Safety and Efficacy of Tisotumab Vedotin Monotherapy & in Combination With Other Cancer Agents in Subjects With Cervical Cancer
- Conditions
- Cervical Cancer
- Interventions
- Registration Number
- NCT03786081
- Lead Sponsor
- Seagen Inc.
- Brief Summary
This is an open label, multi-center trial of tisotumab vedotin monotherapy and in combination with bevacizumab, pembrolizumab, or carboplatin in subjects with recurrent or stage IVB cervical cancer.
The trial consists of two-parts a dose escalation part and an expansion part. The expansion part of the trial will be initiated once the Recommended Phase 2 Dose (RP2D) of the combinations have been determined in the dose escalation part.
- Detailed Description
The dose escalation part will occur in participants with cervical cancer who have progressed during or after standard of care therapy and who are intolerant or ineligible to receive standard of care treatments. Arm A will be conducted by escalating doses of both tisotumab vedotin and bevacizumab. Dose escalations of the tisotumab vedotin + pembrolizumab and tisotumab vedotin + carboplatin combinations (Arms B and C, respectively) will be conducted by combining fixed doses of either pembrolizumab or carboplatin with increasing doses of tisotumab vedotin.
The dose expansion part of this study (Arms D through H) will be conducted in 2 populations: participants with cervical cancer who have not received prior systemic therapy for recurrent or stage IVB cervical cancer (Arms D, E, and H) and participants with cervical cancer who have progressed on or after at least 1 but no more than 2 prior systemic therapies (Arms F and G).
Participants enrolled to Arms D, E, F and H will receive the RP2D of tisotumab vedotin established in the dose escalation part. Participants enrolled to Arm G will receive tisotumab vedotin weekly (at a dose lower than subjects in all other Arms) for three weeks and 1 week off (28-day treatment cycle).
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Female
- Target Recruitment
- 214
- Must have squamous, adenosquamous, or adenocarcinoma of the cervix and progressed on or after standard of care treatments or are ineligible or intolerant to standard of care for recurrent or stage IVB cervical cancer (Arms A, B and C only).
- Must have squamous, adenosquamous, or adenocarcinoma of the cervix and must not have received prior systemic therapy for recurrent or stage IVB cervical cancer (Arms D, E, and H only).
- Must have squamous, adenosquamous, or adenocarcinoma of the cervix and progressed on or after at least one but no more than two prior systemic therapies for recurrent or stage IVB cervical cancer (Arms F and G only).
- Must have baseline measurable disease per RECIST v1.1.
- Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (All Arms).
- Is not pregnant, breastfeeding, or expecting to conceive children within the projected duration of the trial and for at least 6 months after the last trial treatment administration
- Participants of childbearing potential must agree to use adequate contraception during and for 6 months after the last dose of trial treatment administration.
- Must sign an informed consent form (ICF) indicating the trial subject understands the purpose of and procedures required for the trial and are willing to participate in the trial (All Arms).
-
Has clinically relevant bilateral hydronephrosis which cannot be alleviated by ureteral stents or percutaneous drainage. (All Arms)
-
Has clinical signs or symptoms of gastrointestinal obstruction and requires parenteral hydration and/or nutrition. Post-operative obstructions within 4 weeks of abdominal surgery are permitted. (All Arms)
-
Has clinically significant bleeding issues or risks
- Prior history (within 3 months) or current evidence of hemoptysis (1/2 teaspoon or more) (Arm A and bevacizumab-eligible participants in Arm H)
- Recent (within 4 weeks of first dose of trial treatment) clinically significant gastrointestinal or vaginal bleeding requiring PRBC transfusion (Arms A and H only)
- Recent (within 4 weeks of first dose of trial treatment) evidence of wound healing complications that require medical intervention (Arms A and H only)
-
Has active ocular surface disease at baseline. Subjects with prior history of cicatricial conjunctivitis are ineligible (All Arms).
