Clinical Trials /

Study of Sacituzumab Govitecan-hziy in Metastatic Urothelial Cancer

NCT03547973

Description:

The objective of this study is to evaluate the efficacy and safety of sacituzumab govitecan-hziy in participants with metastatic urothelial cancer (mUC).

Related Conditions:
  • Urothelial Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Study of Sacituzumab Govitecan-hziy in Metastatic Urothelial Cancer
  • Official Title: Phase II Open Label, Study of IMMU-132 in Metastatic Urothelial Cancer After Failure of Platinum-Based Regimen or Anti-PD-1/ PD-L1 Based Immunotherapy

Clinical Trial IDs

  • ORG STUDY ID: IMMU-132-06
  • SECONDARY ID: 2018-001167-23
  • NCT ID: NCT03547973

Conditions

  • Metastatic Urothelial Cancer

Interventions

DrugSynonymsArms
Sacituzumab Govitecan-hziyIMMU-132, Trodelvy™Cohort 1: Sacituzumab Govitecan-hziy
PembrolizumabKEYTRUDA®Cohort 3: Sacituzumab Govitecan-hziy + Pembrolizumab
CisplatinCohort 4: Sacituzumab Govitecan-hziy + Cisplatin + Avelumab
AvelumabBAVENCIO®Cohort 4: Sacituzumab Govitecan-hziy + Cisplatin + Avelumab

Purpose

The objective of this study is to evaluate the efficacy and safety of sacituzumab govitecan-hziy in participants with metastatic urothelial cancer (mUC).

Trial Arms

NameTypeDescriptionInterventions
Cohort 1: Sacituzumab Govitecan-hziyExperimentalParticipants with urothelial cancer (UC) previously treated with platinum-based and/or checkpoint inhibitors (CPIs) will receive sacituzumab govitecan-hziy 10 mg/kg intravenously on Days 1 and 8 of a 21-day cycle.
  • Sacituzumab Govitecan-hziy
Cohort 2: Sacituzumab Govitecan-hziyExperimentalParticipants with UC who are ineligible for platinum-based therapy and failed therapy with previous immune CPI therapy will receive sacituzumab govitecan-hziy 10 mg/kg intravenously on Days 1 and 8 of a 21-day cycle.
  • Sacituzumab Govitecan-hziy
Cohort 3: Sacituzumab Govitecan-hziy + PembrolizumabExperimentalParticipants who have had progression or recurrence of UC following a platinum-containing regimen in the metastatic setting, or progression or recurrence of UC within 12 months of completion of platinum-based therapy as neoadjuvant or adjuvant therapy will receive sacituzumab govitecan-hziy 10 mg/kg intravenously on Days 1 and 8 of a 21-day cycle and pembrolizumab at the standard approved dose (200 mg) only on Day 1 of a 21-day cycle. Lower doses of sacituzumab govitecan-hziy may be tested based on dose-limiting toxicities (DLTs) observed to determine the Recommended Phase 2 Dose (RP2D) of sacituzumab govitecan-hziy in combination with pembrolizumab.
  • Sacituzumab Govitecan-hziy
  • Pembrolizumab
Cohort 4: Sacituzumab Govitecan-hziy + Cisplatin + AvelumabExperimentalParticipants with UC who have never received therapy with platinum in the metastatic setting or for unresectable locally advanced disease will first receive cisplatin (either at 70 mg/m^2 on Day 1 of a 21-day cycle or at a split dose of 35 mg/m^2 on Days 1 and 8 of a 21-day cycle with a maximum body surface area of 2) and sacituzumab govitecan-hziy with maximum dose of 10 mg/kg intravenously on Days 1 and 8 of a 21-day cycle for up to 6 cycles. Based on DLTs observed, two additional lower doses may be tested to determine RP2D of sacituzumab govitecan-hziy in combination with cisplatin. If premature termination of 1 agent occurs due to toxicity, the other agent may be continued to complete up to 6 cycles of therapy. For participants who have not progressed, maintenance therapy will begin with infusions of avelumab 800 mg every 2 weeks beginning on Cycle 1, Day 1 and every 2 weeks thereafter and sacituzumab govitecan-hziy 10 mg/kg on Days 1 and 8 every 21 days.
  • Sacituzumab Govitecan-hziy
  • Cisplatin
  • Avelumab
Cohort 5: Sacituzumab Govitecan-hziy + Cisplatin + AvelumabExperimentalParticipants with UC who have never received therapy with platinum in the metastatic setting or for unresectable locally advanced disease will first receive cisplatin (either at 70 mg/m^2 on Day 1 of a 21-day cycle or at a split dose of 35 mg/m^2 on Days 1 and 8 of a 21-day cycle with a maximum body surface area of 2) and sacituzumab govitecan-hziy RP2D determined in Cohort 4 on Days 1 and 8 of a 21-day cycle, and avelumab 800 mg every 2 weeks beginning on Cycle 1, Day 1 and every 2 weeks. For participants who have not progressed after completion of up to 6 cycles of sacituzumab govitecan-hziy, cisplatin, and avelumab, maintenance therapy will be permitted with 800 mg of avelumab every 2 weeks and sacituzumab govitecan-hziy at the 10 mg/kg dose on Days 1 and 8 every 21 days. Maintenance therapy can start 4 to 6 weeks after the last dose of induction chemotherapy and will be permitted to continue until loss of clinical benefit.
  • Sacituzumab Govitecan-hziy
  • Cisplatin
  • Avelumab

