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A Study Evaluating Different Immunotherapies (LAG-3 and PD-1 With or Without TIGIT, Compared to PD-L1 Alone) in Participants With Untreated Locally Advanced Metastatic Urothelial Cancer

Phase 2
Active, not recruiting
Conditions
Urothelial Cancer
Interventions
Registration Number
NCT05645692
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This study will evaluate the safety of tobemstomig alone or in combination with tiragolumab compared with atezolizumab in participants with previously untreated, locally advanced or metastatic urothelial cancer (mUC) who are ineligible to receive a platinum containing chemotherapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
204
Inclusion Criteria
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2
  • Histologically or cytologically documented locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium. Participants with squamous, sarcomatoid, micropapillary, and glandular variant histologies are eligible for inclusion in the study, provided that a urothelial component is present in the tumor specimen. Participants with other variant histologies or pure variant histologies are not eligible for inclusion in this study
  • Ineligible ("unfit") to receive platinum-based chemotherapy
  • No prior chemotherapy for inoperable locally advanced or metastatic or recurrent urothelial carcinoma (UC)
  • Measurable disease; at least one measurable lesion as defined by response evaluation criteria in solid tumors, version 1.1 (RECIST v1.1)
  • Availability of a representative leftover tumor specimen that is suitable for determination of PD-L1 status as assessed by a central laboratory
  • Adequate hematologic and end organ function
  • Negative for hepatitis B and hepatitis C virus (HCV)
  • Adequate cardiovascular function
Exclusion Criteria
  • Pregnancy or breastfeeding
  • GFR <15 mL/min/1.73 m2
  • Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
  • History of leptomeningeal disease
  • Uncontrolled tumor-related pain
  • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
  • Uncontrolled or symptomatic hypercalcemia
  • Active or history of autoimmune disease or immune deficiency
  • History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
  • Active tuberculosis (TB) or acute Epstein-Barr virus (EBV)
  • Significant cardiovascular/cerebrovascular disease within 3 months prior to initiation of study treatment
  • Major surgical procedure, other than for diagnosis, within 4 weeks prior to initiation of study treatment, or anticipation of need for a major surgical procedure during the study
  • History of another primary malignancy other than urothelial carcinoma within 2 years prior to initiation of study treatment, with the exception of malignancies with a negligible risk of metastasis or death
  • Severe infection within 4 weeks prior to initiation of study treatment
  • Treatment with therapeutic oral or intravenous antibiotics within 2 weeks prior to initiation of study treatment. Participants receiving prophylactic antibiotics (e.g., to prevent a urinary tract infection or chronic obstructive pulmonary disease [COPD] exacerbation), or who are receiving oral antibiotics to treat a urinary tract infection are eligible for the study
  • Prior allogeneic stem cell or solid organ transplantation
  • Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during treatment or within 5 months after the final dose of atezolizumab, 4 months after the final dose of tobemstomig, or 90 days after the final dose of tiragolumab
  • Current treatment with anti-viral therapy for HBV
  • Treatment with any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment
  • Treatment with investigational therapy within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study treatment
  • Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-TIGIT and anti-LAG3 therapeutic antibodies or pathways targeting agents
  • Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives prior to initiation of study treatment
  • Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment
  • History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm AAtezolizumabParticipants will receive intravenous (IV) atezolizumab every 3 weeks (Q3W).
Arm CTiragolumabParticipants will receive IV tobemstomig + IV tiragolumab Q3W.
Arm BTobemstomigParticipants will receive IV tobemstomig Q3W.
Arm CTobemstomigParticipants will receive IV tobemstomig + IV tiragolumab Q3W.
Primary Outcome Measures
NameTimeMethod
Incidence and Severity of Adverse EventsUp to approximately 30 months
Secondary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS)Up to approximately 30 months
Overall Survival (OS)Up to approximately 30 months
Duration of Response (DOR)Up to approximately 30 months
PFS6 months and 12 months
OS6 months, 12 months, and 18 months
Disease Control Rate (DCR)Up to 12 weeks
Time to Confirmed Deterioration (TTCD)Baseline up to 3 weeks
Change from Baseline in European Organisation for Research and Cancer Treatment Item Library 187 (EORTC IL 187) ScoresUp to approximately 30 months
Maximum Concentration (Cmax) of TobemstomigUp to approximately 30 months
Time of Maximum Concentration (Tmax) of TobemstomigUp to approximately 30 months
Clearance (CL) of TobemstomigUp to approximately 30 months
Volume of Distribution at Steady State (Vss) of TobemstomigUp to approximately 30 months
Area Under the Curve (AUC) of TobemstomigUp to approximately 30 months
Half-Life (T1/2) of TobemstomigUp to approximately 30 months
Maximum serum concentration (Cmax) of tiragolumabUp to approximately 30 months
Minimum serum concentration (Cmin) of tiragolumabUp to approximately 30 months
Cmax of atezolizumabUp to approximately 30 months
Cmin of atezolizumabUp to approximately 30 months
Incidence of Anti-Drug Antibodies (ADAs)Up to approximately 30 months

