一项研究：评估恩福妥单抗维多汀与帕博利珠单抗联合治疗对肌层浸润性膀胱癌患者保留膀胱的帮助
一项开放标签、单臂、II期研究，旨在评估Enfortumab Vedotin联合Pembrolizumab用于肌层浸润性膀胱癌患者膀胱保留治疗（EV-209）
People with a type of bladder cancer called muscle-invasive bladder cancer have cancer that has spread into the muscle wall of the bladder. The standard treatment is to have chemotherapy, followed by surgery to completely remove the bladder. This has a significant impact on people with long-term life-altering changes. There are also limited options for people who cannot have chemotherapy or who do not want their bladder removed.
Studies show that enfortumab vedotin, when given with pembrolizumab, can help people with advanced bladder cancer. This treatment has also worked well for people with muscle-invasive bladder cancer who can't receive chemotherapy when it was given before and after bladder-removal surgery. However, some people can't have or won't have this surgery. There is still a need for new treatments that let people keep their bladder. This is especially important for people who respond well to the enfortumab vedotin, when given with pembrolizumab, and may benefit from continuing this study treatment instead of having surgery.
The main aims of this study are to check how many people continue to respond well to enfortumab vedotin with pembrolizumab and how many people have their bladder intact after 2 years.
People in this study will be adults who have muscle-invasive bladder cancer and are able to have surgery to remove the bladder.
People cannot take part if they have nerve damage (sensory or motor neuropathy), have had certain other cancers, have diabetes that is not under control, or have had a transplant.
People will receive infusions of enfortumab vedotin on the 1st and 8th day of 3-week (21-day) cycles. They will also receive pembrolizumab on the 1st day of every 3-week cycle. There will be safety checks at each visit with checks of the tumors at some visits. The doctors will continue to check for medical problems throughout the study.
People will continue to receive study treatment unless their cancer doesn't improve after 9 cycles of study treatment, or until their cancer gets worse, they can't tolerate the study treatment, they start other cancer treatment, they or the doctor decides the person should stop receiving study treatment, or sadly they pass away.
People's whose cancer gets worse or doesn't improve after 9 cycles may need bladder surgery, radiotherapy or chemotherapy. People will visit the clinic after they stop their study treatment, in which they will be asked about any medical problems and have a health check. After this, people will continue to have scans every 12 weeks (3 months) for the first 2 years until their cancer gets worse. After this, if their cancer doesn't get worse, they will continue to have scans every 24 weeks (6 months) for up to 5 years to check for any changes in their cancer. After people's cancer gets worse, they won't have any more scans but will have telephone health checks every 3 months.
研究概览
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名：Astellas Pharma Global Development, Inc.
- 电话号码：800-888-7704
- 邮箱：Astellas.registration@astellas.com
学习地点
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Beijing、中国
- 招聘中
- Cancer Hospital, Chinese Academy of Medical Sciences
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Langfang、中国
- 招聘中
- Langfang Campus, Cancer Hospital Chinese Academy of Medical Science
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Shanghai Municipality
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Shanghai、Shanghai Municipality、中国
- 招聘中
- Sichuan Cancer Hospital
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Sichuan
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Chengdu、Sichuan、中国
- 招聘中
- Shanghai Tenth People's Hospital
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Ontario
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Toronto、Ontario、加拿大
- 招聘中
- Site US10003
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-
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Herne、德国
- 招聘中
- Site DE49009
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-
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Bari、意大利
- 招聘中
- Site IT39013
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Foggia、意大利
- 招聘中
- Site IT39005
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Meldola、意大利
- 招聘中
- Site IT39009
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Milan、意大利
- 招聘中
- Site IT39017
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Kyoto、日本
- 招聘中
- Kyoto University Hospital
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Osaka、日本
- 招聘中
- Osaka Metropolitan University Hospital
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Gifu
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Gifu、Gifu、日本
- 招聘中
- Gifu University Hospital
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Hyōgo
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Kobe、Hyōgo、日本
- 招聘中
- Kobe City Hospital Organization - Kobe City Medical Center General Hospital
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Ibaraki
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Tsukuba、Ibaraki、日本
- 招聘中
- University of Tsukuba Hospital
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Kanagawa
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Kawasaki、Kanagawa、日本
- 招聘中
- St. Marianna University Hospital
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Tokyo
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Bunkyo-ku、Tokyo、日本
- 招聘中
- Tokyo Metropolitan Hospital Organization-Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
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Bunkyo-ku、Tokyo、日本
- 招聘中
- Institute of Science Tokyo Hospital
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Koto-ku、Tokyo、日本
- 招聘中
- The Cancer Institute Hospital-Japanese Foundation for Cancer
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Yamaguchi
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Ube、Yamaguchi、日本
- 招聘中
- Yamaguchi University Hospital - Center For Clinical Research
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Cedex Lyon 08、法国
- 招聘中
- Site FR33004
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Paris、法国
