A Study of Lomvastomig (RO7121661) and Tobemstomig (RO7247669) Compared With Nivolumab in Participants With Advanced or Metastatic Squamous Cell Carcinoma of the Esophagus

A 3-Arm, Randomized, Blinded, Active-Controlled, Phase II Study of RO7121661, a PD1-TIM3 Bispecific Antibody and RO7247669, a PD1-LAG3 Bispecific Antibody, Compared With Nivolumab in Participants With Advanced or Metastatic Squamous Cell Carcinoma of the Esophagus

This is a Phase II, randomized, blinded, active-controlled, global, multicenter study designed to evaluate the safety and efficacy of lomvastomig and tobemstomig, compared with nivolumab, in patients with advanced or metastatic esophageal squamous-cell carcinoma (ESCC) refractory or intolerant to fluoropyrimidine- or taxane- and platinum-based regimen.

Following approval of the protocol amendment version 3, recruitment into the lomvastomig arm has been stopped. The decision to stop recruitment for lomvastomig was based on strategic considerations and not based on emerging safety and/or efficacy data. The benefit/risk assessment for lomvastomig remains unchanged.

The study was planned to enroll participants randomized in a 1:1:1 ratio to receive lomvastomig, tobemstomig, or nivolumab. With version 3 of the protocol, recruitment into the lomvastomig arm has stopped, and moving forward, participants will be randomized in a 1:1 ratio to receive either tobemstomig or nivolumab.

Study Overview

• Status: Active, not recruiting
• Conditions: Advanced or Metastatic Esophageal Squamous Cell Carcinoma
• Intervention / Treatment: Drug: Nivolumab; Drug: Lomvastomig; Drug: Tobemstomig

• Study Type: Interventional
• Enrollment (Estimated): 210
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Reference Study ID Number: BP42772 https://forpatients.roche.com/; Phone Number: 888-662-6728 (U.S. Only); Email: global-roche-genentech-trials@gene.com

