DEPECA-1 - A Phase II Study to Evaluate a First-line Systemic Therapy With Enfortumab Vedotin Plus Avelumab for Advanced and Metastatic Penile Carcinoma

DEPECA-1 - DEfeating PEnile Cancer 1 - A Phase II Study to Evaluate a First-line Systemic Therapy With Enfortumab Vedotin Plus Avelumab for Advanced and Metastatic Penile Carcinoma

The DEPECA-1 trial is the first systematic Phase II trial to evaluate response and survival to a combination of antibody-drug conjugate enfortumab vedotin plus the PD-L1 inhibitor avelumab in patients with locally advanced and metastatic penile squamous cell carcinoma (PeCa) in the 1st line setting.

Study Overview

• Status: Recruiting
• Conditions: Penile Squamous Cell Carcinoma (PSCC)
• Intervention / Treatment: Drug: Avelumab; Drug: enfortumab vedotin

• Study Type: Interventional
• Enrollment (Estimated): 25
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Igor Tsaur, Prof. Dr.; Phone Number: +49 7071-29-86000; Email: igor.tsaur@med.uni-tuebingen.de
• Study Contact Backup: Name: Claudia Pauligk, Dr.; Phone Number: +49 69 5899 787 52; Email: depeca-1@ikf-khnw.de

Study Locations

• Germany
  • Dresden, Germany
    • Recruiting
    • Universitätsklinikum Carl Gustav Carus
    • Principal Investigator: Christian Thomas, Prof. Dr.
  • Mainz, Germany
    • Recruiting
    • University Medical Center of Johannes Gutenberg-University
    • Principal Investigator: Anita Thomas, PD Dr.
  • Mannheim, Germany
    • Recruiting
    • University Hospital Mannheim
    • Principal Investigator: Benjamin Meister, Dr.
  • Munich, Germany
    • Recruiting
    • Technical University of Munich, University Hospital Munich
    • Principal Investigator: Margitta Retz, Prof. Dr.
  • Regensburg, Germany
    • Recruiting
    • Caritas St. Josef Medical Center
    • Principal Investigator: Marco Schnabel, PD Dr.
  • Rostock, Germany
    • Recruiting
    • Rostock University Medical Center
    • Principal Investigator: Angelika Borkowetz, Prof. Dr.
  • Tübingen, Germany
    • Recruiting
    • University Hospital Tübingen
    • Contact: Igor Tsaur, Prof. Dr.
    • Principal Investigator: Igor Tsaur, Prof. Dr.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Patient has ability to understand and the willingness to sign a written informed consent.
2. Patient is ≥ 18 years of age at time of signing the written informed consent.
3. Male patients with histologically confirmed diagnosis of penile squamous cell carcinoma.

4. Patients must be considered non-eligible for curative surgical management. Eligibility for trial inclusion should be based on the presence of either distant metastatic disease (M1) or at least one of the following scenarios based on the UICC/AJCC 8th edition TNM clinical and pathological classification of penile cancer:

   1. Stage 3 (cT3) disease with a single lymph node involved (N1).
   2. Stage 4 disease (cT4).
   3. Any T stage with either N2 (involvement of multiple or bilateral inguinal nodes) or N3 (fixed inguinal nodal mass or pelvic lymphadenopathy) disease. Patients without distant metastases are eligible if multidisciplinary team review concludes that they are unsuitable for curative surgery.
5. Tumor material (archival or current) is available for local pathology testing (PD-L1, HPV).
6. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2.
7. Measurable disease per RECIST 1.1 criteria.
8. No prior systemic therapy for metastatic or locally advanced PeCa in the palliative setting. NOTE: (Neo)adjuvant systemic therapy (without IO) is allowed at least 6 months before study enrollment.

9. Patients has adequate blood count, liver-enzymes, and renal function:

   1. ANC (Absolute neutrophil count) > 1,500 cells/μL without the use of hematopoietic growth factors.
   2. Platelet count ≥ 100 x 109/L (>100,000 per mm3).
   3. Hemoglobin ≥ 9 g/dL.
   4. Serum total bilirubin ≤ 1.5x institutional upper normal limit (ULN).
   5. AST (SGOT)/ALT (SGPT) ≤ 2.5 x institutional ULN (or ≤ 5 x ULN if liver metastases are present).
   6. Creatinine clearance ≥ 30 mL/min as calculated by the Cockcroft- Gault equation (or local institutional standard method).
10. No other active malignancy within the past 3 years, except for adequately treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin.
11. No history of significant cardiovascular disease (e.g., myocardial infarction, unstable angina) within the last 6 months.
12. Life expectancy of at least 3 months.
13. Willingness to comply with study requirements, including follow-up visits and procedures.
14. Patients with female partners of childbearing potential must agree to use an effective method of contraception during the study and for 4 months after the last dose of enfortumab vedotin or for at least 30 days after last avelumab treatment administration, whichever occurs last.

Exclusion Criteria:

1. Previous systemic therapy for metastatic or locally advanced PeCa in the palliative setting.
2. Previous treatment with investigational drugs or devices within 30 days prior to the first dose of trial treatment.
3. Known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
4. Active, known, or suspected autoimmune disease requiring systemic treatment within the past 2 years. Patients with controlled autoimmune d disease not requiring systemic immunosuppressive treatment including diabetes type I, vitiligo, psoriasis, or hypo- or hyperthyroid diseases are eligible.
5. Has ongoing sensory or motor neuropathy Grade 2 or higher.
6. Has a history of uncontrolled diabetes (HbA1c > 8%).
7. Clinically significant (i.e., active) cardiovascular disease: cerebral vascular accident/stroke (< 6 months prior to enrollment), myocardial infarction (< 6 months prior to enrollment), unstable angina, congestive heart failure (≥ New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication.

