Urinary Bladder Neoplasms Clinical Trial
— EV-201Official title:
A Single-arm, Open-label, Multicenter Study of Enfortumab Vedotin (ASG-22CE) for Treatment of Patients With Locally Advanced or Metastatic Urothelial Cancer Who Previously Received Immune Checkpoint Inhibitor (CPI) Therapy
Verified date | September 2023 |
Source | Astellas Pharma Inc |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This is a study that will test how an experimental drug (enfortumab vedotin) affects patients with cancer of the urinary system (urothelial cancer). This type of cancer includes cancer of the bladder, renal pelvis, ureter or urethra that has spread to nearby tissues or to other areas of the body. This clinical trial will enroll patients who were previously treated with a kind of anticancer drug called an immune checkpoint inhibitor (CPI). Some CPIs have been approved for the treatment of urothelial cancer. This study will test if the cancer shrinks with treatment. This study will also look at the side effects of the drug. A side effect is a response to a drug that is not part of the treatment effect. Patients who sign up for this trial must also fall into one of these categories: - Patients have already received treatment with platinum-containing chemotherapy - Patients have never received platinum-containing treatment and are not eligible for treatment with cisplatin.
Status | Completed |
Enrollment | 219 |
Est. completion date | July 28, 2023 |
Est. primary completion date | October 27, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Histologically documented urothelial carcinoma (squamous differentiation or mixed cell types allowed). - Metastatic disease or locally advanced disease that is not resectable. - Must have received prior treatment with a CPI in the locally advanced or metastatic urothelial cancer setting. A CPI is defined as a programmed cell death protein 1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor. Patients who received CPI therapy in the neoadjuvant/adjuvant setting and had recurrent or progressive disease either during therapy or within 3 months of therapy completion are eligible. - Must either have prior treatment with platinum-containing chemotherapy (Cohort 1) or be platinum-naïve and ineligible for treatment with cisplatin at time of enrollment (Cohort 2). - Must have had progression or recurrence of urothelial cancer during or following receipt of most recent therapy. - Tumor tissue samples must be available for submission to the sponsor prior to study treatment. - Must have measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) (Version 1.1). - An Eastern Cooperative Oncology Group (ECOG) Performance Status score of =1 for Cohort 1 or =2 for Cohort 2. - Anticipated life expectancy of =3 months as assessed by the investigator. Exclusion Criteria: - Ongoing sensory or motor neuropathy Grade =2. - Active central nervous system (CNS) metastases. - Immunotherapy related myocarditis, colitis, uveitis, or pneumonitis. - Prior enrollment in an enfortumab vedotin study or prior treatment with other monomethyl auristatin E (MMAE)-based antibody-drug conjugates (ADCs). - Uncontrolled tumor-related pain or impending spinal cord compression. |
Country | Name | City | State |
---|---|---|---|
France | Site FR33001 | Villejuif-Cedex-France | |
Germany | Site DE49004 | Muenster | |
Germany | Site DE49001 | Tübingen | |
Italy | Site IT39001 | Milano | |
Italy | Site IT39003 | Terni | |
Japan | Site JP81005 | Chiba | |
Japan | Site JP81011 | Fukuoka | |
Japan | Site JP81012 | Fukuoka | |
Japan | Site JP81001 | Hirosaki | Aomori |
Japan | Site JP81002 | Morioka | Iwate |
Japan | Site JP81003 | Nigata | |
Japan | Site JP81007 | Osaka | |
Japan | Site JP81008 | Osakasayama | Osaka |
Japan | Site JP81006 | Shinjuku-ku | Tokyo |
Japan | Site JP81010 | Tokushima | |
Japan | Site JP81004 | Tsukuba | Ibaraki |
Japan | Site JP81009 | Ube | Yamaguchi |
Korea, Republic of | Site KR82005 | Daejeon | |
Korea, Republic of | Site KR82003 | Seongnam-si | |
Korea, Republic of | Site KR82001 | Seoul | |
Korea, Republic of | Site KR82002 | Seoul | |
Korea, Republic of | Site KR82004 | Seoul | |
Netherlands | Site NL31001 | Amsterdam | |
Spain | Site ES34002 | Barcelona | |
Spain | Site ES34005 | Barcelona | |
Spain | Site ES34003 | Santander | |
Spain | Site ES34004 | Sevilla | |
United States | New York Oncology Hematology, P.C. | Albany | New York |
United States | Alaska Urological Institute | Anchorage | Alaska |
United States | Augusta University | Augusta | Georgia |
United States | Rocky Mountain Cancer Centers - Aurora | Aurora | Colorado |
United States | Texas Oncology - Austin Central | Austin | Texas |
United States | Johns Hopkins Medical Center | Baltimore | Maryland |
United States | Dana Farber Cancer Institute | Boston | Massachusetts |
United States | Massachusetts General Hospital | Boston | Massachusetts |
United States | University of Virginia | Charlottesville | Virginia |
