sioux Falls, South Dakota 57105, United States
    Not yet recruiting
  • Site 1101
    Randwick, New South Wales 2031, Australia
    Not yet recruiting
  • Site 1102
    Adelaide, South Australia 5000, Australia
    Recruiting
  • Site 1103
    Nedlands, 6009, Australia
    Not yet recruiting
  • Site 3002
    Brussels, 1020, Belgium
    Not yet recruiting
  • Site 3001
    Leuven, 3000, Belgium
    Not yet recruiting
  • Site 0201
    Toronto, Ontario M5G 2M9, Canada
    Not yet recruiting
  • Site 0204
    Montreal, Quebec H1T 2M4, Canada
    Not yet recruiting
  • Site 0203
    Montreal, Quebec H2X 0C1, Canada
    Not yet recruiting
  • Site 0202
    Sherbrooke, Quebec J1H 5N4, Canada
    Not yet recruiting
  • Site 3508
    Besançon, 25000, France
    Not yet recruiting
  • Site 3502
    Brest, 29609, France
    Not yet recruiting
  • Site 3507
    Dijon, 21079, France
    Not yet recruiting
  • Site 3504
    Lyon, 69373, France
    Not yet recruiting
  • Site 3503
    Paris, 75014, France
    Not yet recruiting
  • Site 3501
    Pierre-Bénite, 69495, France
    Not yet recruiting
  • Site 3509
    Saint-Herblain, 44805, France
    Not yet recruiting
  • Site 3505
    Strasbourg, 67098, France
    Not yet recruiting
  • Site 3506
    Villejuif, 94805, France
    Not yet recruiting
  • Site 3602
    Berlin, D-13353, Germany
    Not yet recruiting
  • Site 3601
    Dresden, 01307, Germany
    Not yet recruiting
  • Site 3703
    Cork, T12 DC4A, Ireland
    Not yet recruiting
  • Site 3702
    Dublin, D08 NYH1, Ireland
    Not yet recruiting
  • Site 3801
    Bologna, 40138, Italy
    Not yet recruiting
  • Site 3805
    Milan, 20132, Italy
    Not yet recruiting
  • Site 3804
    Milan, 20141, Italy
    Not yet recruiting
  • Site 3803
    Milan, 20159, Italy
    Not yet recruiting
  • Site 3802
    Naples, 80131, Italy
    Not yet recruiting
  • Site 3807
    Prato, 59100, Italy
    Not yet recruiting
  • Site 3806
    Rome, 00168, Italy
    Not yet recruiting
  • Site 4006
    Krakow, 30-348, Poland
    Not yet recruiting
  • Site 4001
    Lodz, 93-338, Poland
    Not yet recruiting
  • Site 4004
    Poznan, 61-848, Poland
    Not yet recruiting
  • Site 4003
    Szczecin, 70-111, Poland
    Not yet recruiting
  • Site 1203
    Daegu, 42601, South Korea
    Recruiting
  • Site 1206
    Goyang-si, 10408, South Korea
    Not yet recruiting
  • Site 1202
    Seoul, 03080, South Korea
    Recruiting
  • Site 1205
    Seoul, 03722, South Korea
    Recruiting
  • Site 1204
    Seoul, 06273, South Korea
    Not yet recruiting
  • Site 1201
    Seoul, 06351, South Korea
    Recruiting
  • Site 4201
    Barcelona, 08028, Spain
    Not yet recruiting
  • Site 4205
    Barcelona, 08041, Spain
    Not yet recruiting
  • Site 4202
    Madrid, 28034, Spain
    Not yet recruiting
  • Site 4206
    Madrid, 28040, Spain
    Not yet recruiting
  • Site 4203
    Málaga, 29011, Spain
    Not yet recruiting
  • Site 4204
    Vigo, 36212, Spain
    Not yet recruiting
  • Site 1301
    Taichung, 40705, Taiwan
    Not yet recruiting
  • Site 1302
    Taipei, 11217, Taiwan
    Not yet recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07546500
Lead sponsor
K-Group, Beta, Inc., a wholly owned subsidiary of Zentalis Pharmaceuticals, Inc
Collaborators
European Network of Gynaecological Oncological Trial Groups (ENGOT), GOG Foundation
Responsible party
Sponsor
First posted
Apr 22, 2026
Start date
Apr 17, 2026
Primary completion
May 31, 2028 (estimated)
Completion
Apr 30, 2030 (estimated)
Last update
Aug 12, 2026

Study contacts

Project Director
Contact
medicalaffairs@zentalis.com
858.263.4333

Oversight

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

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