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The safety and efficacy of this agent(s), or use in this setting, has not been established or is subject to confirmation. For an agent(s) whose safety and efficacy has not been established or confirmed, future regulatory approval or commercial availability is not guaranteed.

Clinical Trial Details

Geo Regions

Category

Genitourinary Cancer

Disitamab vedotin

An Open-label, Randomized, Controlled Phase 3 Study of Disitamab Vedotin in Combination With Pembrolizumab Versus Chemotherapy in Subjects With Previously Untreated Locally Advanced or Metastatic Urothelial Carcinoma That Expresses HER2 (IHC 1+ and Greater)

Phase 3

NCT05911295

Active enrolling

Globe

Locations

United States, Argentina, Australia, Brazil, Canada, Chile, France, Israel, Italy, Korea, Republic of, Peru, Singapore, Spain, Taiwan

QR Code

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for more information at clinicaltrials.gov

Study design
Participant Group/Arm

EXPERIMENTAL: Disitamab vedotin arm

disitamab vedotin + pembrolizumab

Intervention/Treatment

DRUG: disitamab vedotin

Given into the vein (IV; intravenous) every 2 weeks

DRUG: pembrolizumab

400mg given by IV every 6 weeks
Participant Group/Arm

ACTIVE_COMPARATOR: Standard of care arm

gemcitabine + cisplatin OR carboplatin

Intervention/Treatment

DRUG: gemcitabine

1000 mg/m\^2 given by IV on days 1 and 8 of every 3-week cycle

DRUG: cisplatin

70 mg\^2 given by IV on day 1 of every 3-week cycle

DRUG: carboplatin

Area under the plasma concentration-time curve (AUC) 4.5 or 5 given by IV on day 1 of every 3-week cycle
Study design table for Clinical Trial
Key eligibility criteria
Inclusion criteria
  • Histopathological confirmation of locally advanced unresectable or metastatic urothelial carcinoma (LA/mUC), including UC originating from the renal pelvis, ureters, bladder, or urethra.
  • Measurable disease by investigator assessment per RECIST v1.1.
  • Participant must not have received prior systemic therapy for LA/mUC. Exception will be made for neoadjuvant or adjuvant therapy, if disease recurrence/progression occurred more than 12 months after the last dose of therapy.
  • Eligible to receive cisplatin- or carboplatin-containing chemotherapy.
  • Able to provide archived formalin-fixed paraffin-embedded tumor tissue blocks from a muscle-invasive or metastatic UC lesion or biopsy of metastatic UC prior to treatment initiation. If archival tissue is not available a newly obtained baseline biopsy of an accessible tumor lesion is required within 28 days of cycle 1 day 1.
  • HER2 expression of 1+ or greater on immunohistochemistry (IHC).
  • Eastern Cooperative Oncology Group (ECOG) performance score of 0, 1, or 2 within 7 days prior to randomization.
Exclusion criteria
  • Known hypersensitivity to disitamab vedotin, cisplatin, carboplatin, gemcitabine, or pembrolizumab or any of their components.
  • History of severe/life threatening immune-related adverse event (irAE) with PD-(L)1 inhibitors are excluded.
  • Central nervous system (CNS) and/or leptomeningeal metastasis. Participants with treated CNS metastases are permitted if all of the following are met.
    • CNS metastases have been clinically stable for at least 4 weeks and baseline scans show no evidence of new or worsening CNS metastasis.
    • Participant is on a stable dose of ≤ 10 mg/day of prednisone or equivalent for at least 2 week
  • History of or active autoimmune disease that has required systemic treatment in the past 2 years.
  • Prior treatment with an agent directed to another stimulatory or co-inhibitory T cell receptor (including but not limited to CD137 agonists, CAR-T cell therapy, CTLA-4 inhibitors, or OX-40 agonists).
  • Prior solid organ or bone marrow transplantation.
  • Pleural effusion or ascites with symptoms or requiring symptomatic treatment.
  • Estimated life expectancy \<12 week
  • Prior treatment with an MMAE agent or anti-HER2 therapy
  • Key dates
    Study start date
    • September 2023
    Estimated Study Completion Date
    • April 2029
    Key endpoints
    Primary Outcome Measures
    Outcome Measure

    Progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) by blinded independent central review (BICR)

    Measure Description

    The time from randomization to first documentation of disease progression per RECIST v1.1 by BICR, or to death due to any cause.

    Time Frame

    Approximately 3 years

    Outcome Measure

    Overall survival (OS)

    Measure Description

    The time from date of randomization to date of death due to any cause.

    Time Frame

    Approximately 5 years

    Primary Outcome Measures table for Clinical Trial
    Secondary Outcome Measures:
    Outcome Measure

    Objective response rate (ORR) per RECIST v1.1 by BICR

    Measure Description

    The proportion of participants with confirmed complete response (CR) or partial response (PR) according to RECIST v1.1.

