Safety and Efficacy of Tisotumab Vedotin Monotherapy & in Combination With Other Cancer Agents in Subjects With Cervical Cancer

NCT03786081Active, Not RecruitingPHASE1, PHASE2INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Seagen, a wholly owned subsidiary of Pfizer

Enrollment

214

Start Date

2019-02-27

Completion Date

2026-03-31

Study Type

INTERVENTIONAL

Official Title

A Phase 1b/2 Open-Label Trial of Tisotumab Vedotin (HuMax®-TF-ADC) Monotherapy and in Combination With Other Agents in Subjects With Recurrent or Stage IVB Cervical Cancer

Interventions

Tisotumab VedotinBevacizumabPembrolizumabCarboplatin

Conditions

Cervical Cancer

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

* 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).

Exclusion Criteria:

* 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)

Outcome Measures

Primary Outcomes

Dose escalation: Dose Limiting Toxicities (DLTs)

To establish the MTD and RP2D of tisotumab vedotin in combination

Time frame: DLTs will be identified during the first treatment cycle (21 day cycles)

Dose expansion: Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1)

Objective response is defined as confirmed partial response (PR) or complete response (CR)

Time frame: approximately 2 years

Secondary Outcomes

Number of adverse events (AEs)

Any untoward medical occurrence in a clinical trial participant whether or not considered related to the medicinal product.

Time frame: up to 2 years

Dose escalation: ORR per RECIST v1.1

Objective response is defined as confirmed PR or CR.

Time frame: approximately 2 years

Duration of Response (DOR) per RECIST v1.1 by investigator assessment

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.

Time frame: approximately 2 years

Time to Response (TTR) per RECIST v1.1 by investigator assessment

Will be calculated from the date of the first dose to the date of the initial documentation of response (CR or PR).

Time frame: approximately 2 years

Progression free survival (PFS) per RECIST v1.1 by investigator assessment

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.

Time frame: approximately 2 years

Overall Survival (OS)

The time from the date of the first trial drug administration to the date of death due to any cause.

Time frame: approximately 2 years

Maximum concentration (Cmax) (All Arms except G)

Pharmacokinetic (PK) parameter

Time frame: Up to 42 days

Cmax (Arm G only)

PK parameter

Time frame: Up to 2 years

Trough Concentration (Ctrough) (All Arms)

PK parameter

Time frame: Up to 2 years

Area under the concentration-time curve (AUC) (All Arms except G)

PK parameter

Time frame: Through 21 days after first dose

AUC (Arm G only)

PK parameter

Time frame: Through 8 days after first dose

Anti-drug antibodies (ADAs)