- 招聘中
- Site FR33002
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Rennes、法国
- 招聘中
- Site FR33013
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Strasbourg、法国
- 招聘中
- Site FR33009
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Strasbourg、法国
- 招聘中
- Site FR33012
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Suresnes、法国
- 招聘中
- Site FR33011
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Toulouse、法国
- 招聘中
- Site FR33003
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Villejuif、法国
- 招聘中
- Site FR33010
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Lodz、波兰
- 招聘中
- Site PL48005
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Opole、波兰
- 招聘中
- Site PL48007
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Poznan、波兰
- 招聘中
- Site PL48008
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Przemyśl、波兰
- 招聘中
- Site PL48006
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New South Wales、澳大利亚
- 招聘中
- Site AU61002
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Queensland
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Southport、Queensland、澳大利亚
- 招聘中
- Site AU61005
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Arkansas
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Little Rock、Arkansas、美国、72211
- 招聘中
- Arkansas Urology Associates
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California
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Stanford、California、美国、94305
- 招聘中
- Stanford University School of Medicine
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Illinois
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Chicago、Illinois、美国、60612
- 招聘中
- University of Illinois College of Medicine - UIC Cancer Center
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Lisle、Illinois、美国、60532
- 招聘中
- Accellacare of Duly
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Indiana
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Indianapolis、Indiana、美国、46202
- 招聘中
- Indiana University School of Medicine - Simon Cancer Center
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Kansas
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Westwood、Kansas、美国、66205
- 招聘中
- The University of Kansas Cancer Center
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Michigan
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Detroit、Michigan、美国、48201
- 招聘中
- Karmanos Cancer Institute
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Royal Oak、Michigan、美国、48073
- 招聘中
- Profound Research LLC at Michigan Hematology and Oncology Consultants
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New Jersey
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Cherry Hill、New Jersey、美国、08002
- 招聘中
- Sidney Kimmel Comprehensive Cancer Center (SKCCC) Cherry Hill
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Washington Township、New Jersey、美国、08080
- 招聘中
- Sidney Kimmel Comprehensive Cancer Center (SKCC) Washington Township
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New York
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New York、New York、美国、10017
- 招聘中
- NYU Langone Urology Associates
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Pennsylvania
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Bala-Cynwyd、Pennsylvania、美国、19004
- 招聘中
- Centers for Advanced Urology, LLP
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Philadelphia、Pennsylvania、美国、19107
- 招聘中
- Thomas Jefferson University
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Willow Grove、Pennsylvania、美国、19090
- 招聘中
- Sidney Kimmel Comprehensive Cancer - Asplundh Cancer Pavilion
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South Carolina
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Myrtle Beach、South Carolina、美国、29572
- 招聘中
- Carolina Urologic Research Center
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Texas
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Houston、Texas、美国、77030
- 招聘中
- The University of Texas MD Anderson Cancer Center
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Round Rock、Texas、美国、78681
- 招聘中
- Urology Austin, PLLC
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San Antonio、Texas、美国、78229
- 招聘中
- Urology San Antonio
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Wisconsin
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Madison、Wisconsin、美国、53792
- 招聘中
- University of Wisconsin Hospitals and Clinics
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Colchester、英国
- 招聘中
- Site UK44003
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London、英国
- 招聘中
- Site GB44005
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London、英国
- 招聘中
- Site UK44004
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Plymouth、英国
- 招聘中
- Site UK44001
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Granada、西班牙
- 招聘中
- Site ES34011
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Ourense、西班牙
- 招聘中
- Site ES34002
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Pamplona、西班牙
- 招聘中
- Site ES34005
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Gyeonggi-do、韩国
- 招聘中
- Site KR82007
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Seoul、韩国
- 招聘中
- Site KR82003
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Seoul、韩国
- 招聘中
- Site KR82001
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Seoul、韩国
- 招聘中
- Site KR82005
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Seoul、韩国
- 招聘中
- Site KR82010
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Seoul、韩国
- 招聘中
- Site KR82008
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Gyeonggi-do
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Seongnam-si、Gyeonggi-do、韩国
- 招聘中
- Site KR82002
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Jeollanam-do
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Hwasun、Jeollanam-do、韩国
- 招聘中
- Site KR82004
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Participant has histologically-confirmed MIBC, stage cT2-T4aN0M0 or T1-T4aN1M0. NOTE: urothelial carcinomas (UCs) not originating from the bladder (e.g., upper tract [ureters, renal pelvis], urethra) are not eligible. UCs invading into the prostatic stroma with no histologic muscle invasion is allowed, provided that the extent of disease is confirmed via imaging.
