RECRUITING

Enfortumab Vedotin for the Treatment of Patients With Metastatic or Unresectable Squamous Cell Carcinoma of the Penis

Conditions

Metastatic Penile Squamous Cell Carcinoma Stage III Penile Cancer AJCC v8 Stage IV Penile Cancer AJCC v8 Unresectable Penile Squamous Cell Carcinoma

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase II trial tests how well enfortumab vedotin works for treating patients with squamous cell carcinoma of the penis that has spread to other places in the body (metastatic) or cannot be removed by surgery (unresectable). Enfortumab vedotin is a monoclonal antibody, enfortumab, linked to an anticancer drug called vedotin. It works by helping the immune system to slow or stop the growth of tumor cells. Enfortumab attaches to a protein called nectin-4 on tumor cells in a targeted way and delivers vedotin to kill them.

Official Title

Phase II Study of Enfortumab Vedotin Treatment for Metastatic Squamous Cell Carcinoma of the Penis

Quick Facts

Study Start:2023-12-21

Study Completion:2026-11-01

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT06104618

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:MALE

Accepts Healthy Volunteers:Yes

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Age ≥ 18 years * Histological confirmation of squamous cell carcinoma of the penis (PSCC): NOTE: Biopsy confirmation of at least one site of metastasis is encouraged but not required. * At least one site of metastatic or unresectable PSCC. NOTE: Prior therapy is not required for patients whose treatment is considered palliative (for example, presence of distant metastasis). NOTE: Patients who are potentially curable (any T, N1 - N3, M0) must have had tumor progression after standard chemotherapy, radiotherapy, or surgery, or be unable to receive such treatment. Eligible stages include: * Any T, N1 (i.e., a palpable mobile unilateral inguinal lymph node), M0 OR * Any T, N2 (i.e., palpable mobile multiple or bilateral inguinal lymph nodes), M0 OR * Any T, N3 (i.e., fixed inguinal nodal mass or any pelvic lymphadenopathy), M0 OR * Any T, any N, M1 * Patients with clinical N1, M0 mPSCC at protocol entry must be ineligible for surgery because of comorbidities or clinical T4 disease, or have refused surgery * Patients with clinical N1 - N3, M0, and no prior systemic therapy must be: * Unable to receive neoadjuvant (paclitaxel + ifosfamide + cisplatin) TIP because of comorbidities or refused TIP; AND * Unable to receive radiotherapy with curative intent, or refused radiotherapy * Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) * Prior therapy is allowed. Patients may be treatment-naïve or have had any number of prior anti-cancer treatments * Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1 * Hemoglobin ≥ 9.0 g/dL obtained ≤15 days prior to registration * Absolute neutrophil count (ANC) ≥ 1000/mm\^3 obtained ≤ 15 days prior to registration * Platelet count ≥ 100,000/mm\^3 obtained ≤ 15 days prior to registration * Total bilirubin ≤ 1.5 x upper limit of normal (ULN) or ≤ 3 x ULN for patients with Gilbert's disease obtained ≤ 15 days prior to registration * Alanine aminotransferase (ALT) and aspartate transaminase (AST) ≤ 3 x ULN obtained ≤ 15 days prior to registration * Glomerular filtration rate (GFR) or calculated creatinine clearance ≥ 30 ml/min as estimated using the Cockcroft-Gault formula or as measured by 24-hour urine collection obtained ≤ 15 days prior to registration * Provide written informed consent * Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study)	* Pure verrucous carcinoma of the penis * Non-squamous malignancy of the penis * Squamous carcinoma of the urethra * Preexisting sensory or motor neuropathy ≥ grade 2 * Active central nervous system (CNS) metastases. Exception: Treated CNS metastases are allowed if all of the following are true: * CNS metastases are clinically stable for ≥ 6 weeks prior to registration * If needed, steroid dose is stable and ≤ 20 mg/day of prednisone or equivalent for ≥ 2 weeks prior to registration * Baseline imaging shows no evidence of new or enlarged brain metastasis * No leptomeningeal disease * History of uncontrolled diabetes mellitus ≤ 3 months prior to registration NOTE: Uncontrolled diabetes is defined as hemoglobin A1c (HbA1c) ≥ 8.0% or HbA1c 7.0-7.9% with associated diabetes symptoms (polyuria or polydipsia) that are not otherwise explained * Failure to recover from any of the following therapies prior to registration: * Major surgery * Radiotherapy, chemotherapy, biologics, investigational agents, and/or antitumor treatment with immunotherapy * Immunocompromised patients and patients known to be human immunodeficiency virus (HIV) positive * Uncontrolled intercurrent illness including, but not limited to: * Ongoing or active infection requiring systemic treatment * History of cerebral vascular event (stroke or transient ischemic attack) * Myocardial infarction or symptomatic congestive heart failure (New York Heart Association \[NYHA\] Class III-IV) ≤ 6 months prior to registration * Unstable angina pectoris * Cardiac arrhythmia * Or psychiatric illness/social situations that would limit compliance with study requirements (e.g., history of substance abuse) * Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm * Currently receiving systemic antimicrobial treatment for viral, bacterial or fungal infection. NOTE: Routine antimicrobial prophylaxis is allowed * Known active hepatitis B (e.g., hepatitis B surface antigen \[HBsAg\] reactive) or active hepatitis C (e.g., hepatitis C virus \[HCV\] ribonucleic acid (RNA) \[qualitative\] is detected) * Known active keratitis or corneal ulcerations. NOTE: Superficial punctate keratitis is allowed if the disorder is being adequately treated * Known hypersensitivity to enfortumab vedotin or to any excipient contained in the drug formulation of enfortumab vedotin (including histidine, trehalose dihydrate and polysorbate 20) OR subject has known hypersensitivity to biopharmaceutical produced in Chinese hamster ovary cells * Other active malignancy ≤ 2 years prior to registration. EXCEPTIONS: Locally curable cancers that have been apparently cured such as basal or squamous cell skin cancer, non-muscle-invasive bladder cancer, or carcinoma in situ of the breast or low risk Gleason 6 prostate cancer. * History of myocardial infarction ≤ 6 months, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias * Patients who are sexually active and unwilling to use effective contraception (if they are not already surgically sterile) * Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens * Chemotherapy-naïve patients who are potentially curable (any T, N1 - N3, M0) in the absence of any condition that precludes cisplatin-based chemotherapy, such as low GFR, peripheral neuropathy, hearing impairment, or psychosocial considerations

