The primary purpose of this study is to determine the antitumor activity of enfortumab vedotin as measured by confirmed objective response rate (ORR) per RECIST v1.1. This study will also assess other measures of antitumor activity; overall survival (OS); as well as the safety and tolerability of enfortumab vedotin for cohorts 1 to 8 and enfortumab vedotin + pembrolizumab in cohort 9.
This study will consist of 3 periods: screening/baseline, treatment and follow-up. Screening/baseline period will take place up to 28 days prior to the first dose of study treatment. In the treatment period, starting at cycle 1, participants in cohorts 1 to 8 will receive enfortumab vedotin on days 1, 8, and 15 every 28-day cycle until one of the treatment discontinuation criteria are met. participants in cohort 9 will receive enfortumab vedotin on days 1, 8, and pembrolizumab on day 1 of every 21-day cycle until one of the treatment discontinuation criteria are met. Disease assessment will be performed at screening/baseline and repeated every 8 weeks (56 days ± 7 days) for cohorts 1 to 8 and first assessment at week 9 and thereafter every 6 weeks (42 days ± 7 days) for cohort 9 from the first dose of study treatment throughout the study until the participant has radiologically confirmed disease progression, initiates a new subsequent anticancer therapy, dies, withdraws consent, is lost to follow-up or the study closes, whichever occurs first. Participants who discontinue study treatment for reasons other than radiologically-confirmed disease progression by RECIST Version 1.1 will enter into a post treatment follow-up period and continue to receive imaging scans every 8 weeks (56 days ± 7 days) for cohorts 1 to 8 and for cohort 9 first scan will be performed at 9 week and thereafter every 6 weeks (42 days ± 7 days) until the subject has radiologically confirmed disease progression (for cohort 9 confirmed progressive disease \[iCPD\] per modified RECIST 1.1 for immune-based therapeutics \[iRECIST\]), initiates a new anticancer therapy, dies, withdraws consent, is lost to follow-up or the study closes, whichever occurs first. After 1 year on study treatment, the frequency of disease assessment will be reduced to every 12 weeks (84 days ± 7 days) for cohorts 1 to 8. After 18 months on study treatment, the frequency of disease assessment will be reduced to every 9 weeks (63 days ± 7 days) for cohort 9. Participants in cohorts 1to 8 who discontinue study treatment for reasons other than radiologically-confirmed disease progression by RECIST Version 1.1 will enter into a post treatment follow-up period and continue to receive imaging scans every 8 weeks (56 days ± 7 days). Participants in cohort 9 who discontinue study treatment for reasons other than radiologically confirmed disease progression per iRECIST will enter into a post treatment follow-up period and have physical exams, ECOG and disease assessments every 6 weeks (± 7 days) up to 18 months after first dose, then every 9 weeks (± 7 days) until the subject has radiologically confirmed disease progression per iRECIST. After radiologically-confirmed disease progression or initiation of subsequent anticancer therapy, whichever occurs first, participants will be contacted every 12 weeks in the long-term follow-up period for survival status until death, withdrawal of consent, lost to follow-up or study closure, whichever occurs first.
intravenous (IV) infusion
IV infusion
Cohorts 1-8: Confirmed Overall Response Rate (ORR) (Complete Response (CR) and Partial Response(PR)) per RECIST V1.1 per investigator assessment
Confirmed ORR is defined as the proportion of participants whose objective response is a confirmed CR or PR according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 per investigator assessment.
Time frame: Up to 3 years
Cohort 9: Confirmed Overall Response Rate (ORR) (Complete Response (CR) and Partial Response (PR)) per RECIST V1.1 per investigator assessment
Confirmed ORR is defined as the proportion of participants whose objective response is a confirmed CR or PR according to RECIST Version 1.1 per investigator assessment.
Time frame: Up to 3 years
Cohorts 1-8: Duration of Response (DOR) per RECIST V1.1 as per investigator assessment
DOR is defined as the time from the date of first documented response (CR or PR that is subsequently confirmed) to the date of first documented progressive disease (PD) per RECIST version 1.1 or death due to any cause, whichever occurs first. DOR will only be calculated for participants achieving a confirmed CR or PR.
Time frame: Up to 3 years
Cohorts 1-8: Disease Control Rate (DCR) per RECIST V1.1 as per investigator assessment
DCR is defined as the proportion of participants whose Best Overall Response (BOR) is confirmed CR or PR or stable disease (SD).
Time frame: Up to 3 years
Cohorts 1-8: Duration of Progression Free Survival (PFS) per RECIST V1.1 as per investigator assessment
PFS is defined as the time from start of study treatment to first documentation of PD per RECIST version 1.1 or death due to any cause, whichever comes first.