Study Locations

• Argentina
  • Buenos Aires, Argentina, C1426ANZ
    • Inst. Alexander Fleming; Oncologia
  • La Rioja, Argentina, F5300COE
    • Centro Oncologico Riojano Integral (Cori)
• Brazil
  • RS
    • Porto Alegre, RS, Brazil, 90035-903
      • Hospital das Clinicas - UFRGS
  • SP
    • Sao Paulo, SP, Brazil, 01246-000
      • Instituto do Cancer do Estado de Sao Paulo - ICESP
    • Sao Paulo, SP, Brazil, 01308-050
      • Hospital Sirio-Libanes
    • São Paulo, SP, Brazil, 01321-00
      • Beneficencia Portuguesa de Sao Paulo
• Czechia
  • Brno, Czechia, 656 53
    • Masaryk?v onkologický ústav; Klinika komplexní onkologické pé?e
  • Olomouc, Czechia, 779 00
    • Fakultni nemocnice Olomouc; Onkologicka klinika
• Denmark
  • København Ø, Denmark, 2100
    • Rigshospitalet; Onkologisk Klinik
  • Odense C, Denmark, 5000
    • Odense Universitetshospital, Onkologisk Afdeling R
• France
  • Bordeaux, France, 33076
    • Institut Bergonie; Oncologie
  • Lille, France, 59037
    • Hopital Claude Huriez; Medecine Interne Oncologie
  • Lyon, France, 69373
    • CENTRE LEON BERARD; Département d?Hématologie et d?Oncologie
  • Marseille, France, 13385
    • Hopital Timone Adultes; Oncologie Digestive
  • Montpellier, France, 34298
    • Institut regional du Cancer Montpellier
  • Paris, France, 75571
    • APHP - Hopital Saint Antoine
  • St Herblain, France, 44805
    • ICO Rene Gauducheau; CEC
• Hungary
  • Szolnok, Hungary, 5004
    • Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet; Megyei Onkologiai Kozpont
• Italy
  • Emilia-Romagna
    • Meldola, Emilia-Romagna, Italy, 47014
      • Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori IRST - PPDS
  • Friuli-Venezia Giulia
    • Udine, Friuli-Venezia Giulia, Italy, 33100
      • Azienda Sanitaria Universitaria Integrata di Udine - PO Universitario Santa Maria della
  • Veneto
    • Padova, Veneto, Italy, 35128
      • IRCCS Istituto Oncologico Veneto (IOV); Oncologia Medica Seconda
• Kenya
  • Eldoret, Kenya, 30100
    • International Cancer Institute (ICI)
  • Nairobi, Kenya, 00100
    • Aga Khan University Hospital
• Korea, Republic of
  • Jeollanam-do, Korea, Republic of, 58128
    • Chonnam National University Hwasun Hospital
  • Seongnam-si, Korea, Republic of, 463-707
    • Seoul National University Bundang Hospital
  • Seoul, Korea, Republic of, 03722
    • Severance Hospital, Yonsei University Health System
  • Seoul, Korea, Republic of, 05505
    • Asan Medical Center
  • Seoul, Korea, Republic of, 08308
    • Korea University Guro Hospital
• Poland
  • Brzozów, Poland, 36-200
    • Szpital Specjalistyczny Podkarpacki O?rodek Onkologiczny
  • Bydgoszcz, Poland, 85-796
    • Centrum Onkologii w Bydgoszczy
  • Gdynia, Poland, 81-519
    • Szpital Morski im. PCK; Poradnia Onkologiczna
  • Kraków, Poland, 31-202
    • Krakowski Szpital Specjalistyczny im sw. Jana Paw?a II; Oddz. Klin. Chir. Klatki Piersiowej i Onkol.
  • Warszawa, Poland, 02-034
    • NIO im Marii Sklodowskiej-Curie; Klinika Onkologii i Radioterapii
• Russian Federation
  • Baskortostan
    • UFA, Baskortostan, Russian Federation, 450054
      • Bashkirian Republican Clinical Oncology Dispensary
  • Moskovskaja Oblast
    • Moscow, Moskovskaja Oblast, Russian Federation, 143422
      • MEDSI Clinical Hospital on Pyatnitsky Highway; Department of antitumor drug therapy
    • Moscow, Moskovskaja Oblast, Russian Federation, 119991
      • First Moscow State Medical University n.a. I.M. Sechenov
    • Moskva, Moskovskaja Oblast, Russian Federation, 105229
      • Group of companies "Medci"
• Singapore
  • Singapore, Singapore, 329563
    • Curie Oncology
  • Singapore, Singapore, 168583
    • National Cancer Centre; Medical Oncology
• Spain
  • Barcelona, Spain, 08036
    • Hospital Clínic i Provincial; Servicio de Oncología
  • Valencia, Spain, 46010
    • Hospital Clinico Universitario de Valencia; Servicio de Onco-hematologia
  • Navarra
    • Pamplona, Navarra, Spain, 31008
      • Complejo Hospitalario de Navarra; Servicio de Oncologia
