This phase II trial tests how well enfortumab vedotin works for treating patients with squamous cell carcinoma of the penis that has spread to other places in the body (metastatic) or cannot be removed by surgery (unresectable). Enfortumab vedotin is a monoclonal antibody, enfortumab, linked to an anticancer drug called vedotin. It works by helping the immune system to slow or stop the growth of tumor cells. Enfortumab attaches to a protein called nectin-4 on tumor cells in a targeted way and delivers vedotin to kill them.
PRIMARY OBJECTIVE: I. To estimate the best response rate of enfortumab vedotin treatment for patients with metastatic penile squamous cell carcinoma (mPSCC). SECONDARY OBJECTIVES: I. To determine overall response rate (ORR). II. To determine safety and tolerance of enfortumab vedotin in men with mPSCC. III. To characterize duration of response to enfortumab vedotin in mPSCC. IV. To estimate median overall survival and progression-free survival in men with mPSCC treated with enfortumab vedotin. V. To analyze response in subgroups by human papillomavirus (HPV) status (related/unrelated as assessed by p16 biomarker). OUTLINE: Patients receive enfortumab vedotin intravenously (IV) over 30 minutes on days 1,8 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study. After completion of study treatment, patients are followed up at 30 days and then every 3 months until progressive disease, followed by every 6 months for up to 5 years from registration.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Mayo Clinic Hospital in Arizona
Phoenix, Arizona, United States
RECRUITINGMayo Clinic in Florida
Jacksonville, Florida, United States
RECRUITINGMayo Clinic in Rochester
Rochester, Minnesota, United States
RECRUITINGBest response rate
Defined as the proportion of patients who experience either a partial response (PR) or complete response (CR) as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1. The best response rate of CR/PR will be reported descriptively and a 95% confidence interval will be reported.
Time frame: Up to 5 years
Objective response rate (ORR)
Defined as the proportion of patients who experience either a confirmed partial response or confirmed complete response as defined by RECIST v1.1. ORR will be reported descriptively and a 95% confidence interval will be reported.
Time frame: Up to 5 years
Progression free survival (PFS)
Will be estimated using the Kaplan-Meier method. The median PFS and 95% confidence interval will be reported.
Time frame: From study entry to the first of either disease progression or death from any cause, up to 5 years
Overall survival (OS)
Will be estimated using the Kaplan-Meier method. The median OS and 95% confidence interval will be reported.
Time frame: From study entry to death from any cause, up to 5 years
Incidence of adverse events
The maximum grade for each type of adverse event by patient will be summarized by frequencies and percentages using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Time frame: Up to 30 days after last dose of study medication
Duration of Response
Defined for all evaluable patients who have achieved an objective response as the date at which the patient's earliest best objective status is first noted to be either a CR or PR to the earliest date progression is documented.
Time frame: Up to 5 years
Best response by human papillomavirus (HPV) status
The p16 biomarker will be used to assess HPV status. The p16 immunohistochemistry (IHC) outcome will be classified as positive, negative, or not available. Best response rates of either a CR or PR will be determined for each subgroup and 95% confidence intervals will be reported.
Time frame: Up to 5 years
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