United States | University of Chicago Medical Center | Chicago | Illinois |
United States | Cleveland Clinic | Cleveland | Ohio |
United States | James Cancer Hospital / Ohio State University | Columbus | Ohio |
United States | Texas Oncology - Baylor Sammons Cancer Center | Dallas | Texas |
United States | Karmanos Cancer Institute / Wayne State University | Detroit | Michigan |
United States | Duke University Medical Center | Durham | North Carolina |
United States | Virginia Cancer Specialists, PC | Fairfax | Virginia |
United States | Arizona Oncology Associates, PC - HAL | Goodyear | Arizona |
United States | Prisma Health | Greenville | South Carolina |
United States | Houston Methodist Cancer Center | Houston | Texas |
United States | Comprehensive Cancer Centers of Nevada | Las Vegas | Nevada |
United States | Keck Medical Center / University of Southern California | Los Angeles | California |
United States | Norton Cancer Institute, St. Matthews Campus | Louisville | Kentucky |
United States | Vanderbilt University Medical Center | Nashville | Tennessee |
United States | Yale Cancer Center | New Haven | Connecticut |
United States | Columbia University Medical Center | New York | New York |
United States | Memorial Sloan Kettering Cancer Center | New York | New York |
United States | Mount Sinai Medical Center | New York | New York |
United States | New York University (NYU) Cancer Institute | New York | New York |
United States | Keck Medical Center / Newport Beach | Newport Beach | California |
United States | Virginia Oncology Associates | Norfolk | Virginia |
United States | Kaiser Permanente Oakland | Oakland | California |
United States | Ocala Oncology Center | Ocala | Florida |
United States | Chao Family Comprehensive Cancer Center University of California Irvine | Orange | California |
United States | University of California Irvine - Newport | Orange | California |
United States | Thomas Jefferson University | Philadelphia | Pennsylvania |
United States | Mayo Clinic Arizona | Phoenix | Arizona |
United States | University of Pittsburgh Medical Center (UPMC)/Hillman Cancer Center | Pittsburgh | Pennsylvania |
United States | James P. Wilmot Cancer Center / University of Rochester Medical Center | Rochester | New York |
United States | Maryland Oncology Hematology, P.A. | Rockville | Maryland |
United States | Kaiser Permanente Roseville | Roseville | California |
United States | Kaiser Permanente Sacramento | Sacramento | California |
United States | University of California Davis | Sacramento | California |
United States | Washington University in St Louis | Saint Louis | Missouri |
United States | Kaiser Permanente San Francisco | San Francisco | California |
United States | Kaiser Permanente San Jose | San Jose | California |
United States | Kaiser Permanente San Leandro | San Leandro | California |
United States | Kaiser Permanente Santa Clara | Santa Clara | California |
United States | Seattle Cancer Care Alliance / University of Washington | Seattle | Washington |
United States | Kaiser Permanente South San Francisco | South San Francisco | California |
United States | H. Lee Moffitt Cancer Center & Research Institute | Tampa | Florida |
United States | Northwest Cancer Specialists, P.C. | Tigard | Oregon |
United States | Arizona Oncology Associates, PC - HOPE | Tucson | Arizona |
United States | Kaiser Permanente Medical Center Northern California | Vallejo | California |
United States | Kaiser Permanente Walnut Creek | Walnut Creek | California |
Lead Sponsor | Collaborator |
---|---|
Astellas Pharma Inc | Seagen Inc. |
United States, France, Germany, Italy, Japan, Korea, Republic of, Netherlands, Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) | The percentage of participants with confirmed complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). CR is defined as disappearance of all target lesions and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR is defined as a =30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters. | Up to data cut-off date of 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2 (Cohort 1 median follow-up time: 10.15 months [range 0.49, 16.46]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | Duration of Objective Response (DOR) Per BICR | The time from first documentation of objective response (CR or PR that is subsequently confirmed) to the first documentation of progressive disease (PD) or to death due to any cause, whichever comes first. CR and PR are defined in ORR per BICR endpoint. PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 0.5 cm. The appearance of one or more new lesions is also considered progression. DOR was analyzed using Kaplan-Meier methodology. | Up to data cut-off date of 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2 (Cohort 1 median follow-up time: 10.15 months [range 0.49, 16.46]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | Progression-Free