Inclusion Criteria

Exclusion Criteria

* Age ≥ 18 years
* Histological confirmation of squamous cell carcinoma of the penis (PSCC): NOTE: Biopsy confirmation of at least one site of metastasis is encouraged but not required.
* At least one site of metastatic or unresectable PSCC. NOTE: Prior therapy is not required for patients whose treatment is considered palliative (for example, presence of distant metastasis). NOTE: Patients who are potentially curable (any T, N1 - N3, M0) must have had tumor progression after standard chemotherapy, radiotherapy, or surgery, or be unable to receive such treatment. Eligible stages include:
* Any T, N1 (i.e., a palpable mobile unilateral inguinal lymph node), M0 OR
* Any T, N2 (i.e., palpable mobile multiple or bilateral inguinal lymph nodes), M0 OR
* Any T, N3 (i.e., fixed inguinal nodal mass or any pelvic lymphadenopathy), M0 OR
* Any T, any N, M1
* Patients with clinical N1, M0 mPSCC at protocol entry must be ineligible for surgery because of comorbidities or clinical T4 disease, or have refused surgery
* Patients with clinical N1 - N3, M0, and no prior systemic therapy must be:
* Unable to receive neoadjuvant (paclitaxel + ifosfamide + cisplatin) TIP because of comorbidities or refused TIP; AND
* Unable to receive radiotherapy with curative intent, or refused radiotherapy
* Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST 1.1)
* Prior therapy is allowed. Patients may be treatment-naïve or have had any number of prior anti-cancer treatments
* Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
* Hemoglobin ≥ 9.0 g/dL obtained ≤15 days prior to registration
* Absolute neutrophil count (ANC) ≥ 1000/mm\^3 obtained ≤ 15 days prior to registration
* Platelet count ≥ 100,000/mm\^3 obtained ≤ 15 days prior to registration
* Total bilirubin ≤ 1.5 x upper limit of normal (ULN) or ≤ 3 x ULN for patients with Gilbert's disease obtained ≤ 15 days prior to registration
* Alanine aminotransferase (ALT) and aspartate transaminase (AST) ≤ 3 x ULN obtained ≤ 15 days prior to registration
* Glomerular filtration rate (GFR) or calculated creatinine clearance ≥ 30 ml/min as estimated using the Cockcroft-Gault formula or as measured by 24-hour urine collection obtained ≤ 15 days prior to registration
* Provide written informed consent
* Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study)