• Taiwan
  • Chang Hua, Taiwan, 500
    • Changhua Christian Hospital
  • Taipei City, Taiwan, 112201
    • Taipei Veterans General Hospital; Department of Oncology
  • Zhongzheng Dist., Taiwan, 10048
    • National Taiwan University Hospital; Oncology
• Thailand
  • Bangkok, Thailand, 10400
    • Ramathibodi Hospital; Dept of Med.-Div. of Med. Onc
  • Bangkok, Thailand, 10700
    • Siriraj Hospital; Medical Oncology Unit
  • Songkhla, Thailand, 90110
    • Songklanagarind Hospital; Department of Oncology
• Turkey
  • Adana, Turkey, 01230
    • Baskent University Adana Dr. Turgut Noyan Practice and Research Hospital; Medical Oncology
  • Ankara, Turkey, 06520
    • Memorial Ankara Hastanesi
  • Diyarbakir, Turkey, 10000
    • Dicle Uni Medical Faculty; Internal Medicine
  • Erzurum, Turkey, 25240
    • Ataturk University Medical Faculty Yakutiye Research Hospital Medical Oncology Department
  • Malatya, Turkey, 44280
    • Inonu University Medical Faculty Turgut Ozal Medical Center Medical Oncology Department
  • Van, Turkey, 65000
    • Van Yuzuncu Yil University Hospital; Medical Oncology
  • Üsküdar, Turkey, 34662
    • Ac?badem Altunizade Hastanesi; Oncology
• Ukraine
  • Sumy, Ukraine, 40005
    • Regional Municipal Institution Sumy Regional Clinical Oncology Dispensary
  • Kharkiv Governorate
    • Kharkiv, Kharkiv Governorate, Ukraine, 61070
      • Communal Non profit Enterprise Regional Center of Oncology; Oncosurgical dept of thoracic organs
• United Kingdom
  • London, United Kingdom, NW1 2PG
    • UCL Hospital NHS Trust
  • Manchester, United Kingdom, M2O 4BX
    • Christie Hospital Nhs Trust; Medical Oncology
  • Nottingham, United Kingdom, NG5 1PB
    • Nottingham City Hospital; Oncology
  • Oxford, United Kingdom, OX3 7LJ
    • Churchill Hospital; Oxford Cancer and Haematology Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Advanced or metastatic, histologically confirmed esophageal squamous-cell carcinoma (ESCC)
• Patients who have previously received 1 line of treatment with either a fluoropyrimidine- and platinum- or a taxane- and platinum-based regimen in non-curative intention prior to randomization; or patients who received treatment with a fluoropyrimidine-/taxane- and platinum-based regimen in curative intention and had recurrence or progression within 24 weeks after the last dose of the treatment
• Radiologically measurable disease according to RECIST v1.1. Previously irradiated lesions should not be counted as target lesions unless clearly progressed after the radiotherapy
• Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
• A life expectancy of at least (≥)12 weeks
• Tissue samples must be provided for analysis of anti-programmed death ligand-1 (PD-L1) tumor positivity
• Adverse events from any prior radiotherapy, chemotherapy, or surgical procedure must have resolved to Grade ≤1, except alopecia (any grade), vitiligo, endocrinopathy managed with replacement therapy, and Grade 2 peripheral neuropathy
• Adequate cardiovascular, hematological, liver, and renal function
• Serum albumin ≥25 grams per liter (g/L),
• For participants not receiving therapeutic anticoagulation: prothrombin time (PT) and activated partial thromboplastin time ≤1.5 times (×) the upper limit of normal (ULN); for participants receiving therapeutic anticoagulation: stable anticoagulant regimen
• A female participant is eligible to participate if she is not pregnant, not breastfeeding, not a woman of childbearing potential (WOCBP), or a WOCBP who agrees to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods during the treatment period and for at least 5 months after the final dose of study drug and have a negative pregnancy test (blood) within the 7 days prior to randomization.
• A male participant must remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures such as a condom plus an additional contraceptive method and refrain from donating sperm during the treatment period and for at least 5 months after the final dose of study drug

