A phase I study of enfortumab vedotin in Japanese patients with locally advanced or metastatic urothelial carcinoma.

Abstract

Locally advanced or metastatic urothelial cancer is an aggressive form of cancer with high recurrence rates and low survival. Nectin-4 is a cell adhesion molecule commonly expressed in several tumors, including high expression in urothelial cancer. Enfortumab vedotin is an antibody-drug conjugate composed of an anti-Nectin-4 humanized monoclonal antibody linked to the microtubule disrupting agent, monomethyl auristatin E. In this phase I study (NCT03070990), Japanese patients with locally advanced/metastatic urothelial cancer treated with prior chemotherapy, or ineligible for cisplatin, were randomized 1:1 to receive 1.0 mg/kg (Arm A) or 1.25 mg/kg (Arm B) enfortumab vedotin on Days 1, 8, and 15 of each 28-day cycle. Assessing the pharmacokinetic and safety/tolerability profiles of enfortumab vedotin were primary objectives; investigator-assessed antitumor activity (RECIST v1.1) was a secondary objective. Seventeen patients (n = 9, Arm A; n = 8, Arm B) received treatment. Pharmacokinetic data suggest a dose-dependent increase in enfortumab vedotin maximum concentration and area under the concentration-time curve at Day 7. Enfortumab vedotin was well tolerated across both doses. Dysgeusia and alopecia (n = 9 each) were the most common treatment-related adverse events. Regardless of attribution, grade ≥ 3 adverse events occurring in ≥2 patients were anemia and hypertension (n = 2 each). One patient achieved a confirmed complete response (Arm A) and five achieved confirmed partial responses (n = 3, Arm A; n = 2, Arm B). Objective response and disease control rates were 35.3% and 76.5%, respectively. In Japanese patients with locally advanced/metastatic urothelial cancer, enfortumab vedotin is well tolerated with preliminary antitumor activity and a pharmacokinetic profile consistent with prior reports.

• Authors: Shunji Takahashi, Motohide Uemura, Tomokazu Kimura, Yoshihide Kawasaki, Atsushi Takamoto, Akito Yamaguchi, Amal Melhem-Bertrandt, Elaina M Gartner, Takashi Inoue, Rio Akazawa, Takeshi Kadokura, Toshiki Tanikawa
• Journal: Investigational new drugs (Invest New Drugs) Vol. 38 Issue 4 Pg. 1056-1066 (08 2020) ISSN: 1573-0646 [Electronic] United States
• PMID: 31444589 (Publication Type: Clinical Trial, Phase I, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies
• Antibodies, Monoclonal
• Antineoplastic Agents
• enfortumab vedotin

Topics

• Aged
• Aged, 80 and over
• Alopecia (chemically induced)
• Antibodies (blood)
• Antibodies, Monoclonal (adverse effects, immunology, pharmacokinetics, therapeutic use)
• Antineoplastic Agents (adverse effects, immunology, pharmacokinetics, therapeutic use)
• Asian People
• Dysgeusia (chemically induced)
• Female
• Humans
• Male
• Middle Aged
• Treatment Outcome
• Tumor Burden (drug effects)
• Urologic Neoplasms (drug therapy, immunology, metabolism, pathology)