A Phase 2 study of atezolizumab with or without radiotherapy in penile cancer
- Conditions
- MedDRA version: 20.0Level: PTClassification code 10034299Term: Penile cancerSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2018-000603-17-NL
- Lead Sponsor
- Antoni van leeuwenhoek
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- Male
- Target Recruitment
- 32
- Age = 18 years at time of study entry.
- Advanced histologically documented, squamous cell carcinoma of the penis or distal urethra. Advanced disease is defined as:
-Distant metastases, OR
-LRAPC, defined as a large or inoperable primary tumor (T4), palpable nodes >3cm in diameter or fixed nodes, suspicion of extra-nodal extension or pelvic node involvement (N2/N3)
Arm A: Locoregional disease (with or without distant metastases), likely to derive benefit from locoregional radiotherapy and not previously treated with radiotherapy.
Arm B: Benefit of locoregional radiotherapy unlikely OR previously treated with irradiation.
Adequate normal organ and marrow function as defined below:
-Haemoglobin = 5.6/mmol/L
-White blood cell count (WBC) = 2 x 109/L (> 1500 per mm3)
-Absolute neutrophil count (ANC) = 1.5 x 109/L (> 1500 per mm3)
-Platelet count = 100 x 109/L (>100,000 per mm3)
-Serum bilirubin = 1.5 x institutional upper limit of normal (ULN). This will not apply to subjects with confirmed Gilbert’s syndrome, who will be allowed in consultation with a study physician.
-AST/ALT = 2.5 x institutional ULN unless liver metastases are present, in which case it must be = 5x ULN.
-Serum creatinine clearance >30 mL/min by calculation with the Cockcroft-Gault formula (Cockcroft and Gault 1976) or by 24-hour urine collection measurement.
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 20
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 12
1.Involvement in the planning and/or conduct of the study (applies to both Roche staff and/or staff at the study site). Previous enrolment in the present study.
2.Participation in another clinical study with an investigational product during the last 4 weeks
3.Any previous treatment with a PD1 or PD-L1 inhibitor
4.History of another primary malignancy except for:
•Malignancy treated with curative intent and with no known active disease =2 years before the first dose of study drug
•Low potential risk of 3-year cancer-specific death (estimated<5%), including adequately treated non-melanoma skin cancer without evidence of disease, adequately treated carcinoma in situ without evidence of disease, or localized prostate cancer treated with curative intent and absence of prostate-specific antigen (PSA) relapse or incidental prostate cancer (Gleason score = 7 and PSA < 10 ng/mL) undergoing active surveillance.
5.Treatment with the last dose of any systemic anti-cancer therapy = 21 days prior to the first dose of study drug. Local treatment of isolated lesions for palliative intent is acceptable (eg, local surgery or radiotherapy).
6.Current or prior use of immunosuppressive medication within 14 days before the first dose of study drug, with the exceptions of intranasal and inhaled corticosteroids or systemic corticosteroids at systemic doses below = 10 mg/day of prednisone, or an equivalent corticosteroid.
7.History of primary immunodeficiency, allogeneic organ transplant or autoimmune disease, including, but not limited to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener’s granulomatosis, Sjögren’s syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.?Patients with a history of autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone will not be excluded from this study. Patients with controlled diabetes mellitus type 1 on a stable dose of insulin regimen may be eligible for this study.
8.Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (including acute or chronic hepatitis B, hepatitis C or human immunodeficiency virus (HIV), symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or gastritis, active bleeding diatheses or psychiatric illness/social situations that would limit compliance with study requirements or compromise the ability of the subject to give written informed consent
9.Known active tuberculosis
10.Any condition that, in the opinion of the investigator, would interfere with evaluation of study treatment or interpretation of patient safety or study results
11.Brain metastases or leptomeningeal disease. Inclusion of patients with brain metastases is allowed if patients have been adequately treated and no signs of progression on brain imaging =?28 days after completion of treatment (including surgery, radiotherapy or treatment with systemic corticosteroids).
12.Subjects with uncontrolled seizures.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: The primary objective is efficacy of atezolizumab in advanced penile cancer patients measured by progression-free survival;Secondary Objective: The primary objective is efficacy of atezolizumab in advanced penile cancer patients measured by progression-free survival;Primary end point(s): Progression-free survival (PFS) at 1 year after initiation of treatment. A PFS event is defined as RECIST 1.1 progressive disease (appearance of new lesions or progression of existing target/nontarget lesions) or death from any cause.;Timepoint(s) of evaluation of this end point: Progression-free survival at 1 year after enrollment of the last patient.
- Secondary Outcome Measures
Name Time Method Secondary end point(s): Overall Survival (OS) rate at 2 years in the full study population<br>- Feasibility of combining immunotherapy with radiotherapy as measured by number of patients who complete the combined modality treatment (Arm A). Completion is defined as having received at least 90% of planned radiation doses.<br>- Locoregional Recurrence-free survival in patients treated with the combination of radiotherapy and atezolizumab (arm A)<br>- Response rate for patients with measurable disease<br>- Median PFS (as measured by RECIST 1.1) and OS for the full study cohort (Arm A+B)<br>- 2-year PFS (as measured by RECIST 1.1) and OS for PD-L1-positive patients in the full study cohort (Arm A+B);Timepoint(s) of evaluation of this end point: 2 years after enrollment of last patient