NCT03474107

Brief Summary

The purpose of this study was to compare the overall survival (OS) of participants with locally advanced or metastatic urothelial cancer treated with enfortumab vedotin (EV) to the OS of participants treated with chemotherapy. This study compared progression-free survival on study therapy (PFS1); the overall response rate (ORR) and the disease control rate (DCR) per Response Evaluation Criteria in Solid Tumors (RECIST) V1.1 of participants treated with EV to participants treated with chemotherapy. In addition, this study evaluated the duration of response (DOR) per RECIST V1.1 of EV and chemotherapy and assessed the safety and tolerability of EV, as well as, the quality of life (QOL) and Patient Reported Outcomes (PRO) parameters.

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
608

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Jun 2018

Longer than P75 for phase_3

Geographic Reach
18 countries

155 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 16, 2018

Completed
6 days until next milestone

First Posted

Study publicly available on registry

March 22, 2018

Completed
3 months until next milestone

Study Start

First participant enrolled

June 27, 2018

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 15, 2020

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

August 24, 2021

Completed
4.3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

November 27, 2025

Completed
Last Updated

January 9, 2026

Status Verified

December 1, 2025

Enrollment Period

2.1 years

First QC Date

March 16, 2018

Results QC Date

July 7, 2021

Last Update Submit

December 17, 2025

Conditions

Keywords

antibody drug conjugateenfortumab vedotin (EV)ASG-22MEASG-22CEurothelial cancer

Outcome Measures

Primary Outcomes (1)

  • Overall Survival (OS)

    OS was defined as the time from the date of randomization until the documented date of death from any cause. OS was analyzed using Kaplan-Meier estimates. Participants who were still alive at the time of data cutoff date were to be censored at the last known alive date or at the data cutoff date, whichever was earlier.

    From randomization until the analysis cut-off date of 15-Jul-2020 (median OS follow-up was 11.10 months)

Secondary Outcomes (8)

  • Progression Free Survival on Study Therapy (PFS1) as Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)

    From randomization until the analysis cut-off date of 15-Jul-2020 (median OS follow-up was 11.10 months)

  • Overall Response Rate (ORR) as Per RECIST V1.1

    From randomization until the analysis cut-off date of 15-Jul-2020 (median OS follow-up was 11.10 months)

  • Disease Control Rate (DCR) as Per RECIST V1.1

    From randomization until the analysis cut-off date of 15-Jul-2020 (median OS follow-up was 11.10 months)

  • Duration of Response (DOR) as Per RECIST V1.1

    From date of first objective response until the analysis cut-off date of 15-Jul-2020 (median OS follow-up was 11.10 months)

  • Change From Baseline to Week 12 in European Organisation for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire Global Health Status (QL2 Score)

    Baseline and week 12

  • +3 more secondary outcomes

Study Arms (3)

Arm A: Enfortumab Vedotin 1.25 mg/kg

EXPERIMENTAL

Participants received 1.25 milligrams per kilogram (mg/kg) of body weight enfortumab vedotin by intravenous infusion over approximately 30 minutes on days 1, 8 and 15 of every 28-day cycle. Participants received study treatment until radiological disease progression as determined per investigator assessment or other discontinuation criteria were met or upon study termination, or study completion, whichever occurred first.

Drug: Enfortumab Vedotin

Arm B: Chemotherapy

ACTIVE COMPARATOR

Participants received either 75 milligrams per square meter (mg/m\^2) docetaxel by IV infusion over approximately 1 hour or 320 mg/m\^2 vinflunine by IV infusion over approximately 20 minutes or 175 mg/m\^2 paclitaxel by IV infusion over approximately 1 hour on day 1 of every 21-day cycle. Participants received study treatment until radiological disease progression as determined per investigator assessment or other discontinuation criteria were met or upon study termination, or study completion, whichever occurred first.