8. Active infection requiring systemic therapy. The following exceptions apply:

   1. Patients with an HIV infection are eligible if they are on effective antiretroviral therapy with undetectable viral load within 6 months, provided there is no expected drug-drug interaction.
   2. Patients with evidence of chronic HBV infection are eligible if the HBV viral load is undetectable on suppressive therapy (if indicated), and if they have ALT, AST, and total bilirubin levels < ULN, and provided there is no expected drug-drug interaction.
   3. Patients with a history of HCV infection are eligible if they have been treated and cured. For participants with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load, and if they have ALT, AST, and total bilirubin levels < ULN.
9. History of other malignancies within the past 3 years, with the exception of adequately treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin.
10. Severe hepatic impairment (Child-Pugh Class C).
11. Severe renal impairment or requirement for dialysis.
12. History of keratitis and corneal ulceration in the last two years.
13. Active pneumonia, pneumonitis or pulmonary fibrosis.
14. Active tuberculosis.
15. Known prior severe hypersensitivity to the study drugs or any component of their formulations, known severe hypersensitivity reactions to monoclonal antibodies (NCT CTCAE Grade ≥ 3).
16. Inability or unwillingness to comply with study requirements, including follow-up visits and procedures.
17. Inability to provide informed consent.
18. Use of immunosuppressive medication within 14 days prior to the first dose of study treatment, with the exception of intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra-articular injection), systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or equivalent, or steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication).
19. Prior organ transplantation including allogenic stem-cell transplantation.
20. Vaccination within 4 weeks of the first dose of avelumab and while on trials is prohibited except for administration of inactivated vaccines.
21. Persisting toxicity related to prior therapy (NCI CTCAE Grade > 1); however, alopecia or other Grade ≤ 2 not constituting a safety risk based on investigator's judgment are acceptable.
22. Other severe acute or chronic medical conditions including immune colitis, inflammatory bowel disease, or psychiatric conditions including recent (within the past year) or active suicidal ideation or behavior; or laboratory abnormalities that may increase the risk associated with study participation or study treatment administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study.
23. Patient participated in another interventional clinical study according to Medicines Act within 28 days prior to study enrollment or participation in a clinical study according to Medicines Act at the same time as this study unless it is an observational / non-interventional study or during the follow- up period of an interventional study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Combined therapy consisting of enfortumab vedotin and avelumab	Drug: Avelumab; Avelumab, 1,200 mg IV; Drug: enfortumab vedotin; Enfortumab vedotin, 1.25 mg/kg IV

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Objective Response Rate (ORR)	Objective Response Rate (ORR) in 1st line as assessed by investigators, defined as the proportion of patients achieving a complete response (CR) or partial response (PR) according to RECIST 1.1 criteria.	Up to 24 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Progression-free survival (PFS)	Progression-free survival (PFS), defined as the time from the start of treatment to the first documented disease progression acc. to RECIST 1.1 criteria or death from any cause, whichever occurs first.	Up to 5 years.
Overall Survival (OS)	Time from the start of treatment to death from any cause.	Up to 5 years.
Duration of Response (DoR)	Time from the first documented response (CR or PR) to disease progression or death from any cause (whichever occurs first).	Up to 5 years.
Incidence and severity of (serious) adverse events	Incidence and severity of adverse events (AEs) and serious adverse events (SAEs), graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.	Up to 27 months
Quality of life (QoL) using EQ-5D-5L questionnaire	Changes in patient-reported quality of life, using EQ-5D-5L questionnaire and a set of bolt-on questions will be collected.	Up to 24 months.
Quality of life (QoL) using EQ-HWB-S questionnaire	Changes in patient-reported quality of life, using EQ-HWB-S questionnaire and a set of bolt-on questions will be collected.	Up to 24 months.
Disease Control Rate (DCR)	Disease Control Rate (DCR), defined as the proportion of patients achieving CR, PR, or stable disease (SD) according to RECIST 1.1 criteria.	Up to 27 months.

Collaborators and Investigators

• Sponsor: Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest
• Collaborators: Merck KGaA, Darmstadt, Germany; Astellas Pharma GmbH; University Hospital Tübingen
• Investigators: Study Chair: Salah-Eddin Al-Batran, Prof. Dr., Frankfurter Institut für Klinische Krebsforschung IKF GmbH

Study record dates

Study Major Dates

• Study Start (Actual): December 16, 2025
• Primary Completion (Estimated): May 1, 2029
• Study Completion (Estimated): November 1, 2030

Study Registration Dates

• First Submitted: July 18, 2025
• First Submitted That Met QC Criteria: August 6, 2025
• First Posted (Actual): August 7, 2025

Study Record Updates

• Last Update Posted (Actual): April 16, 2026
• Last Update Submitted That Met QC Criteria: April 13, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms; Neoplasms by Histologic Type; Neoplasms, Glandular and Epithelial; Carcinoma; Antineoplastic Agents, Immunological; Antineoplastic Agents; enfortumab vedotin; avelumab
• Other Study ID Numbers: UKT-IKF-DEPECA-1; 2025-521644-37-00 (Ctis)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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