Safety, PK and Efficacy of ONC-392 in Monotherapy and in Combination of Anti-PD-1 in Advanced Solid Tumors and NSCLC (PRESERVE-001)
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ClinicalTrials.gov Identifier: NCT04140526 |
Recruitment Status :
Recruiting
First Posted : October 28, 2019
Last Update Posted : March 20, 2023
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Condition or disease | Intervention/treatment | Phase |
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Non Small Cell Lung Cancer Advanced Solid Tumor Metastatic Melanoma Metastatic Head and Neck Carcinoma Metastatic Renal Cell Carcinoma Metastatic Colorectal Cancer Sarcomas Metastatic Prostate Cancer Ovarian Cancer Small Cell Lung Cancer Metastatic Breast Cancer Pancreas Cancer Gastric Cancer Esophageal Cancer Gastroesophageal Junction Adenocarcinoma Cervical Cancer Adenoid Cystic Carcinoma Salivary Gland Cancer Urothelial Carcinoma | Drug: ONC-392 Drug: Pembrolizumab | Phase 1 Phase 2 |

Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 914 participants |
Allocation: | Non-Randomized |
Intervention Model: | Sequential Assignment |
Intervention Model Description: | Open label |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Safety, Pharmacokinetics (PK), and Efficacy of ONC-392 as a Single Agent and in Combination With Pembrolizumab in Advanced Solid Tumors and NSCLC: An Open Label Phase IA/IB Study. Preserve CTLA4 Checkpoint Function (PRESERVE-001) |
Actual Study Start Date : | September 16, 2020 |
Estimated Primary Completion Date : | December 31, 2023 |
Estimated Study Completion Date : | December 31, 2024 |