Exclusion Criteria:

• Pregnancy, lactation, or breastfeeding
• Known hypersensitivity to any of the components of RO7121661, RO7247669, or nivolumab, including but not limited to, hypersensitivity to Chinese hamster ovary cell products or other recombinant human or humanized antibodies
• Patients with significant malnutrition. Patients whose nutrition has been well controlled for ≥28 days prior to randomization may be enrolled
• Evidence of complete esophageal obstruction not amenable to treatment
• Higher risk of bleeding or fistula caused by esophageal lesions invading adjacent organs (aorta or tracheobronchial tree). Patients with manageable fistula may be included at the Investigator's discretion.
• Symptomatic central nervous system (CNS) metastases
• Spinal cord compression not definitively treated with surgery and/or radiation or without evidence that disease has been clinically stable for ≥14 days prior to randomization
• Active or history of carcinomatous meningitis/leptomeningeal disease
• Asymptomatic CNS primary tumors or metastases if they have requirement for steroids or enzyme inducing anticonvulsants in the last 28 days prior to randomization
• Uncontrolled tumor-related pain. Participants requiring pain medication must be on a stable regimen at study entry
• Active second malignancy (with some exceptions)
• Evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol or interpretation of results, including diabetes mellitus, history of relevant pulmonary disorders, known autoimmune diseases or immune deficiency, or other diseases with ongoing fibrosis (such as scleroderma, pulmonary fibrosis, emphysema, neurofibromatosis, palmar/plantar fibromatosis, etc.).
• Encephalitis, meningitis, or uncontrolled seizures in the year prior to informed consent
• Significant cardiovascular/cerebrovascular disease within 6 months prior to randomization
• Known active or uncontrolled bacterial, viral, fungal, mycobacterial (including but not limited to tuberculosis [TB] and typical mycobacterial disease), parasitic, or other infection (excluding fungal infections of nail beds) or any major episode of infection requiring treatment with intravenous (IV) antibiotics or hospitalization (relating to the completion of the course of antibiotics, except if for tumor fever) within 28 days prior to randomization
• Known clinically significant liver disease, including alcoholic hepatitis, cirrhosis, and inherited liver disease.
• Major surgical procedure or significant traumatic injury (excluding biopsies) within 28 days prior to randomization, or anticipation of the need for major surgery during the course of the study
• Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the participant at high risk from treatment complications
• Dementia or altered mental status that would prohibit informed consent
• Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures (expected to occur once monthly or more frequently)
• Active or history of autoimmune disease or immune deficiency
• Positive human immunodeficiency virus (HIV) test at screening
• Positive hepatitis B surface antigen (HBsAg) or positive total hepatitis B core antibody (HBcAb) test at screening
• Positive hepatitis C virus (HCV) antibody test at screening
• Prior cancer therapy with any immunomodulatory agents including checkpoint inhibitors (CPIs; such as anti-PDL1/PD1, anti-CTLA-4, anti-LAG3, anti-TIM3)
• Vaccination with live vaccines within 28 days prior to randomization, or anticipation that a live attenuated vaccine will be required during the study
• Treatment with therapeutic oral or IV antibiotics within 14 days prior to randomization
• Concurrent therapy with any other investigational drug (defined as treatment for which there is currently no regulatory authority approved indication) 28 days or 5 half-lives of the drug (whichever is shorter) prior to randomization
• Treatment with immune-modulating and immune suppressive agents/medication 5 half-lives or 28 days (whichever is shorter) prior to randomization
• Regular immunosuppressive therapy (i.e., for organ transplantation, chronic rheumatologic disease)
• Radiotherapy within the last 28 days before start of study drug treatment is not allowed, with the exception of limited palliative radiotherapy
• Prior treatment with adoptive cell therapies, such as chimeric antigen receptor T cells (CAR-T) therapies

