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Clinical Trials Search at Vanderbilt-Ingram Cancer Center

Study of Sacituzumab Govitecan in Participants With Urothelial Cancer That Cannot Be Removed or Has Spread

The objective of this study is to evaluate the efficacy and safety of sacituzumab
govitecan-hziy monotherapy and with novel combinations in participants with metastatic
urothelial cancer (mUC).
Bladder, Urologic
Phase II
Chemotherapy - cytotoxic, Mol. targeted/Immunotherapy/Biologics
Avelumab, Carboplatin, Cisplatin, Domvanalimab, Gemcitabine, IMMU-132, MK-3475, Pembrolizumab (MK-3475), Sacituzumab govitecan, Zimberelimab
Davis, Nancy
Vanderbilt University


18 Years
Inclusion Criteria:

Female or male individuals, 18 years of age (19 Years old for South Korea).

Individuals with histologically confirmed urothelial cancer (UC).

Eastern Cooperative Oncology Group (ECOG) Performance status score of 0 or 1.

Cohort 1: Have had progression or recurrence of urothelial cancer following receipt of platinum-containing regimen (cisplatin or carboplatin):

Received a first-line platinum-containing regimen in the metastatic setting or for inoperable locally advanced disease;

Or received neo/adjuvant platinum-containing therapy for localized muscle-invasive urothelial cancer, with recurrence/progression 12 months following completion of therapy.

Cohort 1: In addition to above criterion, have had progression or recurrence of urothelial cancer following receipt of an Anti-programmed Cell Death Protein 1 (anti-PD-1)/ Anti-programmed Death Ligand 1 (PD-L1) therapy.

Cohort 2: Were ineligible for platinum-based therapy for first line metastatic disease and have had progression or recurrence of urothelial cancer after a first-line therapy for metastatic disease with anti-PD-1/PD-L1 therapy. Individual may not have received any platinum for treatment of recurrent, metastatic or advanced disease.

Cohort 3: Progression or recurrence of UC following a platinum containing regimen in the metastatic setting, or progression or recurrence of UC within 12 months of completion of platinum-based therapy as neoadjuvant or adjuvant therapy.

Cohort 4: Individual has not received any platinum-based chemotherapy in the metastatic or unresectable locally advanced setting. Creatinine clearance of at least 50 mL/min calculated by Cockcroft-Gault formula or another validated tool. For individuals receiving cisplatin at 70 mg/m^2 on Day 1 of every 21-day cycle, a creatinine clearance of least 60 mL/min calculated by Cockcroft -Gault formula or another validated tool is required. Individuals with creatinine clearance between 50 to 59 mL/min are to receive a split dose of cisplatin (35 mg/m^2 Day 1 and Day 8 of every 21-day cycle).

Cohorts 4, 5, 6: Archival tumor tissue comprising muscle-invasive or metastatic urothelial carcinoma, or a biopsy of metastatic urothelial carcinoma.

Cohort 5: Individuals received at least 4 cycles and no more than 6 cycles of GEM + cisplatin.

No evidence of progressive disease following completion of first-line chemotherapy (ie, CR, PR, or SD per RECIST v1.1 guidelines as per investigator).

Treatment-free interval of 4 to 10 weeks since the last dose of chemotherapy.

Cohort 6: Cis-ineligible and no prior therapy for metastatic disease or for unresectable locally advanced disease. Checkpoint inhibitor therapy nave or >12 months from completion of adjuvant therapy are permitted.

Cohorts 4 and 6: Have measurable disease by CT or MRI as per RECIST 1.1 criteria. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.

Cohorts 5 and 6: Creatinine clearance 30 mL/min as calculated by the Cockcroft-Gault formula unless otherwise specified

Adequate renal and hepatic function.

Adequate hematologic parameters without transfusional support.

Individuals must have a 3-month life expectancy.

Exclusion Criteria:

Females who are pregnant or lactating.

Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study Day 1 or who has not recovered (i.e., Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.

Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (ie, Grade 1 from AEs due to a previously administered agent).

For Cohort 5: Alopecia, sensory neuropathy Grade 2 is acceptable, or other Grade
Requires concomitant medication interfering with ABCA1 transporter or UGT1A1

Has an active second malignancy.

Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.

Has known active Hepatitis B or Hepatitis C.

Has other concurrent medical or psychiatric conditions.

Cohort 3: Has received anti-PD-1/PD-L1 therapy previously.

Cohorts 3 to 5: Has an active autoimmune disease that required systemic treatment in past 2 years (ie, with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment.

Cohorts 3 to 6: Has received a live vaccine within 30 days prior to the first dose of study drug(s), has history or evidence of interstitial lung disease (ILD) or non-infectious pneumonitis.

Cohort 4: Refractory to platinum (i.e., relapsed 12 months after completion of chemotherapy) in the neoadjuvant/adjuvant setting.

Cohorts 4, 5, and 6: For individuals who received prior CPI, a treatment-free interval >12 months between the last treatment administration and the date of recurrence is required.

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