A Study of MOXR0916 in Combination With Atezolizumab Versus Atezolizumab Alone in Participants With Untreated Locally Advanced or Metastatic Urothelial Carcinoma Who Are Ineligible for Cisplatin-Based Therapy
- Registration Number
- NCT03029832
- Lead Sponsor
- Genentech, Inc.
- Brief Summary
This is a Phase II, multicenter, randomized, placebo-controlled, double-blind study to evaluate the safety and efficacy of MOXR0916 in combination with atezolizumab versus placebo and atezolizumab in participants with locally advanced or metastatic urothelial carcinoma (UC) who have not received prior systemic therapy in the locally advanced/metastatic setting and who are ineligible to receive cisplatin-based therapy.
- Detailed Description
The study design has been amended after the decision to prematurely stop patient accrual due to enrollment challenges. As only 5 participants were enrolled, the study blinding will not be maintained, and placebo infusions will not be administered. Patients assigned to the MOXR0916 arm may continue study treatment with the combination of atezolizumab and MOXR0916 or with atezolizumab alone based on a discussion of benefit and risk with the treating investigator.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 5
- Age >= 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status of <= 2
- Life expectancy >= 12 weeks
- Histologically or cytologically confirmed locally advanced or metastatic urothelial carcinoma (UC)
- Availability of a representative formalin-fixed paraffin-embedded tumor specimen
- No prior systemic therapy for inoperable locally advanced or metastatic UC
- Ineligible for cisplatin-based chemotherapy as defined by any one of the following criteria: Impaired renal function (glomerular filtration rate [GFR] > 30 but < 60 milliliter/minute [mL/min]); National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version (v) 4.0 Grade >= 2 audiometric hearing loss (of 25 Decibel at two contiguous frequencies or more severe); NCI CTCAE v 4.0 Grade >= 2 peripheral neuropathy; ECOG Performance Status of 2
- Measurable disease according to Response Evaluation Criteria in Solid Tumors v1.1
- Adequate hematologic and end-organ function
- Significant cardiovascular disease
- Known clinically significant liver disease
- Any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment
- Prior treatment with CD137 or OX40 agonists, anti-cytotoxic T-lymphocyte-associated protein (CTLA4), anti-programmed death-1 (PD-1), anti- programmed death-ligand 1 (PD-L1), anti-CD-27, anti- glucocorticoid-induced tumor necrosis factor receptor (GITR) therapeutic antibody or pathway-targeting agents
- Untreated central nervous system (CNS) metastases or active (progressing or requiring corticosteroids for symptomatic control) CNS metastases
- Any history of leptomeningeal disease
- Malignancies other than UC within 5 years prior to Cycle 1, Day 1
- History of autoimmune disease
- History of idiopathic pulmonary fibrosis, pneumonitis, organizing pneumonia, or evidence of active pneumonitis on screening chest computed tomography scan
- Active hepatitis B and C virus infection
- Positive HIV test at screening
- Active tuberculosis
- Prior allogeneic stem cell or solid organ transplantation
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description MOXR0916 plus Atezolizumab MOXR0916 - Atezolizumab Atezolizumab - MOXR0916 plus Atezolizumab Atezolizumab -
- Primary Outcome Measures
Name Time Method Progression-Free Survival (PFS) Up to approximately 45 months PFS is defined as the time from randomization to the first occurrence of disease progression or death from any cause, whichever occurs first. Per RECIST v1.1, progressive disease is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters on study (including baseline); and an absolute increase of \>= 5 millimeter (mm) in the sum of diameters.
Overall Survival (OS) Up to approximately 45 months Kaplan Meier estimate of median OS was defined as the time at which half of the participants had died, regardless of the cause of death.
- Secondary Outcome Measures
Name Time Method Objective Response (OR) According to RECIST v1.1 Up to approximately 45 months OR is defined as a complete response (CR) or partial response (PR) on two consecutive occasions \>= 4 weeks apart, as determined by the investigator according to RECIST v1.1. CR is defined as the disappearance of all target lesions. PR is defined as at least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR.
Duration of Objective Response (DOR) According to RECIST v1.1 Up to approximately 45 months DOR is defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause, whichever occurs first, as determined by the investigator according to RECIST v1.1. Objective response is defined as a complete response (CR) or partial response (PR) on two consecutive occasions ≥ 4 weeks apart. CR is defined as the disappearance of all target lesions. PR is defined as at least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR.
