Phase II Trial of Ceralasertib (AZD6738) Alone and in Combination With Olaparib or Durvalumab in Patients With Selected Solid Tumor Malignancies

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information Started >3 years ago More information

Trial Details

Sponsor: Rahul Aggarwal (other)

Phase: 2

Start date: Jan. 17, 2019

Planned enrollment: 89

Trial ID: NCT03682289
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More trial details at ClinicalTrials.gov More info

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Goal: Evaluate the antitumor activity and safety of the ATR inhibitor ceralasertib given alone or combined with olaparib or durvalumab in biomarker-selected advanced solid tumors, and determine whether biomarker-driven assignment (ARID1A status or ATM loss) enriches for clinical benefit.

Patients: Adults with locally advanced or metastatic solid tumors after at least one prior systemic therapy. Three biomarker-defined groups: (1) ARID1A subgroup including RCC (predominant clear cell), urothelial, all pancreatic cancers, endometrial/ovarian, and other solid tumors excluding clear cell ovarian and endometrial; (2) ATM-loss subgroup including metastatic castration-resistant prostate cancer and other solid tumors with pathogenic ATM mutation and/or loss of ATM expression by IHC; (3) Endometrial cancer cohort with pathogenic ARID1A alteration, microsatellite-stable or MMR-intact, and prior exposure to an immune checkpoint inhibitor. ECOG 0–1, measurable disease (RECIST 1.1; PCWG3 criteria for mCRPC as applicable), adequate organ function, and recovery from prior therapy required. Key exclusions include prior ATR inhibitor, uncontrolled CNS disease, significant cardiovascular disease, active autoimmune disease for the durvalumab cohort, strong CYP3A interactions, and chronic viral hepatitis with positive viral load.

Design: Phase II, open-label, nonrandomized, multicohort study with biomarker- and histology-directed assignment to three therapeutic regimens. Planned enrollment is 89. Treatment continues until progression, unacceptable toxicity, or withdrawal; treatment beyond initial progression may be allowed with PI approval.

Treatments: Ceralasertib monotherapy: 160 mg BID days 1–14 of 28-day cycles for patients who are BAF250a negative or have ATM mutation/ATM loss. Ceralasertib plus olaparib: ceralasertib 160 mg daily days 1–7 plus olaparib 300 mg BID days 1–28 in 28-day cycles for BAF250a positive tumors. Ceralasertib plus durvalumab: ceralasertib 240 mg BID days 1–7 plus durvalumab 1500 mg IV day 8 every 28 days for the endometrial cancer cohort, with potential treatment beyond first radiographic progression. Ceralasertib is an oral, selective ATR kinase inhibitor targeting the DNA damage response; ATR blockade impairs replication stress signaling and DNA repair, promoting tumor cell death, particularly in tumors with DDR defects such as ARID1A or ATM alterations. Early-phase trials have shown manageable hematologic toxicity and signals of activity as monotherapy and in combinations, including with PARP inhibitors and immune checkpoint blockade. Olaparib is a PARP inhibitor used broadly in DDR-deficient cancers. Durvalumab is an anti–PD-L1 antibody approved across multiple indications; here it is combined with ATR inhibition to potentially augment immunogenicity and checkpoint response.

Outcomes: Primary endpoints: ORR by RECIST 1.1 for ARID1A cohort (monotherapy and ceralasertib plus olaparib arms), composite response in mCRPC with ATM loss (RECIST 1.1 ORR and/or PSA50 by PCWG3), ORR in other ATM-loss solid tumors, and ORR in the endometrial cohort receiving ceralasertib plus durvalumab, each tested against a 5% null rate where specified. Secondary endpoints: duration of response, progression-free survival (6 and 12 months and over time; RECIST 1.1 or PCWG3 for mCRPC), overall survival in the endometrial cohort, safety and tolerability by CTCAE v4.0, percent change in target lesion size, PSA50 rate and radiographic PFS for prostate cancer.

Burden on patient: Moderate. Oral ceralasertib with or without olaparib limits infusion visits except for the durvalumab arm, which requires IV administration every 28 days. All cohorts require regular clinic visits for toxicity monitoring, labs, and imaging per RECIST/PCWG3 typical of phase II studies. Archival tissue is required, with optional or cohort-specific biopsies for biomarker assessment; endometrial cohort mandates archival tissue for retrospective IHC. No intensive pharmacokinetic sampling is described, reducing visit complexity compared with phase I designs. Hematologic monitoring will be frequent due to expected anemia, neutropenia, and thrombocytopenia from ATR and PARP inhibition. Travel and time commitments align with 28-day cycle assessments and periodic imaging, representing a moderate incremental burden over standard-of-care follow-up for metastatic patients.

Last updated: Oct 2025

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Sites (3)

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City of Hope Comprehensive Cancer Center

Duarte, California, 91010, United States

[email protected] / No phone

Status: Recruiting

University of California, San Francisco

San Francisco, California, 94143, United States

[email protected] / 877-827-3222

Status: Recruiting

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, 60637, United States

[email protected] / 773-834-6413

Status: Recruiting

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