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HR+/HER2- Breast CancerPhase 1/2AVZO-023-1001NCT06998407

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 study testing AVZO-021, Fulvestrant and Letrozole in people with HR+/HER2- Breast Cancer and HR+, HER2-, Advanced Breast Cancer, run by Avenzo Therapeutics, Inc. at 16 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial 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 more about this study

Who is it for?
Ages 18 years and older
What is being tested?
AVZO-021, Fulvestrant and Letrozole
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
380 participants
Where
16 sitesUnited States
Study dates
20 Aug 2025to Aug 2030
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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

Who cannot join

  • 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.
Show all 12Show fewer
  • 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

Trial locations and contacts

16 sites in 1 country. Contact the study team or a site near you to ask about taking part.

16 sites in 1 country

United States16 sites, 16 recruiting
  • Avenzo Therapeutics Recruiting Site

    Boston, Massachusetts, 02215

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Cleveland, Ohio, 44106

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Columbus, Ohio, 43221

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Fairfax, Virginia, 22031

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Fort Worth, Texas, 76104

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Houston, Texas, 77030

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Los Angeles, California, 90025

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Los Angeles, California, 90095

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Nashville, Tennessee, 37203

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    New Haven, Connecticut, 06519

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    New York, New York, 10016

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Orlando, Florida, 32827

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    San Antonio, Texas, 78229

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Sarasota, Florida, 34232

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Seattle, Washington, 98109

    Avenzo Therapeutics

    Recruiting
  • Avenzo Therapeutics Recruiting Site

    Tampa, Florida, 33612

    Avenzo Therapeutics

    Recruiting

Other trials in United States

About this study

Official title: A Phase 1/2, First-in-human Study to Assess the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Antitumor Activity of AVZO-023 as a Single Agent, and in Combination With AVZO-021 and/or Endocrine Therapy in Patients With Advanced Solid Tumors

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.

Being tested
AVZO-021, Fulvestrant, Letrozole, AVZO-023

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AVZO-021Drug

    AVZO-021 is an oral selective CDK2 inhibitor

  • FulvestrantDrug

    Also called Faslodex

    Antineoplastic agent, estrogen receptor antagonist

  • LetrozoleDrug

    Also called Femara

    Antineoplastic agent, aromatase inhibitor

  • AVZO-023Drug

    AVZO-023 is an oral selective CDK4 inhibitor

Study groups in NCT06998407
Study groupRoleWhat they receive
Phase 1, monotherapy (Part 1A) and food effectExperimentalEscalating doses of twice daily, oral AVZO-023 in 28-day cycles, with addition of fulvestrant
Receives: Drug: Fulvestrant; Drug: AVZO-023
Phase 1, combination (Parts 1B)ExperimentalEscalating doses of twice daily, oral AVZO-023 in combination with once daily, oral AVZO-021 in 28-day cycles, with addition of fulvestrant
Receives: Drug: AVZO-021; Drug: Fulvestrant; Drug: AVZO-023
Phase 1, combination (Parts 1C)ExperimentalEscalating doses of twice daily, oral AVZO-023 in combination with once daily, oral AVZO-021, with once daily, oral letrozole in 28-day cycles
Receives: Drug: AVZO-021; Drug: Letrozole; Drug: AVZO-023
Phase 2, combination (Cohorts 2A, 2B, 2C, and 2D)ExperimentalOral 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
Receives: Drug: AVZO-021; Drug: Fulvestrant; Drug: Letrozole; Drug: AVZO-023

What is being measured

The primary outcome is the main question the study is designed to answer.

  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.

    Measured: Cycle 1 (28 Days)

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

    Measured: 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)

    Measured: 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.

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

Secondary outcomes (12)
  1. Objective Response Rate (ORR) (Phase 1)

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

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

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

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

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

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

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

    Measured: 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)

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

  11. Determination of RP2D (Phase 2)

    Measured: Approximately 16 months

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

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

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 May 2025
  2. Study start20 Aug 2025
  3. Primary completionAug 2028 (estimated)
  4. Study completionAug 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
Phase 1 dose-escalation Phase 2 dose-expansion
Masking
None (open label)
Enrolment
380 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06998407
Sponsor's protocol ID
AVZO-023-1001
Acronym
AVZO-023-1001
Status last verified
Feb 2026
First submitted
22 May 2025
Last updated
10 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing AVZO-021, Fulvestrant and Letrozole in people with HR+/HER2- Breast Cancer and HR+, HER2-, Advanced Breast Cancer, run by Avenzo Therapeutics, Inc. at 16 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 10 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Medical Information ((858) 239-2944, ClinicalTrials@avenzotx.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Occurrence of Dose Limiting Toxicities (DLTs) during the first cycle (Phase 1) (time frame: Cycle 1 (28 Days)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Aug 2026.

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