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Study of MPDL3280A (ANTI PD-L1 ANTIBODY) in Patients with PD-L1-selected, High-risk Muscle-invasive Bladder Cancer after Surgery

Phase 1
Conditions
Muscle-invasive bladder cancer
Therapeutic area: Diseases [C] - Cancer [C04]
MedDRA version: 18.0Level: LLTClassification code 10022877Term: Invasive bladder cancerSystem Organ Class: 100000004864
Registration Number
EUCTR2014-005603-25-FR
Lead Sponsor
F. Hoffmann-La Roche Ltd
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
440
Inclusion Criteria

- Age >=18 years
- Histologically or cytologically confirmed muscle-invasive transitional cell carcinoma (TCC) (also termed urothelial carcinoma [UC]) of the bladder (excluding TCC of renal pelvis, ureters, or urethra)
- Tumor Nodes Metastasis (TNM) classification at pathological examination of cystectomy specimen - For patients treated with prior neoadjuvant chemotherapy: tumor stage of ypT2-T4a or ypN+; For patients not treated with prior neoadjuvant chemotherapy: tumor stage of pT3-T4a or pN+
- Cystectomy with lymph node dissection
- MIBC with a PD-L1 immunohistochemistry (IHC) score of IC2/3 prospectively determined on the cystectomy tumor specimens by a central laboratory
- Absence of residual disease and absence of metastasis, as confirmed by a negative baseline computed tomography (CT) or magnetic resonance imaging (MRI) scan of the pelvis, abdomen, and chest no more than 6 weeks prior to randomization
- Full recovery from cystectomy within 12 weeks following surgery
- Eastern Cooperative Oncology Group performance status score of <=2
- Life expectancy >=12 weeks
- Adequate hematologic and end-organ function
- For women who are not postmenopausal (>=12 months of non-therapy-induced amenorrhea) or surgically sterile (absence of ovaries and/or uterus): agreement to remain abstinent or use single or combined non-hormonal contraceptive methods that result in a failure rate of <1% per year during the treatment period and for at least 90 days after the last dose of study drug

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 264
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 176

Exclusion Criteria

- Any approved anti-cancer therapy, including chemotherapy, or hormonal therapy within 3 weeks prior to initiation of study treatment
- Adjuvant chemotherapy or radiation therapy for UC following cystectomy
- Treatment with any other investigational agent or participation in another clinical trial with therapeutic intent within 28 days prior to enrollment
- Malignancies other than MIBC within 5 years prior to Cycle 1, Day 1
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- History of autoimmune disease
- History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan
- Tested Positive for HIV
- Patients with active hepatitis B virus and tuberculosis
- Prior allogeneic stem cell or solid organ transplant
- Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or greater), myocardial infarction within the previous 3 months, unstable arrhythmias, or unstable angina
- Major surgical procedure other than for diagnosis within 28 days prior to Cycle 1, Day 1 or anticipation of need for a major surgical procedure during the course of the study
- Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-CD40, anti-CTLA-4, anti-PD-1, and anti-PD-L1 therapeutic antibodies

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: To evaluate the efficacy of adjuvant MPDL3280A treatment in patients with programmed death ligand 1 (PD L1) selected muscle invasive bladder cancer (MIBC), as measured by disease-free survival (DFS);Secondary Objective: • To evaluate the efficacy of adjuvant MPDL3280A treatment, as measured by overall survival (OS), disease-specific survival (DSS) and distant metastasis-free survival (DMFS)<br>• To evaluate the safety and tolerability of MPDL3280A in the adjuvant setting<br>• To evaluate the incidence of anti-therapeutic antibodies (ATAs) against MPDL3280A and to explore the potential relationship of the immunogenicity response with pharmacokinetics (PK), safety, and efficacy<br>• To characterize the pharmacokinetics of MPDL32820A<br>• To assess health status as measured by the EuroQol 5-dimension, 5-level version (EQ-5D-5L) questionnaire<br>;Primary end point(s): Investigator-assessed DFS;Timepoint(s) of evaluation of this end point: Up to 6 years
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): 1. OS<br>2. DSS<br>3. DMFS<br>4. Incidence of adverse events<br>5. Changes in vital signs and clinical laboratory results<br>6. Incidence of ATA response to MPDL3280A and potential correlation with PK, pharmacodynamic, safety, and efficacy parameters<br>7. Maximum observed serum MPDL3280A concentration (Cmax)<br>8. Minimum observed serum MPDL3280A concentration (Cmin)<br>9. EQ-5D-5L<br>;Timepoint(s) of evaluation of this end point: 1-5. Up to 6 years<br>6. Day 1 of Cycles 1, 2, 3, 8 and every 8 cycles starting Cycle 8 until 120 days after the last dose of MDPL3280A and at treatment discontinuation visit<br>7. Day 1 of Cycle 1<br>8. Day 1 of Cycles 1, 2, 3, 8 and every 8 cycles starting Cycle 8 until 120 days after the last dose of MDPL3280A and at treatment discontinuation visit<br>9. Up to 6 years<br>
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