A Phase Ib/II, open-label, multicenter, randomized, umbrella study in participants with MIBC and in participants with locally advanced or metastatic Urothelial Carcinoma (UC) who have progressed during or following a platinum-containing regimen. The study is designed with the flexibility to open new treatment arms as new treatments become available, close existing treatment arms that demonstrate minimal clinical activity or unacceptable toxicity, or modify the participant population (e.g., with regard to prior anti-cancer treatment or biomarker status). Participants in the mUC Cohort who experience loss of clinical benefit or unacceptable toxicity during Stage 1 may be eligible to continue treatment with a different treatment regimen for Stage 2.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
272
For the control, + EV, + Nira, + Tira, and + SG arms, + RO7122290, Atezolizumab will be administered intravenously (IV) at a fixed dose of 1200 mg every 3 weeks (Q3W) on Day 1 of each 21-day cycle. For the Atezo + Hu5F9-G4 and + TCZ arms, Atezo will be administered IV at a fixed dose of 840 mg every 2 weeks (Q2W) on Days 1 and 15 of each 28-day cycle.
Enfortumab vedotin will be administered at a dose of 1.25 mg/kg IV on Days 1 and 8 of each 21-day cycle.
Niraparib will be administered at a dose of 200 mg once daily (QD) by mouth.
Participants will receive an 1-mg/kg priming dose IV on Day 1 followed by three weekly IV doses of 30 mg/kg on Days 8, 15, and 22. During Cycle 2, participants will receive weekly IV doses of 30 mg/kg on Days 1, 8, 15, and 22. For all subsequent cycles, participants will receive 30 mg/kg on Days 1 and 15. Cycle = 28 days.
Tiragolumab will be administered at a dose of 600 mg IV on Day 1 of each 21-day cycle.
Sacituzumab Govitecan will be administered at a dose of 10 mg/kg by IV on Day 1 and 8 of each 21-day cycle.
Tocilizumab will be administered by IV infusion at a dose of 8 mg/kg every 4 weeks (Q4W) on Day 1 of each 28-day cycle.
Cisplatin will be administered at a dose of 70mg/m\^2 by IV on Day 1 of each cycle for Cycles 1-3 pre-surgery.
Gemcitabine will be administered at a dose of 1000mg/m\^2 by IV on Days 1 and 8 of each cycle for Cycles 1-3 pre-surgery.
UCLA Department of Medicine
Los Angeles, California, United States
UCSF Comprehensive Cancer Ctr
San Francisco, California, United States
Stanford Cancer Center
Stanford, California, United States
University of Kentucky Chandler Medical Center
Lexington, Kentucky, United States
Norton Cancer Institute
Louisville, Kentucky, United States
Objective Response Rate (ORR) for mUC Cohort Stage 1
Objective response rate, defined as the proportion of participants with a CR or PR on two consecutive occasions \>=4 weeks apart during Stage 1, as determined by the investigator according to RECIST v1.1.
Time frame: Baseline until disease progression or loss of clinical benefit (approximately 5-7 years)
pCR for Muscle Invasive Bladder Cancer (MIBC) Cohorts
pCR, defined as the proportion of participants with an absence of residual invasive cancer of the complete resected specimen.
Time frame: Randomization to approximately 5-7 years
Progression Free Survival (PFS) for mUC Cohort Stage 1
PFS after randomization, defined as the time from randomization to the first occurrence of disease progression or death from any cause (whichever occurs first) in Stage 1, as determined by the investigator according to RECIST v1.1.
Time frame: Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5-7 years) as determined by the investigator according to RECIST 1.1
Overall Survival (OS) for mUC Cohort Stage 1
OS after randomization,defined as the time from randomization to death from any cause.
Time frame: Randomization to death from any cause, through the end of study (approximately 5-7 years)
Overall Survival (at specific time-points) for mUC Cohort Stage 1
OS rate at specific timepoints, defined as the proportion of patients who have not experienced death from any cause at that timepoint.
Time frame: 12 months
Duration of Response (DOR) for mUC Cohort Stage 1
DOR, defined as the time from the first occurrence of a documented objective response during Stage 1 to disease progression or death from anycause (whichever occurs first), as determined by the investigator according to RECIST v1.1.
Time frame: Randomization until first occurrence of a documented objective response to the first recorded occurrence of disease progression or death from any cause (whichever occurs first), through end of study (approximately 5-7 years)
Disease Control Rate (DCR) for mUC Cohort Stage 1
Disease control, defined as stable disease \>= 18 weeks or a CR or PR, as determined by the investigator according to RECIST v1.1.
Time frame: Baseline through end of study (approximately 5-7 years)
Percentage of Participants with Adverse Events for mUC Cohort Stage 1
Time frame: Baseline to end of study (approximately 5-7 years)
Serum Concentration of Atezolizumab for mUC Cohort Stage 2
Time frame: At pre-defined intervals from first administration of study drug up to approximately 5-7 years
Serum Concentration of Enfortumab Vedotin for mUC Cohort Stage 2
Time frame: At pre-defined intervals from first administration of study drug up to approximately 5-7 years
Serum Concentration of Sacituzumab Govitecan for mUC Cohort Stage 2
Time frame: At pre-defined intervals from first administration of study drug up to approximately 5-7 years
Presence of ADAs to Atezolizumab for mUC Cohort Stage 2
For drugs for which ADA formation is measured: presence of ADAs during the study relative to the presence of ADAs at baseline.
Time frame: Baseline to approximately 5-7 years
Percentage of Participants with Adverse Events for mUC Cohort Stage 2
Time frame: Baseline to end of study (approximately 5-7 years)
Landmark Recurrence-Free Survival (RFS) for MIBC Cohorts
Landmark RFS, defined as RFS at specific timepoints.
Time frame: 12, 18, 24 months
Landmark Event-Free Survival (EFS) for MIBC Cohorts
Landmark EFS, defined as EFS at specific timepoints.
Time frame: 12, 18, 24 months
Landmark Overall Survival (OS) for MIBC Cohorts
Landmark OS, defined as OS at specific timepoints.
Time frame: 12, 18, 24 months
Percentage of Participants with Adverse Events for MIBC Cohorts
Time frame: Baseline to approximately 5-7 years
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Memorial Sloan-Kettering Cancer Center
Commack, New York, United States
Levine Cancer Institute
Charlotte, North Carolina, United States
University Hospitals Cleveland Medical Center
Cleveland, Ohio, United States
Cleveland Clinic
Cleveland, Ohio, United States
The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
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