Time frame: Up to 2 years

Locations

Arizona Oncology Associates, Phoenix, United States

Univ California, Irvine Medical Center, Orange, United States

Olive View - UCLA Research and Education Institute, Sylmar, United States

Baptist MD Anderson Cancer Center, Jacksonville, United States

Augusta University, Augusta, United States

University of Chicago, Chicago, United States

Indiana University School of Medicine, Indianapolis, United States

University of Kansas Medical Center, Westwood, United States

Oschner Clinic, New Orleans, United States

Dana-Farber Cancer Institute, Boston, United States

Billings Clinic Cancer Center, Billings, United States

Montana Cancer Consortium, Billings, United States

SUNY Downstate Medical Center, Brooklyn, United States

Memorial Sloan Kettering Cancer Center, New York, United States

University of North Carolina Chapel Hill, Chapel Hill, United States

University of Cincinnati Physicians Group, Cincinnati, United States

Cleveland Clinic, Cleveland, United States

Cleveland Clinic, Cleveland, United States

Ohio State University Wexner Medical Center, Hilliard, United States

Fox Chase Cancer Center, Philadelphia, United States

Magee-Womens Hospital of UPMC, Pittsburgh, United States

Brown University - Women's and Infant Hospital, Providence, United States

St Francis Hospital Cancer Center, Greenville, United States

Huntsman Cancer Center, Salt Lake City, United States

Carilion Clinic, Roanoke, United States

AZ Sint-Jan, Bruges, Belgium

Cliniques universitaires Saint-Luc, Brussels, Belgium

Grand Hôpital de Charleroi, Charleroi, Belgium

Universitair Ziekenhuis Antwerpen (UZA), Edegem, Belgium

Universitair Ziekenhuis Gent, Ghent, Belgium

UZ Leuven, Leuven, Belgium

Universitaire Ziekenhuizen Leuven,, Leuven, Belgium

Centre Hospitalier de l'Ardenne, Libramont, Belgium

Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium

Grand Hôpital de Charleroi, Loverval, Belgium

CHU UCL Namur, Namur, Belgium

Sainte-Elisabeth, Namur, Belgium

Fakultni nemocnice Olomouc, Olomouc, Czechia

Fakultni nemocnice Olomouc, Olomouc, Czechia

Fakultni nemocnice Ostrava, Ostrava-Poruba, Czechia

Vseobecna fakultni nemocnice v Praze, Prague, Czechia

Vseobecna fakultni nemocnice v Praze, Prague, Czechia

Fakultni nemocnice Bulovka, Prague, Czechia

Nemocnice Na Bulovce, Prague, Czechia

Rigshospitalet, Copenhagen, Denmark

Cork University Hospital, Cork, Ireland

Mater Misericordiae University Hospital, Dublin, Ireland

Waterford Regional Hospital, Waterford, Ireland

University Hospital Waterford, Waterford, Ireland

Azienda Ospedaliera Cannizzaro, Catania, Italy

IEO Istituto Europeo di Oncologia, Milan, Italy

Istituto Nazionale Tumori Fondazione G. Pascale, Naples, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Amsterdam UMC, Locatie AMC, Amsterdam, Netherlands

AMC Medical Research, Amsterdam, Netherlands

Universitair Medisch Centrum Groningen (UMCG), Groningen, Netherlands

Radboudumc, Nijmegen, Netherlands

Erasmus Medisch Centrum, Rotterdam, Netherlands

Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands

UMC Utrecht, Utrecht, Netherlands

University Medical Center Utrecht (UMC Utrecht), Utrecht, Netherlands

Hospital Universitari Vall d'Hebron, Barcelona, Spain

Hospital Universitario Reina Sofia, Córdoba, Spain

Hospital Universitario Virgen de la Arrixaca, El Palmar, Spain

Hospital 12 De Octubre, Madrid, Spain

Baskent University Adana Application and Research Center, Adana, Turkey (Türkiye)

Baskent University Ankara Hospital, Ankara, Turkey (Türkiye)

Velindre Cancer Centre, Cardiff, United Kingdom

Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom

Royal Marsden Hospital- Sutton, Sutton, United Kingdom

Linked Papers

2023-08-31

Tisotumab Vedotin in Combination With Carboplatin, Pembrolizumab, or Bevacizumab in Recurrent or Metastatic Cervical Cancer: Results From the innovaTV 205/GOG-3024/ENGOT-cx8 Study

PURPOSE Tissue factor is highly expressed in cervical carcinoma and can be targeted by tisotumab vedotin (TV), an antibody-drug conjugate. This phase Ib/II study evaluated TV in combination with bevacizumab, pembrolizumab, or carboplatin for recurrent or metastatic cervical cancer (r/mCC). METHODS This open-label, multicenter study (ClinicalTrials.gov identifier: NCT03786081 ) included dose-escalation arms that assessed dose-limiting toxicities (DLTs) and identified the recommended phase II dose (RP2D) of TV in combination with bevacizumab (arm A), pembrolizumab (arm B), or carboplatin (arm C). The dose-expansion arms evaluated TV antitumor activity and safety at RP2D in combination with carboplatin as first-line (1L) treatment (arm D) or with pembrolizumab as 1L (arm E) or second-/third-line (2L/3L) treatment (arm F). The primary end point of dose expansion was objective response rate (ORR). RESULTS A total of 142 patients were enrolled. In dose escalation (n = 41), no DLTs were observed; the RP2D was TV 2 mg/kg plus bevacizumab 15 mg/kg on day 1 once every 3 weeks, pembrolizumab 200 mg on day 1 once every 3 weeks, or carboplatin AUC 5 on day 1 once every 3 weeks. In dose expansion (n = 101), the ORR was 54.5% (n/N, 18/33; 95% CI, 36.4 to 71.9) with 1L TV + carboplatin (arm D), 40.6% (n/N, 13/32; 95% CI, 23.7 to 59.4) with 1L TV + pembrolizumab (arm E), and 35.3% (12/34; 19.7 to 53.5) with 2L/3L TV + pembrolizumab (arm F). The median duration of response was 8.6 months, not reached, and 14.1 months, in arms D, E, and F, respectively. Grade ≥3 adverse events (≥15%) were anemia, diarrhea, nausea, and thrombocytopenia in arm D and anemia in arm F (none ≥15%, arm E). CONCLUSION TV in combination with bevacizumab, carboplatin, or pembrolizumab demonstrated manageable safety and encouraging antitumor activity in treatment-naive and previously treated r/mCC.