A Phase 2 Study of Sitravatinib in Combination With PD-(L)1 Checkpoint Inhibitor Regimens in Patients With Advanced or Metastatic Urothelial Carcinoma
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ClinicalTrials.gov Identifier: NCT03606174 |
Recruitment Status :
Terminated
(The study was terminated due to sponsor decision / portfolio prioritization, and not due to safety reasons.)
First Posted : July 30, 2018
Results First Posted : August 24, 2023
Last Update Posted : August 24, 2023
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Study Type | Interventional |
---|---|
Study Design | Allocation: Non-Randomized; Intervention Model: Parallel Assignment; Masking: None (Open Label); Primary Purpose: Treatment |
Conditions |
Urothelial Carcinoma Urothelial Carcinoma Bladder Urothelial Carcinoma Ureter Urothelial Carcinoma of the Renal Pelvis and Ureter Urothelial Carcinoma Urethra |
Interventions |
Drug: Sitravatinib Drug: Nivolumab Drug: Pembrolizumab Drug: Enfortumab vedotin |
Enrollment | 260 |
Recruitment Details | 260 participants were enrolled into this study at investigative sites in the United States. |
Pre-assignment Details | Screening tests and procedures were performed within the 28 days preceding administration of the first dose. |
Arm/Group Title | Cohort 1 | Cohort 2 | Cohort 3 | Cohort 4 | Cohort 5 | Cohort 6 | Cohort 7 | Cohort 8 | Cohort 9 Dose Level 1 | Cohort 9 Dose Level 2 | Cohort 9 Dose Level 3 |
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Arm/Group Description |
Participants with locally advanced or metastatic urothelial carcinoma (UC) with documented disease progression on or after previous anti-programmed cell death (PD)-ligand(L)-1 as most recent treatment, and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 1. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules once daily (QD) in 28-day cycles. Nivolumab was received via an intravenous (IV) infusion over approximately 30 minutes (± 5 minutes) at 240 mg once every 2 weeks (Q2W) or 480 mg once every 4 weeks (Q4W), at the discretion of the Investigator and in accordance with the current nivolumab US Prescribing Information (USPI). |
Participants with locally advanced or metastatic UC with documented disease progression on or after previous anti-PD-L-1 as most recent treatment, and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 2. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti PD-(L)1 as the most recent treatment, who previously received (in combination or separately) other selected immunotherapies, and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 3. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti-PD-(L)1 as the most recent treatment, who previously received (in combination or separately) other selected immunotherapies, and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 4. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC who had not previously received an anti-PD-(L)1, and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 5. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC who had not previously received an anti-PD-(L)1, and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 6. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti PD-(L)1 and antibody-drug conjugate (ADC) (in combination or separately, and in any order), and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 7. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 100 mg malate capsules, or 120 mg free base capsule formulation QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti PD-(L)1 and ADC (in combination or separately, and in any order), and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 8. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 100 mg malate capsules, or 120 mg free base capsule formulation QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC who had previously received a PD-(L)1 checkpoint inhibitor (CPI) and a platinum-based chemotherapy were enrolled into Cohort 9, which included a lead-in dose-escalation part. A dose-expansion part was planned, but was not enrolled. During the lead-in dose-escalation part, participants in Cohort 9 Dose Level 1 were enrolled to receive sitravatinib 35 mg QD orally via capsules in 21-day cycles, enfortumab vedotin 1.25 mg/kg IV infusion on Days 1 and 8 every 3 weeks (Q3W), and pembrolizumab 200 mg Q3W as an IV infusion. |
Participants with locally advanced or metastatic UC who had previously received a PD-(L)1 checkpoint inhibitor (CPI) and a platinum-based chemotherapy were enrolled into Cohort 9, which included a lead-in dose-escalation part. A dose-expansion part was planned, but was not enrolled. During the lead-in dose-escalation part, participants in Cohort 9 Dose Level 2 were enrolled to receive sitravatinib 35 mg QD orally via capsules in 21-day cycles, enfortumab vedotin 1.0 mg/kg IV infusion on Days 1 and 8 Q3W, and pembrolizumab 200 mg Q3W as an IV infusion. |
Participants with locally advanced or metastatic UC who had previously received a PD-(L)1 checkpoint inhibitor (CPI) and a platinum-based chemotherapy were enrolled into Cohort 9, which included a lead-in dose-escalation part. A dose-expansion part was planned, but was not enrolled. During the lead-in dose-escalation part, participants in Cohort 9 Dose Level 3 were enrolled to receive sitravatinib 70 mg QD orally via capsules in 21-day cycles, enfortumab vedotin 1.0 mg/kg IV infusion on Days 1 and 8 Q3W, and pembrolizumab 200 mg Q3W as an IV infusion. |
Period Title: Overall Study | |||||||||||
Started | 49 | 23 | 18 | 9 | 53 | 27 | 56 | 9 | 8 | 4 | 4 |
Started Cohort 9 Lead-in Dose-escalation Part | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 8 | 4 | 4 |