Time frame: Up to 3 years
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Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
329
Arizona Oncology
Tucson, Arizona, United States
University of California - San Francisco
San Francisco, California, United States
University of Colorado
Aurora, Colorado, United States
Florida Cancer Specialists
Fort Myers, Florida, United States
Florida Cancer Specialists
Tallahassee, Florida, United States
Florida Cancer Specialists
West Palm Beach, Florida, United States
Piedmont Hospital
Atlanta, Georgia, United States
Northside Hospital
Atlanta, Georgia, United States
Northwestern University Medical Center
Chicago, Illinois, United States
University of Chicago
Chicago, Illinois, United States
...and 29 more locations
Cohorts 1-8: Duration of Overall Survival (OS)
OS is defined as the time from start of study treatment to date of death due to any cause.
Time frame: Up to 3 years
Cohorts 1-8: Number of participants with Adverse Events (AEs)
AEs will be coded using medical dictionary for regulatory activities (MedDRA). An AE is any untoward medical occurrence in a participant administered enfortumab vedotin, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of enfortumab vedotin whether or not considered related to the enfortumab vedotin. An AE is considered "serious" if the event: results in death; is life-threatening; results in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions; results in congenital anomaly or birth defect; requires inpatient hospitalization (except for planned procedures) or leads to prolongation of hospitalization (except if prolongation of planned hospitalization is not caused by an AE); or other medically important events.
Time frame: Up to 2 years
Cohorts 1-8: Number of participants with laboratory value abnormalities and/or adverse events (AEs)
Number of participants with potentially clinically significant laboratory values.
Time frame: Up to 2 years
Cohorts 1-8: Number of participants with vital sign abnormalities and /or adverse events (AEs)
Number of participants with potentially clinically significant vital sign values.
Time frame: Up to 2 years
Cohorts 1-8: Number of participants with routine 12-lead electrocardiogram (ECG) abnormalities and/or Adverse Events (AEs)
Number of participants with potentially clinically significant ECG values.
Time frame: Up to 2 years
Cohorts 1-8: Number of participants at each grade of the Eastern Cooperative Oncology Group Performance Status (ECOG PS)
The ECOG scale will be used to assess performance status. Grades range from 0 (equals fully active, able to carry on all pre-disease performance without restriction), and 5 (equals dead).
Time frame: Up to 2 years
Cohort 9: Duration of Response (DOR) per RECIST V1.1 as per investigator assessment
DOR is defined as the time from the date of first documented response (CR or PR that is subsequently confirmed) to the date of first documented progressive disease (PD) per RECIST version 1.1 or death due to any cause, whichever occurs first. DOR will only be calculated for participants achieving a confirmed CR or PR.
Time frame: Up to 3 years
Cohort 9: Disease Control Rate (DCR) per RECIST V1.1 as per investigator assessment
DCR is defined as the proportion of participants whose Best Overall Response (BOR) is confirmed CR or PR or stable disease (SD).
Time frame: Up to 3 years
Cohort 9: Duration of Progression Free Survival (PFS) per RECIST V1.1 as per investigator assessment
PFS is defined as the time from start of study treatment to first documentation of PD per RECIST version 1.1 or death due to any cause, whichever comes first.
Time frame: Up to 3 years
Cohort 9: Duration of Overall Survival (OS)
OS is defined as the time from start of study treatment to date of death due to any cause.
Time frame: Up to 3.5 years
Cohort 9: Number of participants with Adverse Events (AEs)
AEs will be coded using medical dictionary for regulatory activities (MedDRA). An AE is any untoward medical occurrence in a participant administered enfortumab vedotin, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of enfortumab vedotin whether or not considered related to the enfortumab vedotin. An AE is considered "serious" if the event: results in death; is life-threatening; results in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions; results in congenital anomaly or birth defect; requires inpatient hospitalization (except for planned procedures) or leads to prolongation of hospitalization (except if prolongation of planned hospitalization is not caused by an AE); or other medically important events.
Time frame: Up to 2 years
Cohort 9: Number of participants with laboratory value abnormalities and/or adverse events (AEs)
Number of participants with potentially clinically significant laboratory values.
Time frame: Up to 2 years
Cohort 9: Number of participants with vital sign abnormalities and /or adverse events (AEs)
Number of participants with potentially clinically significant vital sign values.
Time frame: Up to 2 years
Cohort 9: Number of participants with routine 12-lead electrocardiogram (ECG) abnormalities and/or Adverse Events (AEs)
Number of participants with potentially clinically significant ECG values.
Time frame: Up to 2 years
Cohort 9: Number of participants at each grade of the Eastern Cooperative Oncology Group Performance Status (ECOG PS)
The ECOG scale will be used to assess performance status. Grades range from 0 (equals fully active, able to carry on all pre-disease performance without restriction), and 5 (equals dead).
Time frame: Up to 2 years