Eligibility Criteria

        Key Inclusion Criteria:

          -  Participants with histologically confirmed urothelial cancer (UC).

          -  Eastern Cooperative Oncology Group (ECOG) Performance status score of 0 or 1.

          -  Cohort 1: Have had progression or recurrence of urothelial cancer following receipt of
             platinum-containing regimen (cisplatin or carboplatin):

               -  Received a first-line platinum-containing regimen in the metastatic setting or
                  for inoperable locally advanced disease;

               -  Or received neo/adjuvant platinum-containing therapy for localized
                  muscle-invasive urothelial cancer, with recurrence/progression ≤12 months
                  following completion of therapy.

          -  Cohort 1: In addition to above criterion, have had progression or recurrence of
             urothelial cancer following receipt of an Anti-programmed Cell Death Protein 1
             (anti-PD-1)/ Anti-programmed Death Ligand 1 (PD-L1) therapy.

          -  Cohort 2: Were ineligible for platinum-based therapy for first line metastatic disease
             and have had progression or recurrence of urothelial cancer after a first-line therapy
             for metastatic disease with anti-PD-1/PD-L1 therapy. Individual may not have received
             any platinum for treatment of recurrent, metastatic or advanced disease.

          -  Cohort 3: Progression or recurrence of UC following a platinum containing regimen in
             the metastatic setting, or progression or recurrence of UC within 12 months of
             completion of platinum-based therapy as neoadjuvant or adjuvant therapy.

          -  Cohorts 4 and 5: Individual has not received any platinum-based chemotherapy in the
             metastatic or unresectable locally advanced setting. Creatinine clearance of at least
             50 mL/min calculated by Cockcroft-Gault formula or another validated tool. For
             individuals receiving cisplatin at 70 mg/m^2 on Day 1 of every 21-day cycle, a
             creatinine clearance of least 60 mL/min calculated by Cockcroft -Gault formula or
             another validated tool is required. Individuals with creatinine clearance between 50
             to 59 mL/min are to receive a split dose of cisplatin (35 mg/m^2 Day 1 and Day 8 of
             every 21-day cycle).

          -  Adequate renal and hepatic function.

          -  Adequate hematologic parameters without transfusional support.

          -  Individuals must have a 3-month life expectancy.

          -  Have measurable disease by Computed Tomography Imaging (CT) or Magnetic Resonance
             Imaging (MRI) as per RECIST 1.1 criteria.

        Key Exclusion Criteria:

          -  Females who are pregnant or lactating.

          -  Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study
             Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events
             due to agents administered more than 4 weeks earlier.

          -  Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy
             within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at
             baseline) from adverse events due to a previously administered agent.