Survival (PFS) Per BICR | The time from start of study treatment to first documentation of objective tumor progression (PD per RECIST 1.1), or to death due to any cause, whichever comes first. PD is defined in the DOR per BICR endpoint. | Up to data cut-off date of 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2 (Cohort 1 median follow-up time: 10.15 months [range 0.49, 16.46]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | ORR Per Investigator Assessment | The percentage of participants with confirmed complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). CR and PR are defined in the ORR per BICR endpoint. | Up to data cut-off date of 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2 (Cohort 1 median follow-up time: 10.15 months [range 0.49, 16.46]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | DOR Per Investigator Assessment | The time from first documentation of objective response (CR or PR that is subsequently confirmed) to the first documentation of PD or to death due to any cause, whichever comes first. CR and PR are defined in ORR per BICR endpoint. PD is defined in the DOR per BICR endpoint. | Up to data cut-off date of 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2 (Cohort 1 median follow-up time: 10.15 months [range 0.49, 16.46]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | PFS Per Investigator Assessment | The time from start of study treatment to first documentation of objective tumor progression (PD per RECIST 1.1), or to death due to any cause, whichever comes first. PD is defined in the DOR per BICR endpoint. | Up to data cut-off date of 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2 (Cohort 1 median follow-up time: 10.15 months [range 0.49, 16.46]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | Number of Participants With Treatment-Emergent Laboratory Abnormalities (Hematology) | A treatment-emergent laboratory abnormality is a value increases or decrease by 1 toxicity grade after the first study dose. | Up to data cut-off date of 08 Sept 2020 (The median duration of treatment was 4.60 months for Cohort 1 [range: 0.5, 29.4 months] and 5.98 months for Cohort 2 [range: 0.3, 24.6 months]). | |
Secondary | Number of Participants With Treatment-Emergent Laboratory Abnormalities (Serum Chemistry) | A treatment-emergent laboratory abnormality is a value increases or decrease by 1 toxicity grade after the first study dose. | Up to data cut-off date of 08 Sept 2020 (The median duration of treatment was 4.60 months for Cohort 1 [full range: 0.5, 29.4 months] and 5.98 months for Cohort 2 [full range: 0.3, 24.6 months]). | |
Secondary | Incidence of Antitherapeutic Antibody (ATA) | Participants who were tested positive for ATA at any time post-baseline were considered to be transiently positive or persistently positive if >=2 consecutive samples were confirmed as positive. | Up to data cut-off date of 08 Sept 2020 (The median duration of treatment was 4.60 months for Cohort 1 [full range: 0.5, 29.4 months] and 5.98 months for Cohort 2 [full range: 0.3, 24.6 months]). | |
Secondary | Disease Control Rate at 16 Weeks (DCR16) Per BICR | Percentage of participants with CR, PR, or stable disease (SD) at Week 16 visit. CR and PR are defined in ORR per BICR endpoint. SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. | Up to Week 16. Data cut-off date 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2. | |
Secondary | DCR16 Per Investigator Assessment | Percentage of participants with CR, PR, or stable disease (SD) at Week 16 visit. CR and PR are defined in ORR per BICR endpoint. SD is defined in DCR16 per BICR endpoint. | Up to Week 16. Data cut-off date 01 Mar 2019 for cohort 1 and 08 Sept 2020 for cohort 2. | |
Secondary | Overall Survival (OS) at Time of Primary Analysis | OS is defined as the time from first dose of enfortumab vedotin to death from any cause. This data is part of a pre-specified primary analysis. Updated data will be provided in a separate outcome measure upon study completion. | Up to data cut-off date of 08 Sept 2020 (Cohort 1 median follow-up time: 28.4 months [range 0.49, 32.62]. Cohort 2 median follow up time: 13.4 months [range 0.33 to 29.27]). | |
Secondary | Number of Participants With Adverse Events (AEs) at Time of Primary Analysis | An AE is any untoward medical occurrence in a patient or clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment. A treatment emergent adverse event (TEAE) was defined as a newly occurring or worsening AE after the first dose of study treatment and within 30 days after the last dose of study treatment. This data is part of a pre-specified primary analysis. Updated data will be provided in a separate outcome measure upon study completion. | Up to data cut-off date of 08 Sept 2020 (The median duration of treatment was 4.60 months for Cohort 1 [range: 0.5, 29.4 months] and 5.98 months for Cohort 2 [range: 0.3, 24.6 months]). | |