Trial Locations

Locations (61)

Aarhus Universitetshospital

🇩🇰

Aarhus N, Denmark

Royal Marsden Hospital

🇬🇧

London, United Kingdom

Royal Preston Hosptial

🇬🇧

Preston, United Kingdom

Lister Hospital

🇬🇧

Stevenage, United Kingdom

Royal Marsden Hospital (Sutton)

🇬🇧

Sutton, United Kingdom

Hospital de Amor Amazônia

🇧🇷

Porto Velho, Rondônia, Brazil

Szpital Wojewódzki im. Miko?aja Kopernika

🇵🇱

Koszalin, Poland

Szpital Uniwersytecki w Krakowie

🇵🇱

Kraków, Poland

Centrum Medyczne Pratia Poznan

🇵🇱

Pozna?, Poland

Szpital Grochowski im. dr med. Rafa?a Masztaka Sp. z o.o.

🇵🇱

Warszawa, Poland

Vall d'Hebron Institute of Oncology (VHIO), Barcelona

🇪🇸

Barcelona, Spain

Institut Catala d Oncologia Hospital Duran i Reynals

🇪🇸

Barcelona, Spain

Hospital Universitario Clínico San Carlos

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital de Madrid Norte Sanchinarro- Centro Integral Oncologico Clara Campal

🇪🇸

Madrid, Spain

Adana Baskent University Medical Faculty

🇹🇷

Adana, Turkey

Ankara City Hospital

🇹🇷

Ankara, Turkey

Trakya Universitesi Tip Fakultesi, Medikal Onkoloji Bilim Dali, Balkan Yerleskesi

🇹🇷

Edirne, Turkey

Izmir Medical Point Hospital

🇹🇷

Izmir, Turkey

Goztepe Prof.Dr. Suleyman Yalcin City Hospital

🇹🇷

Kadiköy, Turkey

Barts and the London NHS Trust

🇬🇧

London, United Kingdom

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Macquarie University Hospital

🇦🇺

Macquarie Park, New South Wales, Australia

Lyell McEwin Hospital

🇦🇺

Adelaide, South Australia, Australia

ICON Cancer Care Adelaide

🇦🇺

Kurralta Park, South Australia, Australia

Hospital Universitario Evangelico De Curitiba

🇧🇷

Curitiba, Paraná, Brazil

Hospital das Clinicas - UFRGS

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

*X*CEPHO - Centro de Estudos e Pesquisas em Hematologia e Oncologia

🇧🇷

Santo André, São Paulo, Brazil

Hospital Alemao Oswaldo Cruz

🇧🇷

Sao Paulo, São Paulo, Brazil

Beijing Cancer Hospital

🇨🇳

Beijing, China

West China Hospital - Sichuan University

🇨🇳

Chengdu City, China

Sun yat-sen University Cancer Center

🇨🇳

Guangzhou, China

Ruijin Hospital, Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai City, China

Herlev Hospital

🇩🇰

Herlev, Denmark

Odense Universitetshospital, Onkologisk Afdeling, Klinisk Forsknings Enhed

🇩🇰

Odense C, Denmark

Centre Leon Berard

🇫🇷

Lyon CEDEX 08, France

Gustave Roussy

🇫🇷

Villejuif CEDEX, France

Krankenhaus Martha-Maria Halle-Dölau, Klinik für Urologie

🇩🇪

Halle (Saale), Germany

Martini-Klinik am UKE GmbH

🇩🇪

Hamburg, Germany

Alexandras General Hospital of Athens

🇬🇷

Athens, Greece

Attikon University General Hospital

🇬🇷

Chaidari, Greece

Theageneio Hospital

🇬🇷

Thessaloniki, Greece

Istituto Nazionale Tumori Irccs Fondazione G. Pascale

🇮🇹

Napoli, Campania, Italy

Azienda Ospedaliero-Universitaria S.Orsola-Malpighi

🇮🇹

Bologna, Emilia-Romagna, Italy

IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola

🇮🇹

Meldola, Emilia-Romagna, Italy

Policlinico Universitario "Agostino Gemelli"

🇮🇹

Roma, Lazio, Italy

Irccs Ospedale San Raffaele

🇮🇹

Milano, Lombardia, Italy

A.O. Universitaria Ospedale Consorziale Policlinico Di Bari

🇮🇹

Bari, Puglia, Italy

Azienda Ospedaliera S. Maria - Terni

🇮🇹

Terni, Umbria, Italy

IRCCS Istituto Oncologico Veneto (IOV)

🇮🇹

Padova, Veneto, Italy

Seoul National University Bundang Hospital

🇰🇷

Gyeonggi-do, Korea, Republic of

Gachon University Gil Medical Center

🇰🇷

Incheon, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Health Pharma Professional Research

🇲🇽

Cdmx, Mexico CITY (federal District), Mexico

Centro Medico Nacional Siglo Xxi - Imss

🇲🇽

Mexico City, Mexico CITY (federal District), Mexico

Instituto Nacional de Cancerologia

🇲🇽

Mexico City, Mexico CITY (federal District), Mexico

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