Time to Pain Progression, Pain Palliation, and Fatigue Progression as Measured by Participant-Reported Severity According to the M. D. Anderson Symptom Inventory (MDASI) Up to approximately 45 months The MDASI is a cancer-related, self-reported questionnaire consisting of 19 items assessing symptom severity and interference with different aspects of a participant's life. The MDASI items are rated from 0 to 10, with 0 indicating that the symptom is either not present or does not interfere with the participant's activities and 10 indicating that the symptom is "as bad as you can imagine" or "interfered completely" with the participant's life.
Percentage of Participants Reporting Symptom Interference With Daily Living at the Time of Progression According to the MDASI Up to approximately 45 months The MDASI is a cancer-related, self-reported questionnaire consisting of 19 items assessing symptom severity and interference with different aspects of a participant's life. The MDASI items are rated from 0 to 10, with 0 indicating that the symptom is either not present or does not interfere with the participant's activities and 10 indicating that the symptom is "as bad as you can imagine" or "interfered completely" with the participant's life.
Percentage of Participants With Adverse Event (AEs) Up to approximately 45 months An adverse event is any untoward medical occurrence, regardless of causal attribution.
Area Under the Plasma Drug Concentration-time Curve (AUC) of MOXR0916 and Atezolizumab Cycle 1 (each cycle is 21 days), Day 1: predose and 30 min. after atezolizumab infusion; Cycle 1, on Days 8 and 15. Cycles 2 4, Day 1: predose and 30 min. after atezolizumab infusion. Cycles 8, 12, and 16: predose AUC represents the body's exposure to an administered drug.
Maximum Plasma Concentration (Cmax) of MOXR0916 and Atezolizumab Cycle 1 (each cycle is 21 days), Day 1: predose and 30 min. after atezolizumab infusion; Cycle 1, on Days 8 and 15. Cycles 2 4, Day 1: predose and 30 min. after atezolizumab infusion. Cycles 8, 12, and 16: predose Cmax refers to the maximum (or peak) serum concentration that a drug achieves in a specified compartment or test area of the body after the drug has been administrated and prior to the administration of a second dose.
Minimum Plasma Concentration (Cmin) of MOXR0916 and Atezolizumab Cycle 1 (each cycle is 21 days), Day 1: predose and 30 min. after atezolizumab infusion; Cycle 1, on Days 8 and 15. Cycles 2 4, Day 1: predose and 30 min. after atezolizumab infusion. Cycles 8, 12, and 16: predose Cmin refers to the minimum (trough) serum concentration of a drug in a specified compartment or test area of the body.
Clearance of MOXR0916 and Atezolizumab Cycle 1 (each cycle is 21 days), Day 1: predose and 30 min. after atezolizumab infusion; Cycle 1, on Days 8 and 15. Cycles 2 4, Day 1: predose and 30 min. after atezolizumab infusion. Cycles 8, 12, and 16: predose Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes.
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to MOXR0916 and Atezolizumab Cycles 1 - 4 and 8, 12, and 16 (each cycle is 21 days), Day 1: predose ATAs may be produced by the body in response to an administered drug.
Trial Locations
- Locations (22)
Arizona Oncology - HOPE Wilmot
🇺🇸Tucson, Arizona, United States
Nebraska Methodist Hospital; Cancer Center
🇺🇸Omaha, Nebraska, United States
University of Colorado
🇺🇸Denver, Colorado, United States
Yale University
🇺🇸New Haven, Connecticut, United States
New York Oncology Hematology, P.C.
🇺🇸Albany, New York, United States
SCRI Tennessee Oncology Chattanooga
🇺🇸Chattanooga, Tennessee, United States
University of Chicago; Hematology/Oncology
🇺🇸Chicago, Illinois, United States
Maryland Oncology Hematology, P.A.
🇺🇸Columbia, Maryland, United States
Columbia University Medical Center; Clinical Research Management Office
🇺🇸New York, New York, United States
Texas Oncology-Baylor Sammons Cancer Center
🇺🇸Dallas, Texas, United States
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Virginia Oncology Associates - Lake Wright Cancer Center
🇺🇸Norfolk, Virginia, United States
GasthuisZusters Antwerpen
🇧🇪Wilrijk, Belgium
Princess Margaret Cancer Center
🇨🇦Toronto, Ontario, Canada
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Asan Medical Center - Oncology
🇰🇷Seoul, Korea, Republic of
Leicester Royal Infirmary NHS Trust
🇬🇧Leicester, United Kingdom
Barts and the London NHS Trust.
🇬🇧London, United Kingdom
Kansas City - Menorah Medical Center
🇺🇸Kansas City, Kansas, United States
Miami Cancer Institute of Baptist Health, Inc.
🇺🇸Miami, Florida, United States
Onc/Hem Care Clin Trials LLC
🇺🇸Cincinnati, Ohio, United States
Sarah Cannon Research Inst.
🇺🇸Nashville, Tennessee, United States