Secondary | Pharmacokinetics (PK) Parameter for Enfortumab Vedotin: Maximum Concentration (Cmax) (Serum) | Cmax was derived from the PK blood samples collected. Day 1 data informed by samples collected on Day 1, Day 3, and Day 8. Day 15 data informed by samples collected on Day 15, Day 17, and Day 22. | Up to data cut-off date of 08 Sept 2020. Collected during cycle 1 and 2 of treatment (approximately 2 months) at Day 1 pre-dose and end of infusion, Day 3, Day 8 pre-dose and end of infusion, Day 15 pre-dose and end of infusion, Day 17, and Day 22. | |
Secondary | PK Parameter for Enfortumab Vedotin: Time to Maximum Concentration (Tmax) (Serum) | Tmax was derived from the PK blood samples collected. Time of maximum concentration corresponds to the end of infusion sample time. Day 1 data informed by samples collected on Day 1, Day 3, and Day 8. Day 15 data informed by samples collected on Day 15, Day 17, and Day 22. | Up to data cut-off date of 08 Sept 2020. Collected during cycle 1 and 2 of treatment (approximately 2 months) at Day 1 pre-dose and end of infusion, Day 3, Day 8 pre-dose and end of infusion, Day 15 pre-dose and end of infusion, Day 17, and Day 22. | |
Secondary | PK Parameter for Enfortumab Vedotin: Area Under Concentration-Time Curve (AUC) (Serum) | AUC was derived from the PK blood samples collected. | Up to data cut-off date of 08 Sept 2020. AUC0-7 was assessed (in cycles 1 and 2) based on concentration data from Day 1 to Day 8 (pre dose) and AUC0-14 was assessed based on data from D15 (pre dose) to D29 (pre-dose). | |
Secondary | PK Parameter for Free Monomethyl Auristatin E (MMAE): Cmax (Plasma) | Cmax was derived from the PK blood samples collected. Day 1 data informed by samples collected on Day 1, Day 3, and Day 8. Day 15 data informed by samples collected on Day 15, Day 17, and Day 22. | Up to data cut-off date of 08 Sept 2020. Collected during cycle 1 and 2 of treatment (approximately 2 months) at Day 1 pre-dose and end of infusion, Day 3, Day 8 pre-dose and end of infusion, Day 15 pre-dose and end of infusion, Day 17, and Day 22. | |
Secondary | PK Parameter for Free MMAE: Tmax (Plasma) | Tmax was derived from the PK blood samples collected. Day 1 data informed by samples collected on Day 1, Day 3, and Day 8. Day 15 data informed by samples collected on Day 15, Day 17, and Day 22. | Up to data cut-off date of 08 Sept 2020. Collected during cycle 1 and 2 of treatment (approximately 2 months) at Day 1 pre-dose and end of infusion, Day 3, Day 8 pre-dose and end of infusion, Day 15 pre-dose and end of infusion, Day 17, and Day 22. | |
Secondary | PK Parameter for Free MMAE: AUC (Plasma) | AUC was derived from the PK blood samples collected. | Up to data cut-off date of 08 Sept 2020. AUC0-7 was assessed (in cycles 1 and 2) based on concentration data from Day 1 to Day 8 (pre dose) and AUC0-14 was assessed based on data from D15 (pre dose) to D29 (pre-dose). | |
Secondary | PK Parameter for Total Antibody (TAb): Cmax (Serum) | Cmax was derived from the PK blood samples collected. Day 1 data informed by samples collected on Day 1, Day 3, and Day 8. Day 15 data informed by samples collected on Day 15, Day 17, and Day 22. | Up to data cut-off date of 08 Sept 2020. Collected during cycle 1 and 2 of treatment (approximately 2 months) at Day 1 pre-dose and end of infusion, Day 3, Day 8 pre-dose and end of infusion, Day 15 pre-dose and end of infusion, Day 17, and Day 22. | |
Secondary | PK Parameter for TAb: Tmax (Serum) | Tmax was derived from the PK blood samples collected. Time of maximum concentration corresponds to the end of infusion sample time. Day 1 data informed by samples collected on Day 1, Day 3, and Day 8. Day 15 data informed by samples collected on Day 15, Day 17, and Day 22. | Up to data cut-off date of 08 Sept 2020. Collected during cycle 1 and 2 of treatment (approximately 2 months) at Day 1 pre-dose and end of infusion, Day 3, Day 8 pre-dose and end of infusion, Day 15 pre-dose and end of infusion, Day 17, and Day 22. | |
Secondary | PK Parameter for TAb: AUC (Serum) | AUC was derived from the PK blood samples collected. | Up to data cut-off date of 08 Sept 2020. AUC0-7 was assessed (in cycles 1 and 2) based on concentration data from Day 1 to Day 8 (pre dose) and AUC0-14 was assessed based on data from D15 (pre dose) to D29 (pre-dose). | |
Secondary | Overall Survival (OS) | Updated Time Frame description will be provided at study completion. | ||
Secondary | Number of Participants With Adverse Events (AEs) | An AE is any untoward medical occurrence in a patient or clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment. A treatment emergent adverse event (TEAE) was defined as a newly occurring or worsening AE after the first dose of study treatment and within 30 days after the last dose of study treatment. | Updated Time Frame description will be provided at study completion. |
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