A Modular Phase I/IIa, Open-label Study to Assess the Safety, Tolerability, Pharmacokinetics and Preliminary Efficacy of Ascending Doses of AZD5335 Monotherapy and in Combination With Anti-cancer Agents in Participants With Solid Tumors

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Trial Details

Sponsor: AstraZeneca (industry)

Phase: 1/2

Start date: June 5, 2023

Planned enrollment: 506

Trial ID: NCT05797168
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

chevron Show for: AZD5305 (saruparib)

chevron Show for: AZD9574 (palacaparib)

chevron Show for: AZD5335 (Torvutatug samrotecan)

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Goal: Assess safety, tolerability, pharmacokinetics, and preliminary antitumor activity of the folate receptor‑alpha–targeted antibody‑drug conjugate AZD5335 given alone and in combinations with other anticancer agents in advanced solid tumors, and identify recommended doses/regimens for further study.

Patients: Adults (≥18 years) with advanced, measurable solid tumors per RECIST v1.1, ECOG 0–1, adequate organ function, life expectancy ≥12 weeks, and prior standard therapy or in whom a trial is the best option. Archival and/or fresh tumor tissue is required; a fresh biopsy is preferred if there has been prior targeted therapy such as an ADC. Key exclusions include uncontrolled brain metastases, active serious infections (uncontrolled HIV, active HBV/HCV), prior significant ILD/pneumonitis, significant cardiovascular disease or QTcF >470 msec, unresolved ≥Grade 2 toxicities, and recent live vaccination. Contraception requirements apply to participants of childbearing potential and their partners.

Design: Modular, open-label, multi-center Phase I/IIa study with randomized allocation across modules. Dose escalation and expansion evaluate AZD5335 as monotherapy and in combinations to define safety, dose-limiting toxicities, pharmacokinetics, and preliminary efficacy.

Treatments: Module 1: AZD5335 monotherapy. AZD5335 (proposed INN: torvutatug samrotecan) is an investigational FRα-targeted antibody-drug conjugate delivering a topoisomerase I inhibitor payload (DAR8) designed for potent DNA damage with a bystander effect in FRα-expressing tumors. Early first-in-human data in heavily pretreated, platinum-resistant ovarian cancer show objective responses, particularly in tumors with high FRα expression, with a manageable safety profile dominated by low-grade gastrointestinal events and hematologic toxicities (notably anemia and neutropenia); the maximum tolerated dose had not been reached in dose escalation at last report. Module 2: AZD5335 plus saruparib (AZD5305), a selective PARP1 inhibitor engineered to maintain efficacy with potentially reduced hematologic toxicity versus nonselective PARP inhibitors. Module 3: AZD5335 plus bevacizumab, an anti-VEGF monoclonal antibody used widely with chemotherapy and biologics in solid tumors. Module 4: AZD5335 plus carboplatin with or without bevacizumab; carboplatin is a standard DNA-damaging platinum agent. Module 5: AZD5335 plus AZD9574, a brain-penetrant, selective PARP1 inhibitor under early clinical evaluation with preclinical activity in HRD models, including intracranial disease.

Outcomes: Primary endpoints include safety and tolerability: incidence of adverse events and serious adverse events, and dose-limiting toxicities during Cycle 1 (21 days). Key secondary endpoints include pharmacokinetics for AZD5335 and combination partners (AUC, Cmax, Tmax, clearance, half-life), immunogenicity (anti-drug antibodies), exploratory pharmacodynamic/biomarker assessments of target expression, and antitumor activity by RECIST v1.1: objective response rate, duration of response, disease control rate, progression-free survival, and overall survival. PK sampling is performed at predefined intervals for approximately 12 weeks; time-to-event endpoints are followed for up to about 2 years.

Burden on patient: High. As a Phase I/IIa modular study with dose escalation and multiple combinations, participants can expect frequent clinic visits, intensive pharmacokinetic blood sampling over the first 12 weeks, serial safety assessments (labs, ECGs, vitals, physical exams), and protocol-mandated tumor imaging. Tumor tissue submission is required, and fresh biopsies may be requested, especially after prior targeted therapies such as ADCs. Combination modules with cytotoxics and biologics add infusion time and potential supportive care visits. Travel frequency and time in clinic will exceed typical standard-of-care schedules, particularly during early cycles and PK time points.

Last updated: Oct 2025

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