* Pure verrucous carcinoma of the penis
* Non-squamous malignancy of the penis
* Squamous carcinoma of the urethra
* Preexisting sensory or motor neuropathy ≥ grade 2
* Active central nervous system (CNS) metastases. Exception: Treated CNS metastases are allowed if all of the following are true:
* CNS metastases are clinically stable for ≥ 6 weeks prior to registration
* If needed, steroid dose is stable and ≤ 20 mg/day of prednisone or equivalent for ≥ 2 weeks prior to registration
* Baseline imaging shows no evidence of new or enlarged brain metastasis
* No leptomeningeal disease
* History of uncontrolled diabetes mellitus ≤ 3 months prior to registration NOTE: Uncontrolled diabetes is defined as hemoglobin A1c (HbA1c) ≥ 8.0% or HbA1c 7.0-7.9% with associated diabetes symptoms (polyuria or polydipsia) that are not otherwise explained
* Failure to recover from any of the following therapies prior to registration:
* Major surgery
* Radiotherapy, chemotherapy, biologics, investigational agents, and/or antitumor treatment with immunotherapy
* Immunocompromised patients and patients known to be human immunodeficiency virus (HIV) positive
* Uncontrolled intercurrent illness including, but not limited to:
* Ongoing or active infection requiring systemic treatment
* History of cerebral vascular event (stroke or transient ischemic attack)
* Myocardial infarction or symptomatic congestive heart failure (New York Heart Association \[NYHA\] Class III-IV) ≤ 6 months prior to registration
* Unstable angina pectoris
* Cardiac arrhythmia
* Or psychiatric illness/social situations that would limit compliance with study requirements (e.g., history of substance abuse)
* Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
* Currently receiving systemic antimicrobial treatment for viral, bacterial or fungal infection. NOTE: Routine antimicrobial prophylaxis is allowed
* Known active hepatitis B (e.g., hepatitis B surface antigen \[HBsAg\] reactive) or active hepatitis C (e.g., hepatitis C virus \[HCV\] ribonucleic acid (RNA) \[qualitative\] is detected)
* Known active keratitis or corneal ulcerations. NOTE: Superficial punctate keratitis is allowed if the disorder is being adequately treated
* Known hypersensitivity to enfortumab vedotin or to any excipient contained in the drug formulation of enfortumab vedotin (including histidine, trehalose dihydrate and polysorbate 20) OR subject has known hypersensitivity to biopharmaceutical produced in Chinese hamster ovary cells
* Other active malignancy ≤ 2 years prior to registration. EXCEPTIONS: Locally curable cancers that have been apparently cured such as basal or squamous cell skin cancer, non-muscle-invasive bladder cancer, or carcinoma in situ of the breast or low risk Gleason 6 prostate cancer.
* History of myocardial infarction ≤ 6 months, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias
* Patients who are sexually active and unwilling to use effective contraception (if they are not already surgically sterile)
* Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
* Chemotherapy-naïve patients who are potentially curable (any T, N1 - N3, M0) in the absence of any condition that precludes cisplatin-based chemotherapy, such as low GFR, peripheral neuropathy, hearing impairment, or psychosocial considerations

Contacts and Locations

Principal Investigator

Lance C. Pagliaro, M.D.

PRINCIPAL_INVESTIGATOR

Mayo Clinic in Rochester

Study Locations (Sites)

Mayo Clinic Hospital in Arizona

Phoenix, Arizona, 85054

United States

Mayo Clinic in Florida

Jacksonville, Florida, 32224-9980

United States

Mayo Clinic in Rochester

Rochester, Minnesota, 55905

United States

Collaborators and Investigators

Sponsor: Mayo Clinic

Lance C. Pagliaro, M.D., PRINCIPAL_INVESTIGATOR, Mayo Clinic in Rochester

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-12-21

Study Completion Date2026-11-01

Study Record Updates

Study Start Date2023-12-21

Study Completion Date2026-11-01

Terms related to this study

Additional Relevant MeSH Terms

Metastatic Penile Squamous Cell Carcinoma
Stage III Penile Cancer AJCC v8
Stage IV Penile Cancer AJCC v8
Unresectable Penile Squamous Cell Carcinoma