    Time Frame

    Approximately 3 years

    Outcome Measure

    ORR per RECIST v1.1 by investigator assessment

    Measure Description

    The proportion of participants with confirmed CR or PR according to RECIST v1.1.

    Time Frame

    Approximately 3 years

    Outcome Measure

    Duration of Response (DOR) per RECIST v1.1 by BICR

    Measure Description

    The time from first documented response of CR or PR (that is subsequently confirmed) to the first documented disease progression per RECIST v1.1, or to death due to any cause.

    Time Frame

    Approximately 3 years

    Outcome Measure

    DOR per RECIST v1.1 by investigator assessment

    Measure Description

    The time from first documented response of CR or PR (that is subsequently confirmed) to the first documented disease progression per RECIST v1.1, or to death due to any cause.

    Time Frame

    Approximately 3 years

    Outcome Measure

    Control Rate (DCR) per RECIST v1.1 by BICR

    Measure Description

    The proportion of participants with confirmed CR, PR, or stable disease according to RECIST v1.1.

    Time Frame

    Approximately 3 years

    Outcome Measure

    DCR per RECIST v1.1 by investigator assessment

    Measure Description

    The proportion of participants with confirmed CR, PR, or stable disease according to RECIST v1.1.

    Time Frame

    Approximately 3 years

    Outcome Measure

    PFS per RECIST v1.1 by investigator assessment

    Measure Description

    The time from randomization to first documentation of disease progression per RECIST v1.1, or to death due to any cause.

    Time Frame

    Approximately 3 years

    Outcome Measure

    Number of participants with adverse events (AEs)

    Measure Description

    Any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

    Time Frame

    Through 30 days after the last study treatment; approximately 2 years

    Outcome Measure

    Number of participants with laboratory abnormalities

    Measure Description

    Time Frame

    Through 30 days after the last study treatment; approximately 2 years

    Outcome Measure

    Treatment discontinuation rate due to AEs

    Measure Description

    Time Frame

    Approximately 2 years

    Outcome Measure

    Number of electrocardiogram (ECG) abnormalities

    Measure Description

    Time Frame

    Through 30 days after the last study treatment; approximately 2 years

    Outcome Measure

    Change from baseline of left ventricular ejection fraction (LVEF)

    Measure Description

    Time Frame

    Through 2 years after last study treatment; approximately 4 years

    Outcome Measure

    Change from baseline to Week 16 in European Organization for Research and Treatment of Cancer core Quality of Life questionnaire (EORTC QLQ-C30) Global Health Status (GHS)/QoL Score

    Measure Description

    The EORTC QLQ-C30 is used to evaluate health-related quality of life, functioning, disease symptoms, and treatment-related side effects. Scores range from 0-100. For GHS/QoL and functional scales, higher scores represent higher QoL or functioning. For symptom scales, higher scores represent more symptoms/worse status.

    Time Frame

    Approximately 2 years

    Outcome Measure

    Time to Deterioration in EORTC QLQ-C30 GHS/QoL Score

    Measure Description

    The time from the date of randomization to the date of first deterioration (change from baseline ≥10) in GHS/QoL score with no subsequent recovery. The EORTC QLQ-C30 is used to evaluate health-related quality of life, functioning, disease symptoms, and treatment-related side effects. Scores range from 0-100. For GHS/QoL and functional scales, higher scores represent higher QoL or functioning. For symptom scales, higher scores represent more symptoms/worse status.

    Time Frame

    Approximately 2 years

    Outcome Measure

    Time to pain progression

    Measure Description

    The time from the date of randomization to whichever of the following occurs earlier: * an increase in Numeric Rating Scale (NRS) for pain intensity of 2 points or more from baseline at 2 consecutive visits, * an increase in number of opioid or analgesic use from baseline, * or initiation of opioid or analgesic use. NRS for pain intensity asks participants to best describe their pain at its worst in the last 24 hours from 0 to 10. On the NRS, 0 means no pain and 10 means pain as bad as you can imagine.

    Time Frame

    Approximately 2 years

    Secondary Outcome Measures table for Clinical Trial
    Number of participants

    700

    Collaborators and investigators

    Sponsor: Seagen Inc.

    Collaborator: RemeGen Co., Ltd., Merck Sharp & Dohme LLC

    This information is current as of November 13th 2024.

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    More Information Close NCT# stands for National Clinical Trial number. This is a unique identification code given to each clinical trial registered on ClinicalTrials.gov. The format is "NCT" followed by an 8-digit number (for example, NCT00000419). Also called the ClinicalTrials.gov identifier. NCT05911295