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Nivolumab	Drug: Nivolumab; 240 mg administered by IV infusion once every 2 weeks on Day 1 of each 14-day cycle.; Other Names: Opdivo®
Experimental: Lomvastomig	Drug: Lomvastomig; 2100 milligrams (mg) administered by intravenous (IV) infusion once every 2 weeks on Day 1 of each 14-day cycle.; Other Names: RG7769; PD1-TIM3 BsAb; RO7121661
Experimental: Tobemstomig	Drug: Tobemstomig; 2100 mg administered by IV infusion once every 2 weeks on Day 1 of each 14-day cycle.; Other Names: RG6139; PD1-LAG3 BsAb; RO7247669

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Overall Survival, Defined as the Time from Randomization to Death from Any Cause	Up to 4 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Participants Reporting Clinically Meaningful Improvement in Global Health Status/Quality of Life (GHS/QoL), and Emotional and Social Functioning, Defined as a ≥10-Point Increase from Baseline as Measured by the EORTC QLQ-C30	EORTC QLQ-C30 = European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30	Baseline (Day 1 of Cycle 1) and Day 1 of Cycles 4, 7, 10, and then every 6 cycles thereafter (each cycle is 14 days) until treatment discontinuation; and every 3 months during the first year of post-treatment follow-up (up to 3 years)
Percentage of Participants Reporting a Clinically Meaningful Improvement in GHS/QoL, and Emotional and Social Functioning, Defined as a ≥10-Point Increase from Baseline as Measured by the EORTC IL97 Questionnaire	EORTC IL97 = European Organisation for Research and Treatment of Cancer - Item Library 97	Baseline (Cycle 1 Day 1) and Day 1 of Cycles 2, 3, 5, 6, 8, and 9 (each cycle is 14 days)
Percentage of Participants Reporting a Clinically Meaningful Improvement in Dysphagia, Defined as a ≥10-Point Increase from Baseline as Measured by the EORTC QLQ-OES18	EORTC QLQ-OES18 = European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire for Esophageal Cancer	Baseline (Cycle 1 Day 1) and Day 1 of each subsequent treatment cycle (each cycle is 14 days) until treatment discontinuation; and every 3 months during the first year of post-treatment follow-up (up to 3 years)
Change from Baseline in the Number of T-cell Subsets by Phenotype and Activation Status (CD4/CD8 HLA-DR+Ki67+) in the Peripheral Blood		Predose at Baseline (Day 1 of Cycle 1) and on Day 1 of Cycles 2, 3, 5, and 7, and then every 3 cycles thereafter (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Change from Baseline in the Number of CD8+ T-cells Infiltrating the Tumor Microenvironment		Baseline and Day 1 of Cycle 3 (each cycle is 14 days)
Change from Baseline in the Number of CD8+ T-cells Proliferating (CD8+Ki67+) in the Tumor Microenvironment		Baseline and Day 1 of Cycle 3 (each cycle is 14 days)
Baseline PDL1, CD8+PD1+, CD8+TIM3+, and CD8+LAG3+ Expression in the Tumor Microenvironment		At Baseline
Number of Participants with Adverse Events, Severity Graded According to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0 (NCI-CTCAE v5.0)		Up to 4 years
Objective Response Rate (ORR), Defined as the Percentage of Participants with a Complete or Partial Response According to Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1)		Up to 4 years
Disease Control Rate (DCR), Defined as the Percentage of Participants with an Objective Response or Stable Disease According to RECIST v1.1		Up to 4 years
Duration of Response for Participants with ORR, Defined as the Time from the First Occurrence of a Documented Objective Response to Disease Progression According to RECIST v1.1 or Death from any Cause, Whichever Occurs First		Up to 4 years
Progression-Free Survival (PFS), Defined as the Time from Randomization to the First Occurrence of Progression as Determined According to RECIST v1.1 or Death from any Cause, Whichever Occurs First		Up to 4 years
Serum Concentrations of Tobemstomig and Nivolumab		Predose and at end of infusion on Day 1 of every treatment cycle and on Day 8 of Cycles 1 and 5 (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Area Under the Time-Serum Concentration Curve (AUC) of Tobemstomig and Nivolumab		Predose and at end of infusion on Day 1 of every treatment cycle and on Day 8 of Cycles 1 and 5 (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Maximum Serum Concentrations of Tobemstomig and Nivolumab		Predose and at end of infusion on Day 1 of every treatment cycle and on Day 8 of Cycles 1 and 5 (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Total Clearance of Tobemstomig and Nivolumab		Predose and at end of infusion on Day 1 of every treatment cycle and on Day 8 of Cycles 1 and 5 (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Volume of Distribution at Steady State of Tobemstomig and Nivolumab		Predose and at end of infusion on Day 1 of every treatment cycle and on Day 8 of Cycles 1 and 5 (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Terminal Half-Life of Tobemstomig and Nivolumab		Predose and at end of infusion on Day 1 of every treatment cycle and on Day 8 of Cycles 1 and 5 (each cycle is 14 days); and at treatment discontinuation (up to 2 years)
Number of Participants with Anti-Drug Antibodies (ADAs) to Tobemstomig or Nivolumab at Baseline and During the Study		Predose at Baseline (Day 1 of Cycle 1) and on Day 1 of Cycles 2, 3, 4, 5, and 7, and then every 3 cycles thereafter (each cycle is 14 days); and at treatment discontinuation (up to 2 years)

Collaborators and Investigators

• Sponsor: Hoffmann-La Roche
• Investigators: Study Director: Clinical Trials, Hoffmann-La Roche

Study record dates

Study Major Dates

• Study Start (Actual): June 25, 2021
• Primary Completion (Estimated): June 30, 2025
• Study Completion (Estimated): June 30, 2025

Study Registration Dates

• First Submitted: March 4, 2021
• First Submitted That Met QC Criteria: March 4, 2021
• First Posted (Actual): March 8, 2021

Study Record Updates

• Last Update Posted (Actual): March 20, 2024
• Last Update Submitted That Met QC Criteria: March 19, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms by Histologic Type; Neoplasms; Neoplasms by Site; Neoplasms, Glandular and Epithelial; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Head and Neck Neoplasms; Esophageal Diseases; Neoplasms, Squamous Cell; Carcinoma; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Antineoplastic Agents, Immunological; Immune Checkpoint Inhibitors; Nivolumab
• Other Study ID Numbers: BP42772; 2020-004606-60 (EudraCT Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Qualified researchers may request access to individual patient level data through the request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/ourmember/roche/).

For further details on Roche's Global Policy on Sharing of Clinical Study Information and how to request access to related clinical study documents, see here (https://www.roche.com/innovation/process/clinical-trials/data-sharing/).

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No