Phase 2
N=219
A Study of Enfortumab Vedotin for Patients With Locally Advanced or Metastatic Urothelial Bladder Cancer
Carcinoma, Transitional Cell · Urinary Bladder Neoplasms · Urologic Neoplasms · Renal Pelvis Neoplasms · Urothelial Cancer
Bottom Line
View on ClinicalTrials.gov: NCT03219333 ↗Enrolled (actual)
219
Serious AEs
43.9%
Results posted
Dec 2021
Primary outcome: Primary: Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) — 44; 51.7 Percentage of Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Enfortumab vedotin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Astellas Pharma Inc
- Primary completion
- Oct 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) |
44; 51.7 | — |
| SECONDARY Duration of Objective Response (DOR) Per BICR |
7.6; 10.9 | — |
| SECONDARY Progression-Free Survival (PFS) Per BICR |
5.8; 5.8 | — |
| SECONDARY ORR Per Investigator Assessment |
39; 50.6 | — |
| SECONDARY DOR Per Investigator Assessment |
7.9; 10.7 | — |
| SECONDARY PFS Per Investigator Assessment |
5.8; 7.2 | — |
| SECONDARY Number of Participants With Treatment-Emergent Laboratory Abnormalities (Hematology) |
52; 39; 12; 4; 33; 28 | — |
| SECONDARY Number of Participants With Treatment-Emergent Laboratory Abnormalities (Serum Chemistry) |
34; 26; 1; 0; 38; 16 | — |
| SECONDARY Incidence of Antitherapeutic Antibody (ATA) |
109; 76; 2; 3; 1; 1 | — |
| SECONDARY Disease Control Rate at 16 Weeks (DCR16) Per BICR |
50; 58.4 | — |
| SECONDARY DCR16 Per Investigator Assessment |
55; 64.0 | — |
| SECONDARY Overall Survival (OS): Primary Analysis |
12.4; 14.7 | — |
| SECONDARY Number of Participants With Adverse Events (AEs): Primary Analysis |
125; 89; 117; 86; 93; 62 | — |
| SECONDARY Pharmacokinetics (PK) Parameter for Enfortumab Vedotin: Maximum Concentration (Cmax) (Serum) |
26.6; 23.9; 26.0; 21.7; 24.5; 22.0 | — |
| SECONDARY PK Parameter for Enfortumab Vedotin: Time to Maximum Concentration (Tmax) (Serum) |
0.0278; 0.0264; 0.0285; 0.0264; 0.0264; 0.0264 | — |
| SECONDARY PK Parameter for Enfortumab Vedotin: Area Under Concentration-Time Curve (AUC) (Serum) |
34.6; 33.5; 31.3; 26.3; 36.4; 32.0 | — |
| SECONDARY PK Parameter for Free Monomethyl Auristatin E (MMAE): Cmax (Plasma) |
3.1; 2.6; 3.9; 3.5; 2.4; 2.2 | — |
| SECONDARY PK Parameter for Free MMAE: Tmax (Plasma) |
1.9; 1.9; 2.0; 1.9; 2.0; 1.8 | — |
| SECONDARY PK Parameter for Free MMAE: AUC (Plasma) |
14.1; 13.0; 19.1; 18.1; 11.3; 10.6 | — |
| SECONDARY PK Parameter for Total Antibody (TAb): Cmax (Serum) |
26.6; 26.4; 30.9; 27.3; 26.2; 26.3 | — |
| SECONDARY PK Parameter for TAb: Tmax (Serum) |
0.0278; 0.0264; 0.0285; 0.0264; 0.0264; 0.0264 | — |
| SECONDARY PK Parameter for TAb: AUC (Serum) |
63.4; 66.8; 77.6; 72.3; 73.2; 72.9 | — |
| SECONDARY Number of Participants With Adverse Events (AEs): Final Analysis |
125; 89; 117; 86; 93; 62 | — |
| SECONDARY Overall Survival (OS): Final Analysis |
12.4; 15.6 | — |
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.
Eligibility Criteria
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.
Data sourced from ClinicalTrials.gov (NCT03219333). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.