Arm | Intervention/treatment |
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Experimental: ONC-392 Treatment as single agent
The Part A study will test ONC-392 intravenous (IV) infusion up to five predefined dose levels from 0.1 mg/kg to 10 mg/kg ONC-392 as monotherapy every 21 days (Q3W). The Part A study will determine the maximal tolerable dose (MTD) and the recommended Phase 2 dose in monotherapy (RP2D-M). In Part C, Arms A-C, I-N monotherapy expansion cohorts will further assess the safety and efficacy of ONC-392 in different dose levels as monotherapy in pancreatic cancer, triple negative breast cancer, non small cell lung cancer with driver mutations, PD-1 resistant non small cell lung cancer, PD-1 resistant melanoma, head and neck cancer, ovarian cancer, renal cell carcinoma and other solid tumors. Part D is a Phase II study on recurrent and/or metastatic adenoid cystic carcinoma. |
Drug: ONC-392
ONC-392 will be given by intravenous infusion, once every 21 days (Q3W). In Part C Arm M and in Part D, ONC-392 will be given Q4W.
Other Name: A humanized anti-CTLA4 IgG1 monoclonal antibody made by OncoC4, Inc. |
Experimental: ONC-392 in combination with pembrolizumab
The Part B1 study will test ONC-392 intravenous (IV) infusion, Q3W, in combination with fixed dose of pembrolizumab. The dose for pembrolizumab will be fixed at 200mg/cycle dosed every 21 days (Q3W). The Part B1 will start at one level below RP2D-M dose for ONC-392 and 200mg of pembrolizumab. When 2 DLTs occur before 6 patients are enrolled, the ONC-392 dose will be decreased to the next dose level until ≤ 1/6 patients treated at that dose develops a DLT. This dose level will be designated RP2D-C. In Part C, the expansion cohorts Arm D to G will assess the safety and efficacy of ONC-392 in different dose levels and Pembrolizumab combination therapy in non small cell lung cancer, and metastatic melanoma. |
Drug: ONC-392
ONC-392 will be given by intravenous infusion, once every 21 days (Q3W). In Part C Arm M and in Part D, ONC-392 will be given Q4W.
Other Name: A humanized anti-CTLA4 IgG1 monoclonal antibody made by OncoC4, Inc. Drug: Pembrolizumab Pembrolizumab will be given intravenous (IV) infusion at 200 mg/cycle, once every 21 days (Q3W).
Other Names:
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- Dose limiting toxicity (DLT) in monotherapy [ Time Frame: 21 days ]The number of subjects who have dose limiting toxicity during the first cycle of study drug, ONC-392, administration.
- Maximal tolerable dose (MTD) in monotherapy [ Time Frame: 21 days ]The study drug, ONC-392, dose level that has two out of six subjects who have dose limiting toxicity.
- Recommended Phase II Dose (RP2D) [ Time Frame: 21 days ]The study drug, ONC-392, dose level that is one level below MTD, or an intermediate dose level that below MTD and pre-specified in protocol. This dose level will be the RP2D for monotherapy.
- Rate of treatment related adverse events (TRAE) according to CTCAE v5.0 [ Time Frame: One year ]The safety profile will be presented as tabulated TRAE.
- The serum half life of the study drug, ONC-392, in monotherapy. [ Time Frame: 12 weeks ]To determine the drug concentration in serum samples that are taken in various timepoints during the treatment in order to calculate drug half life.
- The serum half life of the study drug, ONC-392, in combination therapy with Pembrolizumab. [ Time Frame: 12 weeks ]To determine the drug concentration in serum samples that are taken in various timepoints during the treatment in order to calculate drug half life.
- Objective Response Rate (ORR) [ Time Frame: 1 year ]To determine the objective response rate based on RECIST v1.1.
- Progression Free Survival (PFS) [ Time Frame: 1 year ]To determine the progression free survival based on RECIST 1.1 and iRECIST.
- Overall Survival (OS) [ Time Frame: 1 year ]To determine the overall survival.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
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. Patients must have a histological or cytological diagnosis of NSCLC or any other type of carcinoma or sarcomas, progressive metastatic disease, or progressive locally advanced disease not amenable to local therapy.
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In the Part A Phase I dose escalation study of ONC-392 monotherapy, patients with advanced/metastatic solid tumors of any histology are eligible for participation.
Please note: tumor types of primary interest in this study are malignant melanoma, renal cell carcinoma, hepatocellular carcinoma, non-small cell lung cancer, head and neck carcinoma, gastric carcinoma, ovarian carcinoma, colorectal cancer, any type of sarcoma.
- In Part B dose finding of the ONC-392 plus pembrolizumab combination, patients with advanced/metastatic solid tumors of any histology that Pembrolizumab has been approval as standard of care are eligible for participation.
- In Part C, patients with pancreatic cancer, triple negative breast cancer, non small cell lung cancer, melanoma, Head and Neck cancer, ovarian cancer, and other solid tumors are eligible.
- In Part D, patients with recurrent and/or metastatic adenoid cystic carcinoma with disease progression within 12 months are eligible.
- Patients must have RECIST V1.1 Measurable disease:
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- Patient is male or female and >18 years of age on day of signing informed consent.
- Patient must have a performance status of 0 or 1 on the ECOG Performance Scale
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Patient must have adequate organ function as indicated by the following laboratory values:
Hematological: Absolute neutrophil count (ANC) ≥1,500 /mcL; Plateletsa ≥100,000 / mcL; Hemoglobin ≥9 g/dL or ≥5.6 mmol/L- without qualifications; Renal: Serum creatinine ≤1.5 X upper limit of normal (ULN); Hepatic: Serum total bilirubin ≤1.5 X ULN; OR Direct bilirubin ≤ ULN for patients with total bilirubin levels >1.5 ULN; AST (SGOT) and ALT (SGPT) ≤2.5 X ULN, OR ≤5 X ULN for patients with active liver metastases Coagulation: International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 X ULN Activated Partial Thromboplastin Time (aPTT) ≤1.5 X ULN
- Patient has voluntarily agreed to participate by giving written informed consent.
- Female patient of childbearing potential has a negative urine or serum pregnancy test.
- Female and Male patients must agree to use adequate methods of contraception starting with the first dose of study drug through 90 days after the last dose of study therapy.
Exclusion Criteria:
A patient meeting any of the following criteria is not eligible to participate in this study:
- Patients who have not recovered to CTCAE ≤ 1 from the AE due to cancer therapeutics. The washout period for cancer therapeutic drugs (such as chemotherapy, radioactive, or targeted therapy) is 21 days, and for antibody drug 28 days.
- Patients who are currently enrolled in a clinical trial of an investigational agent or device.
- Patients who are on chronic systemic steroid therapy at doses >10 mg/day
- Patients who have active symptomatic brain metastasis or leptomeningeal metastasis.
- Patients who have an active infection requiring systemic IV therapy within 14 days of prior to administration of ONC-392 or combined ONC-392 and Pembrolizumab.
- Patients who have a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate, in the opinion of the treating Investigator.
- Patients with known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
- Patients who are pregnant or breastfeeding.
- For the Part B and Part C Arm D to G, the patients that are deemed to be not suitable for Pembrolizumab.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04140526
Contact: Pan Zheng, MD, PhD | 202 751 6823 | pzheng@oncoc4.com | |
Contact: Martin Devenport, PhD | 4102070582 | mdevenport@oncoc4.com |

Principal Investigator: | Tianhong Li, MD | University of California, Davis |
Responsible Party: | OncoC4, Inc. |
ClinicalTrials.gov Identifier: | NCT04140526 |
Other Study ID Numbers: |
ONC-392-001 4R44CA250824-02 ( U.S. NIH Grant/Contract ) 20193108 ( Other Identifier: WIRB ) |
First Posted: | October 28, 2019 Key Record Dates |
Last Update Posted: | March 20, 2023 |
Last Verified: | March 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Carcinoma Lung Neoplasms Small Cell Lung Carcinoma Salivary Gland Neoplasms Pancreatic Neoplasms Carcinoma, Adenoid Cystic Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site Lung Diseases Respiratory Tract Diseases Carcinoma, Bronchogenic |
Bronchial Neoplasms Digestive System Neoplasms Digestive System Diseases Adenocarcinoma Endocrine Gland Neoplasms Endocrine System Diseases Head and Neck Neoplasms Mouth Neoplasms Mouth Diseases Stomatognathic Diseases Salivary Gland Diseases Pancreatic Diseases Pembrolizumab Antineoplastic Agents, Immunological Antineoplastic Agents |