-
Clinically significant cardiac disease
-
Requires anti-coagulation therapy (Arms A and H only)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description E: Tisotumab vedotin + pembrolizumab Tisotumab Vedotin Dose expansion: Tisotumab vedotin in combination with pembrolizumab once every three weeks in previously untreated patients F: Tisotumab vedotin + pembrolizumab Tisotumab Vedotin Dose expansion: Tisotumab vedotin in combination with pembrolizumab once every three weeks in previously treated patients B: Tisotumab vedotin + pembrolizumab Tisotumab Vedotin Dose escalation: Tisotumab vedotin in combination with pembrolizumab once every three weeks in previously treated patients A: Tisotumab Vedotin + bevacizumab Tisotumab Vedotin Dose escalation: Tisotumab vedotin in combination with bevacizumab once every three weeks in previously treated patients A: Tisotumab Vedotin + bevacizumab Bevacizumab Dose escalation: Tisotumab vedotin in combination with bevacizumab once every three weeks in previously treated patients B: Tisotumab vedotin + pembrolizumab Pembrolizumab Dose escalation: Tisotumab vedotin in combination with pembrolizumab once every three weeks in previously treated patients E: Tisotumab vedotin + pembrolizumab Pembrolizumab Dose expansion: Tisotumab vedotin in combination with pembrolizumab once every three weeks in previously untreated patients G: Tisotumab vedotin monotherapy Tisotumab Vedotin Dose expansion: Tisotumab vedotin monotherapy weekly for three weeks and 1 week off (28 day treatment cycle) in previously treated patients. D: Tisotumab vedotin + carboplatin Carboplatin Dose expansion:Tisotumab vedotin in combination with carboplatin once every three weeks in previously untreated patients C: Tisotumab vedotin + carboplatin Tisotumab Vedotin Dose escalation: Tisotumab vedotin in combination with carboplatin once every three weeks in previously treated patients C: Tisotumab vedotin + carboplatin Carboplatin Dose escalation: Tisotumab vedotin in combination with carboplatin once every three weeks in previously treated patients D: Tisotumab vedotin + carboplatin Tisotumab Vedotin Dose expansion:Tisotumab vedotin in combination with carboplatin once every three weeks in previously untreated patients F: Tisotumab vedotin + pembrolizumab Pembrolizumab Dose expansion: Tisotumab vedotin in combination with pembrolizumab once every three weeks in previously treated patients H: Tisotumab vedotin + pembrolizumab + carboplatin +/- bevacizumab Tisotumab Vedotin Dose expansion: Tisotumab vedotin in combination with pembrolizumab and carboplatin with or without bevacizumab once every three weeks in previously untreated patients H: Tisotumab vedotin + pembrolizumab + carboplatin +/- bevacizumab Bevacizumab Dose expansion: Tisotumab vedotin in combination with pembrolizumab and carboplatin with or without bevacizumab once every three weeks in previously untreated patients H: Tisotumab vedotin + pembrolizumab + carboplatin +/- bevacizumab Pembrolizumab Dose expansion: Tisotumab vedotin in combination with pembrolizumab and carboplatin with or without bevacizumab once every three weeks in previously untreated patients H: Tisotumab vedotin + pembrolizumab + carboplatin +/- bevacizumab Carboplatin Dose expansion: Tisotumab vedotin in combination with pembrolizumab and carboplatin with or without bevacizumab once every three weeks in previously untreated patients
- Primary Outcome Measures
Name Time Method Dose escalation: Dose Limiting Toxicities (DLTs) DLTs will be identified during the first treatment cycle (21 day cycles) To establish the MTD and RP2D of tisotumab vedotin in combination
Dose expansion: Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) approximately 2 years Objective response is defined as confirmed partial response (PR) or complete response (CR)
- Secondary Outcome Measures
Name Time Method Number of adverse events (AEs) up to 2 years Any untoward medical occurrence in a clinical trial participant whether or not considered related to the medicinal product.
Duration of Response (DOR) per RECIST v1.1 by investigator assessment approximately 2 years Will be calculated from the date of initial documentation of a response (CR or PR) to the date of first documented evidence of progressive disease (PD) or death.
Dose escalation: ORR per RECIST v1.1 approximately 2 years Objective response is defined as confirmed PR or CR.
Time to Response (TTR) per RECIST v1.1 by investigator assessment approximately 2 years Will be calculated from the date of the first dose to the date of the initial documentation of response (CR or PR).
Progression free survival (PFS) per RECIST v1.1 by investigator assessment approximately 2 years The time from the date of the first trial drug administration to the date of the first documented disease progression or death due to any cause.
Overall Survival (OS) approximately 2 years The time from the date of the first trial drug administration to the date of death due to any cause.
