Clinical Development Oncoral

Oncoral is an oral tablet formulation of irinotecan intended for use as a chemotherapeutic drug in combination regimens for the treatment of gastric cancer


Oncoral has been evaluated in an investigator sponsored Phase I trial at Herlev Hospital, Denmark, with promising results. The study was a dose-escalating safety, tolerability and pharmacokinetics study of orally administered Oncoral in adult patients with advanced solid tumors. The objectives of the study were to determine the safety, tolerability and maximum tolerated dose of Oncoral given as single agent and when administered in combination with the oral chemotherapeutic drug capecitabine. Additional objectives were to determine any objective tumor response or stable disease, and to describe the pharmacokinetics of Oncoral given as single agent. The first patient was enrolled in July, 2015, and a total of 25 patients were enrolled in the part of the study with Oncoral given as single agent. The second part of the study with Oncoral given in combination with capecitabine was initiated in June 2017 and included 12 additional patients. The study was completed in 2018

Link to study at

The clinical development strategy for Oncoral is to obtain Phase II data and then to partner for the further development to market. The plan is to design and conduct a Phase II study on Oncoral in combination with capecitabine and a selected targeted anti-cancer agent, in irinotecan naive, HER2 negative patients with un-resectable or metastatic gastric cancer. The choice of targeted agent will be decided based on interactions with clinical advisors and regulatory authorities. Preliminary plans for the Phase II study involve a dose-escalation part with Oncoral, capecitabine and the selected targeted agent in order to determine safety and tolerability and define doses for the extension part of the Phase II study. The extension part of the study aims at establishing proof of clinical concept based on relevant safety and efficacy parameters. Results from the completed investigator sponsored Phase I study will be considered when designing the Phase II study.


Our lead candidate Mangoral is a liver imaging drug (i.e. a liver specific contrast agent) being developed for detection and localization of potential liver metastases, using Magnetic Resonance Imaging (“MRI”) in patients where use of the current gold standard gadolinium-based contrast agents (“GBCAs”) may be medically inadvisable or cannot be administered. Mangoral is currently in Phase III clinical development.


Oncoral is a novel tablet-based formulation of the well-known chemotherapeutic agent irinotecan, intended for the treatment of advanced gastric (stomach) cancer. Irinotecan is today mainly used for treating metastasized colorectal cancer. Although irinotecan is currently not approved for treating gastric cancer in the United States and in the EU, there is off-label use for this indication. Oncoral has completed Phase I studies with encouraging results and is ready for Phase II studies.


Ascelia has established a development program for lead candidate Mangoral, consisting of a pivotal Phase III efficacy study and two supportive studies. Mangoral started Phase III studies in beginning 2020. The clinical development strategy for Oncoral, Ascelia Pharma´s second drug candidate, is to obtain Phase II data and then to partner for the further development.