Started Cohort 9 Dose-expansion Part | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 | 0 | 0 |
Completed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Not Completed | 49 | 23 | 18 | 9 | 53 | 27 | 56 | 9 | 8 | 4 | 4 |
Reason Not Completed | |||||||||||
Death | 37 | 15 | 15 | 7 | 35 | 12 | 35 | 8 | 5 | 3 | 0 |
Lost to Follow-up | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 |
Withdrawal by Subject | 6 | 0 | 0 | 1 | 2 | 1 | 4 | 0 | 0 | 0 | 1 |
Study Terminated by Sponsor | 5 | 7 | 3 | 0 | 11 | 6 | 12 | 1 | 3 | 1 | 2 |
Miscellaneous | 1 | 1 | 0 | 1 | 4 | 7 | 5 | 0 | 0 | 0 | 1 |
[1]
N/A for Cohorts 1-8
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Arm/Group Title | Cohort 1 | Cohort 2 | Cohort 3 | Cohort 4 | Cohort 5 | Cohort 6 | Cohort 7 | Cohort 8 | Cohort 9 Dose Level 1 | Cohort 9 Dose Level 2 | Cohort 9 Dose Level 3 | Total | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Arm/Group Description |
Participants with locally advanced or metastatic urothelial carcinoma (UC) with documented disease progression on or after previous anti-programmed cell death (PD)-ligand(L)-1 as most recent treatment, and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 1. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules once daily (QD) in 28-day cycles. Nivolumab was received via an intravenous (IV) infusion over approximately 30 minutes (± 5 minutes) at 240 mg once every 2 weeks (Q2W) or 480 mg once every 4 weeks (Q4W), at the discretion of the Investigator and in accordance with the current nivolumab US Prescribing Information (USPI). |
Participants with locally advanced or metastatic UC with documented disease progression on or after previous anti-PD-L-1 as most recent treatment, and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 2. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti PD-(L)1 as the most recent treatment, who previously received (in combination or separately) other selected immunotherapies, and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 3. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti-PD-(L)1 as the most recent treatment, who previously received (in combination or separately) other selected immunotherapies, and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 4. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC who had not previously received an anti-PD-(L)1, and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 5. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC who had not previously received an anti-PD-(L)1, and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 6. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 120 mg capsules QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti PD-(L)1 and antibody-drug conjugate (ADC) (in combination or separately, and in any order), and who were previously treated with a platinum-based chemotherapy were enrolled into Cohort 7. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 100 mg malate capsules, or 120 mg free base capsule formulation QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC with documented disease progression on or after a previous anti PD-(L)1 and ADC (in combination or separately, and in any order), and who were considered ineligible for platinum-based chemotherapy were enrolled into Cohort 8. Participants received sitravatinib in combination with nivolumab. Sitravatinib was received orally via 100 mg malate capsules, or 120 mg free base capsule formulation QD in 28-day cycles. Nivolumab was received via an IV infusion over approximately 30 minutes (± 5 minutes) at 240 mg Q2W or 480 mg Q4W, at the discretion of the Investigator and in accordance with the current nivolumab USPI. |
Participants with locally advanced or metastatic UC who had previously received a PD-(L)1 checkpoint inhibitor (CPI) and a platinum-based chemotherapy were enrolled into Cohort 9, which included a lead-in dose-escalation part. A dose-expansion part was planned, but was not enrolled. During the lead-in dose-escalation part, participants in Cohort 9 Dose Level 1 were enrolled to receive sitravatinib 35 mg QD orally via capsules in 21-day cycles, enfortumab vedotin 1.25 mg/kg IV infusion on Days 1 and 8 every 3 weeks (Q3W), and pembrolizumab 200 mg Q3W as an IV infusion. |
Participants with locally advanced or metastatic UC who had previously received a PD-(L)1 checkpoint inhibitor (CPI) and a platinum-based chemotherapy were enrolled into Cohort 9, which included a lead-in dose-escalation part. A dose-expansion part was planned, but was not enrolled. During the lead-in dose-escalation part, participants in Cohort 9 Dose Level 2 were enrolled to receive sitravatinib 35 mg QD orally via capsules in 21-day cycles, enfortumab vedotin 1.0 mg/kg IV infusion on Days 1 and 8 Q3W, and pembrolizumab 200 mg Q3W as an IV infusion. |
Participants with locally advanced or metastatic UC who had previously received a PD-(L)1 checkpoint inhibitor (CPI) and a platinum-based chemotherapy were enrolled into Cohort 9, which included a lead-in dose-escalation part. A dose-expansion part was planned, but was not enrolled. During the lead-in dose-escalation part, participants in Cohort 9 Dose Level 3 were enrolled to receive sitravatinib 70 mg QD orally via capsules in 21-day cycles, enfortumab vedotin 1.0 mg/kg IV infusion on Days 1 and 8 Q3W, and pembrolizumab 200 mg Q3W as an IV infusion. |
Total of all reporting groups | |
Overall Number of Baseline Participants | 49 | 23 | 18 | 9 | 53 | 27 | 56 | 9 | 8 | 4 | 4 | 260 | |
Baseline Analysis Population Description |
Measured in the safety population, which included all participants who received ≥ 1 dose of any study treatment (sitravatinib, nivolumab, pembrolizumab, or enfortumab vedotin).