Maximum concentration (Cmax) (All Arms except G) Up to 42 days Pharmacokinetic (PK) parameter
Cmax (Arm G only) Up to 2 years PK parameter
Trough Concentration (Ctrough) (All Arms) Up to 2 years PK parameter
Area under the concentration-time curve (AUC) (All Arms except G) Through 21 days after first dose PK parameter
AUC (Arm G only) Through 8 days after first dose PK parameter
Anti-drug antibodies (ADAs) Up to 2 years
Trial Locations
- Locations (67)
University of Chicago
🇺🇸Chicago, Illinois, United States
Dana-Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Indiana University School of Medicine
🇺🇸Indianapolis, Indiana, United States
Huntsman Cancer Center
🇺🇸Salt Lake City, Utah, United States
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Rigshospitalet
🇩🇰Copenhagen, Denmark
Fakultni nemocnice Bulovka
🇨🇿Praha, Czechia
Nemocnice Na Bulovce
🇨🇿Praha, Czechia
AMC Medical Research
🇳🇱Amsterdam, Netherlands
Universitair Medisch Centrum Groningen (UMCG)
🇳🇱Groningen, Netherlands
Erasmus Medisch Centrum
🇳🇱Rotterdam, Netherlands
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
Velindre Cancer Centre
🇬🇧Cardiff, South Glamorgan, United Kingdom
Hospital Universitario Virgen de la Arrixaca
🇪🇸El Palmar, Spain
Azienda Ospedaliera Cannizzaro
🇮🇹Catania, Italy
IEO Istituto Europeo di Oncologia
🇮🇹Milano, Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
🇮🇹Rome, Italy
Waterford Regional Hospital
🇮🇪Waterford, Ireland
University Hospital Waterford
🇮🇪Waterford, Ireland
Hospital Universitario Reina Sofia
🇪🇸Cordoba, Spain
Hospital 12 De Octubre
🇪🇸Madrid, Spain
Olive View - UCLA Research and Education Institute
🇺🇸Sylmar, California, United States
Augusta University
🇺🇸Augusta, Georgia, United States
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
SUNY Downstate Medical Center
🇺🇸Brooklyn, New York, United States
Baptist MD Anderson Cancer Center
🇺🇸Jacksonville, Florida, United States
Univ California, Irvine Medical Center
🇺🇸Orange, California, United States
Magee-Womens Hospital of UPMC
🇺🇸Pittsburgh, Pennsylvania, United States
University of Cincinnati Physicians Group
🇺🇸Cincinnati, Ohio, United States
Ohio State University Wexner Medical Center
🇺🇸Hilliard, Ohio, United States
Brown University - Women's and Infant Hospital
🇺🇸Providence, Rhode Island, United States
Cliniques Universitaires Saint-Luc
🇧🇪Bruxelles, Belgium
Carilion Clinic
🇺🇸Roanoke, Virginia, United States
Universitair Ziekenhuis Antwerpen (UZA)
🇧🇪Edegem, Belgium
Fakultni nemocnice Ostrava
🇨🇿Ostrava-Poruba, Czechia
Vseobecna fakultni nemocnice v Praze
🇨🇿Praha 2, Czechia
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
Istituto Nazionale Tumori Fondazione G. Pascale
🇮🇹Napoli, Italy
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, Strathclyde, United Kingdom
Arizona Oncology Associates
🇺🇸Phoenix, Arizona, United States
Oschner Clinic
🇺🇸New Orleans, Louisiana, United States
University of North Carolina Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
AZ Sint-Jan
🇧🇪Brugge, Belgium
Erasmus University Medical Center Rotterdam
🇳🇱Rotterdam, Netherlands
Royal Marsden Hospital- Sutton
🇬🇧Sutton, Surrey, United Kingdom
UZ Leuven
🇧🇪Leuven, Belgium
Amsterdam UMC, Locatie AMC
🇳🇱Amsterdam, Netherlands
University Medical Center Utrecht (UMC Utrecht)
🇳🇱Utrecht, Netherlands
Cliniques universitaires Saint-Luc
🇧🇪Brussels, Belgium
Grand Hôpital de Charleroi
🇧🇪Loverval, Belgium
Sainte-Elisabeth
🇧🇪Namur, Belgium
Mater Misericordiae University Hospital
🇮🇪Dublin, Ireland
Baskent University Ankara Hospital
🇹🇷Ankara, Turkey
St Francis Hospital Cancer Center
🇺🇸Greenville, South Carolina, United States
Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
Montana Cancer Consortium
🇺🇸Billings, Montana, United States
Universitair Ziekenhuis Gent
🇧🇪Gent, Belgium
Universitaire Ziekenhuizen Leuven,
🇧🇪Leuven, Belgium
Centre Hospitalier Universitaire (CHU) de Liège
🇧🇪Liège, Belgium
CHU UCL Namur
🇧🇪Namur, Belgium
Radboudumc
🇳🇱Nijmegen, Netherlands
UMC Utrecht
🇳🇱Utrecht, Netherlands
Centre Hospitalier de l'Ardenne
🇧🇪Libramont, Belgium
Cork University Hospital
🇮🇪Cork, Ireland
Baskent University Adana Application and Research Center
🇹🇷Adana, Turkey
University of Kansas Medical Center
🇺🇸Westwood, Kansas, United States
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