- Participant has predominant UC histology (≥ 50%). NOTE: Participants with mixed histology are eligible provided the urothelial component is ≥ 50% (participants whose tumors contain predominant [≥ 50%] plasmacytoid variant are not eligible). Participants whose tumors contain any neuroendocrine histology are not eligible.
- Participant is deemed eligible for radical cystectomy and pelvic lymph node dissection.
- Participant has accessible archival tumor tissue from the primary tumor, for which source and availability have been confirmed prior to study intervention. If no archival tumor tissue is available, the participant will have a biopsy to obtain tumor tissue prior to study intervention.
- Participant has Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
- Have a transurethral resection of a bladder tumor within 60 days (+14 days) prior to, or during screening (from the date of informed consent form signature).
Exclusion Criteria:
-
Participant has preexisting sensory or motor neuropathy Grade ≥ 2.
-
Participant has ≥ N2 disease or metastatic disease (M1) as identified by imaging
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Participant has a history of uncontrolled diabetes mellitus within 3 months prior to screening. Uncontrolled diabetes (within 3 months before first dose) is defined as hemoglobin A1c (HbA1c) ≥ 8% or HbA1c between 7% and < 8% with associated diabetes symptoms (polyuria or polydipsia) that are not otherwise explained. The lowest HbA1c during the screening period will be used to determine eligibility.
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Participant has a second malignancy diagnosed within 3 years before first dose of study intervention, or any evidence of residual disease from a previously diagnosed malignancy. Participant with non-melanoma skin cancer, localized prostate cancer treated with curative intent with no evidence of progression, low-risk or very low-risk (per standard guidelines) localized prostate cancer under active surveillance/watchful waiting without intent to treat, or carcinoma in situ of any type (if complete resection was performed) are allowed.
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Participant has known active keratitis or corneal ulcerations. Participant with superficial punctate keratitis is allowed if the disorder is being adequately treated.
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Participant has a history of (non-infectious) pneumonitis/interstitial lung disease (ILD) that required steroids or has current pneumonitis/ILD.
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Participant has a history of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan.
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Participant has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study intervention. Inhaled or topical steroids are permitted in the absence of active autoimmune disease. Physiologic replacement doses of corticosteroids are permitted for participants with adrenal insufficiency.
-
Participant has active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
- Replacement therapy (e.g., thyroxine, insulin, physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed.
- Brief (< 7 days) use of systemic corticosteroids is allowed when use is considered standard of care.
- Participant with vitiligo, psoriasis, type 1 diabetes mellitus, hypothyroidism, or resolved childhood asthma/atopy will not be excluded.
- Participant requiring intermittent use of bronchodilators, inhaled steroids, or local steroid injections will not be excluded.
- Participant with hypothyroidism that is stable with hormone replacement therapy or Sjögren's syndrome will not be excluded.
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Participant has received prior therapy with an anti-programmed cell death protein 1 (PD-1), anti-programmed death-ligand 1 (PD-L1), or anti-programmed death-ligand 2 agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor (e.g., CTLA-4, OX-40, CD137).
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Participant has received prior systemic anti-cancer therapy for MIBC/non-muscle invasive bladder cancer (NMIBC), or received prior systemic anti-cancer therapy including investigational agents (including enfortumab vedotin or other monomethyl auristatin E-based antibody-drug conjugates) within 3 years prior to screening.
NOTE: Prior treatment for NMIBC with intravesical instillation therapy such as Bacillus Calmette-Guérin or intravesical chemotherapy is permitted. Prior systemic treatment (including, but not limited to, anti-PD-1/PD-L1 treatment with pembrolizumab, etc.) received for NMIBC is not permitted.
- Participant has received a partial cystectomy of the bladder to remove any NMIBC or MIBC.
- Participant has received any prior radiotherapy to the bladder.