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||||||||||||
Age, Continuous
Mean (Standard Deviation) Unit of measure: Years |
|||||||||||||
Number Analyzed | 49 participants | 23 participants | 18 participants | 9 participants | 53 participants | 27 participants | 56 participants | 9 participants | 8 participants | 4 participants | 4 participants | 260 participants | |
67.3 (9.63) | 72.3 (7.94) | 67.6 (12.89) | 75.1 (7.62) | 65.2 (8.34) | 70.0 (8.23) | 67.1 (9.07) | 78.0 (7.02) | 65.1 (6.40) | 69.0 (8.00) | 75.8 (9.54) | 68.3 (9.39) | ||
Sex: Female, Male
Measure Type: Count of Participants Unit of measure: Participants |
|||||||||||||
Number Analyzed | 49 participants | 23 participants | 18 participants | 9 participants | 53 participants | 27 participants | 56 participants | 9 participants | 8 participants | 4 participants | 4 participants | 260 participants | |
Female |
13 26.5%
|
7 30.4%
|
6 33.3%
|
1 11.1%
|
10 18.9%
|
10 37.0%
|
17 30.4%
|
4 44.4%
|
0 0.0%
|
1 25.0%
|
1 25.0%
|
70 26.9%
|
|
Male |
36 73.5%
|
16 69.6%
|
12 66.7%
|
8 88.9%
|
43 81.1%
|
17 63.0%
|
39 69.6%
|
5 55.6%
|
8 100.0%
|
3 75.0%
|
3 75.0%
|
190 73.1%
|
|
Ethnicity (NIH/OMB)
Measure Type: Count of Participants Unit of measure: Participants |
|||||||||||||
Number Analyzed | 49 participants | 23 participants | 18 participants | 9 participants | 53 participants | 27 participants | 56 participants | 9 participants | 8 participants | 4 participants | 4 participants | 260 participants | |
Hispanic or Latino |
4 8.2%
|
0 0.0%
|
0 0.0%
|
2 22.2%
|
1 1.9%
|
0 0.0%
|
2 3.6%
|
1 11.1%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
10 3.8%
|
|
Not Hispanic or Latino |
44 89.8%
|
23 100.0%
|
18 100.0%
|
7 77.8%
|
52 98.1%
|
27 100.0%
|
53 94.6%
|
8 88.9%
|
8 100.0%
|
4 100.0%
|
4 100.0%
|
248 95.4%
|
|
Unknown or Not Reported |
1 2.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 1.8%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
2 0.8%
|
|
Race (NIH/OMB)
Measure Type: Count of Participants Unit of measure: Participants |
|||||||||||||
Number Analyzed | 49 participants | 23 participants | 18 participants | 9 participants | 53 participants | 27 participants | 56 participants | 9 participants | 8 participants | 4 participants | 4 participants | 260 participants | |
American Indian or Alaska Native |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
|
Asian |
0 0.0%
|
0 0.0%
|
2 11.1%
|
0 0.0%
|
1 1.9%
|
0 0.0%
|
4 7.1%
|
1 11.1%
|
0 0.0%
|
1 25.0%
|
1 25.0%
|
10 3.8%
|
|
Native Hawaiian or Other Pacific Islander |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
|
Black or African American |
2 4.1%
|
2 8.7%
|
1 5.6%
|
0 0.0%
|
5 9.4%
|
1 3.7%
|
2 3.6%
|
0 0.0%
|
0 0.0%
|
1 25.0%
|
0 0.0%
|
14 5.4%
|
|
White |
46 93.9%
|
21 91.3%
|
15 83.3%
|
9 100.0%
|
46 86.8%
|
26 96.3%
|
48 85.7%
|
8 88.9%
|
8 100.0%
|
2 50.0%
|
3 75.0%
|
232 89.2%
|
|
More than one race |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
|
Unknown or Not Reported |
1 2.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 1.9%
|
0 0.0%
|
2 3.6%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
4 1.5%
|
Name/Title: | Director, Clinical Operations |
Organization: | Mirati Therapeutics |
Phone: | 858-381-5289 |
EMail: | LatvenL@Mirati.com |
Responsible Party: | Mirati Therapeutics Inc. |
ClinicalTrials.gov Identifier: | NCT03606174 |
Other Study ID Numbers: |
516-003 |
First Submitted: | July 20, 2018 |
First Posted: | July 30, 2018 |
Results First Submitted: | August 3, 2023 |
Results First Posted: | August 24, 2023 |
Last Update Posted: | August 24, 2023 |