          -  Requires concomitant medication interfering with ABCA1 transporter or UGT1A1

          -  Has an active second malignancy.

          -  Has known active central nervous system (CNS) metastases and/or carcinomatous
             meningitis.

          -  Has known active Hepatitis B or Hepatitis C

          -  Has other concurrent medical or psychiatric conditions

          -  Cohorts 3 to 5: Has active autoimmune disease requiring systemic treatment with
             steroids or other immunosuppressive agent or any condition that in the Investigator's
             judgment precludes treatment with pembrolizumab, has received a live vaccine within 30
             days prior to the first dose of study drug(s), has history or evidence of interstitial
             lung disease (ILD) or non-infectious pneumonitis, has received anti-PD-1/PD-L1 therapy
             previously

          -  Cohorts 4 and 5: Refractory to platinum (i.e., relapsed ≤ 12 months after completion
             of chemotherapy) in the neoadjuvant/adjuvant setting.

        Note: Other protocol defined Inclusion/Exclusion criteria may apply.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Response Rate (ORR) Based on Central Review by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) Criteria.
Time Frame:Up to Survival Follow-up Visit (maximum of 2 years after Safety Follow-up Visit (30 days after last dose date))
Safety Issue:
Description:ORR will be defined as the rate of the best overall response as Complete Remission (CR) or Partial Response (PR) and based on central review by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) criteria.

Secondary Outcome Measures

Measure:Overall Response Rate (ORR)
Time Frame:Up to Survival Follow-up Visit (maximum of 2 years after Safety Follow-up Visit (30 days after last dose date))
Safety Issue:
Description:ORR will be defined as the rate of the best overall response as CR or PR and based on investigator review by RECIST 1.1 criteria for cohorts 3, 4, and 5. ORR will also be evaluated based on investigator review by Modified RECIST 1.1 for Immune-Based Therapeutics (iRECIST 1.1) for Cohort 3 only.
Measure:Duration of Response (DOR)
Time Frame:Up to Survival Follow-up Visit (maximum of 2 years after Safety Follow-up Visit (30 days after last dose date))
Safety Issue:
Description:DOR will be calculated from the date of the first evaluation showing documented response, PR, or CR, to the date of the first disease progression or death and based on central and investigator review by RECIST 1.1 criteria for all cohorts. DOR will also be evaluated based on investigator review by iRECIST 1.1 for Cohort 3 only.
Measure:Progression-Free Survival (PFS)
Time Frame:Up to Survival Follow-up Visit (maximum of 2 years after Safety Follow-up Visit (30 days after last dose date))
Safety Issue:
Description:PFS is defined as the time from the first dose until objective tumor progression,or death, whichever comes first and based on central and investigator review by RECIST 1.1 criteria for all cohorts. PFS will also be evaluated based on investigator review by iRECIST 1.1 for Cohort 3 only.
Measure:Overall Survival (OS)
Time Frame:Up to Survival Follow-up Visit (maximum of 2 years after Safety Follow-up Visit (30 days after last dose date))
Safety Issue:
Description:OS will be measured from the date of first dose to death from any cause.
Measure:Clinical Benefit Rate (CBR)
Time Frame:Up to Survival Follow-up Visit (maximum of 2 years after Safety Follow-up Visit (30 days after last dose date))
Safety Issue:
Description:CBR is defined as CR + PR + Stable Disease (SD) for at least 6 months and based on central and investigator review by RECIST 1.1 criteria for cohorts 3, 4, and 5. CBR will also be evaluated based on investigator review by iRECIST 1.1 for Cohort 3 only.
Measure:Cohorts 3, 4, and 5: Percentage of Participants Experiencing Treatment Emergent Adverse Events (TEAEs)
Time Frame:First dose date up to last dose date plus 30 days (approximately 3 years)
Safety Issue:
Description:
Measure:Cohorts 3, 4, and 5: Percentage of Participants Experiencing any Clinically Significant Laboratory Abnormalities
Time Frame:First dose date up to last dose date plus 30 days (approximately 3 years)
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Gilead Sciences

Last Updated

August 4, 2021