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：Enfortumab Vedotin with Pembrolizumab
Participants will receive enfortumab vedotin on days 1 and 8 of every 21-day cycle and pembrolizumab on day 1 of every 21-day cycle. |
IV Intravenous infusion (IV)
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Overall clinical complete response (cCR) rate after treatment with enfortumab vedotin in combination with pembrolizumab as assessed by investigator
大体时间：Up to 27 weeks
|
cCR rate is defined as the proportion of participants having cCR after treatment with enfortumab vedotin in combination with pembrolizumab. cCR is defined as no visible tumor detected on cystoscopy or no residual tumor on transurethral resection of bladder tumor (TURBT); no evidence of malignancy, except for the presence of Ta (low grade), and no radiographic evidence of residual or metastatic disease on imaging (magnetic resonance urogram [MRU] or computed tomography urogram [CTU] if contraindicated). Bladder wall thickening on imaging is acceptable if not associated with malignancy, except for the presence of Ta (low grade), and negative urine cytology. |
Up to 27 weeks
|
|
Bladder-intact event-free survival (BI-EFS) rate in participants who achieve cRC after 9 cycles of treatment with enfortumab vedotin in combination with pembrolizumab as assessed by investigator
大体时间：2 years
|
BI-EFS rate is defined as the proportion of participants who have not had an observed BI-EFS event 2 years after the first dose. BI-EFS is defined as the time from first dose to either histologically confirmed recurrent muscle-invasive bladder cancer (MIBC), disease progression, cystectomy, or death from any cause. |
2 years
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Overall cCR rate after 4 cycles of treatment with enfortumab vedotin in combination with pembrolizumab as assessed by investigator
大体时间：Up to 12 weeks
|
cCR rate is defined as the proportion of participants having cCR after completing 4 cycles of enfortumab vedotin and/or pembrolizumab. cCR is defined as no visible tumor detected on cystoscopy or no residual tumor on TURBT; no evidence of malignancy, except for the presence of Ta (low grade), and no radiographic evidence of residual or metastatic disease on imaging (MRU or CTU if contraindicated). Bladder wall thickening on imaging is acceptable if not associated with malignancy, except for the presence of Ta (low grade), and negative urine cytology. |
Up to 12 weeks
|
|
BI-EFS rate in participants who achieve cCR after 4 cycles of treatment with enfortumab vedotin in combination with pembrolizumab as assessed by investigator
大体时间：2 years
|
BI-EFS rate is defined as the proportion of participants who have not had an observed BI-EFS event 2 years after the first dose. BI-EFS is defined as the time from first dose to either histologically confirmed recurrent MIBC, disease progression, cystectomy, or death from any cause. |
2 years
|
|
Overall Survival (OS)
大体时间：Up to 5 years
|
OS is defined as the time from first dose to death due to any cause in participants who achieve cCR after completing up to 9 cycles of enfortumab vedotin and/or pembrolizumab. |
Up to 5 years
|
|
Disease-Free Survival (DFS) as assessed by investigator
大体时间：Up to 5 years
|
DFS is defined as the time from cCR to the first occurrence of either radiologically or pathologically confirmed local or distant recurrence, or death from any cause in participants who achieve cCR after completing up to 9 cycles of enfortumab vedotin and/or pembrolizumab. |
Up to 5 years
|
|
Metastatic-free Survival (MFS) as assessed by investigator
大体时间：Up to 5 years
|
MFS is defined as the time from first dose to the first occurrence of either radiologically or pathologically confirmed distant metastasis, or death from any cause in participants who achieve cCR after completing up to 9 cycles of enfortumab vedotin and/or pembrolizumab. |
Up to 5 years
|
|
Number of participants with Adverse Events (AEs)
大体时间：Up to 12 months
|
AEs will be coded using the MedDRA. An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. |
Up to 12 months
|
|
Number of participants with laboratory value abnormalities and/or adverse events (AEs)
大体时间：Up 11.5 months
|
Number of participants with potentially clinically significant laboratory values. |
Up 11.5 months
|
|
Treatment discontinuation rate due to AEs
大体时间：Up 12 months
|
Treatment discontinuation rate is defined as the number of participants discontinuing due to AEs. |
Up 12 months
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 7465-CL-0209
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
IPD 计划说明
Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as compounds terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.
IPD 共享时间框架
Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
IPD 共享访问标准
Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
IPD 共享支持信息类型
- 研究方案
- 树液
- 企业社会责任
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.