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Onalespib is a synthetic non-ansamycin small molecule that acts as a potent inhibitor of heat shock protein 90 (HSP90), binding to the amino terminal of the protein with high affinity. Paclitaxel is a well-established microtubule-stabilizing agent used in cancer therapy. The combination of onalespib and paclitaxel has been investigated for advanced triple-negative breast cancer (TNBC). Onalespib at 260 mg/m² given intravenously on days 1, 8, and 15 of a 28-day cycle in combination with standard dose/schedule of paclitaxel was established as the recommended phase II dose. The combination was reasonably well tolerated; pharmacokinetic analysis showed only minor drug-drug interactions without significant alteration in exposure for either agent. While durable objective responses or prolonged progression-free survival were not observed overall, some patients—including those previously progressing on taxane therapy—experienced long-lasting benefit[2][4][3].
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