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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03219333
Other study ID # SGN22E-001
Secondary ID
Status Completed
Phase Phase 2
First received
Last updated
Start date October 8, 2017
Est. completion date July 28, 2023

Study information

Verified date September 2023
Source Astellas Pharma Inc
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

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.


Description:

Japan Pharmaceuticals and Medical Devices Agency (PMDA) has approved enfortumab vedotin (Padcev) for the treatment of advanced urothelial cancer. The study will continue as a post marketing study in Japan. This study will examine the safety and anticancer activity of enfortumab vedotin given intravenously to patients with locally advanced or metastatic urothelial cancer who previously received a CPI and either previously received platinum-containing chemotherapy (Cohort 1) or are platinum-naïve and cisplatin-ineligible (Cohort 2). Patients who received platinum in the adjuvant/neoadjuvant setting and did not progress within 12 months of completion will be considered platinum-naïve. Approximately 100 patients are expected to be enrolled in each cohort. The primary goal of the study is to determine the confirmed ORR of enfortumab vedotin.


Recruitment information / eligibility

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.

Study Design


Intervention

Drug:
Enfortumab vedotin
Intravenous (IV) infusion on days 1, 8 and 15 every 28 days

Locations

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

Sponsors (2)

Lead Sponsor Collaborator
Astellas Pharma Inc Seagen Inc.

Countries where clinical trial is conducted

United States,  France,  Germany,  Italy,  Japan,  Korea, Republic of,  Netherlands,  Spain, 

Outcome

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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