Drug: DocetaxelDrug: VinflunineDrug: Paclitaxel

Cross-over Extension (COE)

EXPERIMENTAL

Eligible participants from chemotherapy arm who met the criteria for COE will receive 1.25 mg/kg of body weight enfortumab vedotin by intravenous infusion over approximately 30 minutes on days 1, 8 and 15 of every 28-day cycle until discontinuation criteria is met.

Drug: Enfortumab Vedotin

Interventions

Intravenous infusion

Also known as: ASG-22ME, ASG-22CE
Arm A: Enfortumab Vedotin 1.25 mg/kgCross-over Extension (COE)

Intravenous infusion

Arm B: Chemotherapy

Intravenous infusion

Arm B: Chemotherapy

Intravenous infusion

Arm B: Chemotherapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Subject is legally an adult according to local regulation at the time of signing informed consent.
  • Subject has histologically or cytologically confirmed urothelial carcinoma (i.e., cancer of the bladder, renal pelvis, ureter, or urethra). Subjects with urothelial carcinoma (transitional cell) with squamous differentiation or mixed cell types are eligible.
  • Subject must have experienced radiographic progression or relapse during or after a checkpoint inhibitor (CPI) (anti-programmed cell death protein 1 (PD1) or anti-programmed death-ligand 1 (PD-L1)) for locally advanced or metastatic disease. Subjects who discontinued CPI treatment due to toxicity are eligible provided that the subjects have evidence of disease progression following discontinuation. The CPI need not be the most recent therapy. Subjects for whom the most recent therapy has been a non-CPI based regimen are eligible if the subjects have progressed/relapsed during or after the subjects most recent therapy. Locally advanced disease must not be amenable to resection with curative intent per the treating physician.
  • Subject must have received a platinum containing regimen (cisplatin or carboplatin) in the metastatic/locally advanced, neoadjuvant or adjuvant setting. If platinum was administered in the adjuvant/neoadjuvant setting subject must have progressed within 12 months of completion.
  • Subject has radiologically documented metastatic or locally advanced disease at baseline.
  • An archival tumor tissue sample should be available for submission to central laboratory prior to study treatment. If an archival tumor tissue sample is not available, a fresh tissue sample should be provided. If a fresh tissue sample cannot be provided due to safety concerns, enrollment into the study must be discussed with the medical monitor.
  • Subject has ECOG PS of 0 or 1
  • The subject has the following baseline laboratory data:
  • absolute neutrophil count (ANC) ≥ 1500/mm3
  • platelet count ≥ 100 × 10\^9/L
  • hemoglobin ≥ 9 g/dL
  • serum total bilirubin ≤ 1.5 × upper limit of normal (ULN) or ≤ 3 × ULN for subjects with Gilbert's disease
  • creatinine clearance (CrCl) ≥ 30 mL/min as estimated per institutional standards or as measured by 24 hour urine collection (glomerular filtration rate \[GFR\] can also be used instead of CrCl)
  • alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN or ≤ 3 x ULN for subjects with liver metastases
  • Female subject must either:
  • +10 more criteria

You may not qualify if:

  • Subject has preexisting sensory or motor neuropathy Grade ≥ 2.
  • Subject has active central nervous system (CNS) metastases. Subjects with treated CNS metastases are permitted on study if all the following are true:
  • CNS metastases have been clinically stable for at least 6 weeks prior to screening
  • If requiring steroid treatment for CNS metastases, the subject is on a stable dose ≤ 20 mg/day of prednisone or equivalent for at least 2 weeks
  • Baseline scans show no evidence of new or enlarged brain metastasis
  • Subject does not have leptomeningeal disease
  • Subject has ongoing clinically significant toxicity (Grade 2 or higher with the exception of alopecia) associated with prior treatment (including systemic therapy, radiotherapy or surgery). Subject with ≤ Grade 2 immunotherapy-related hypothyroidism or panhypopituitarism may be enrolled when well-maintained/controlled on a stable dose of hormone replacement therapy (if indicated). Subjects with ongoing ≥ Grade 3 immunotherapy-related hypothyroidism or panhypopituitarism are excluded. Subjects with ongoing immunotherapy related colitis, uveitis, or pneumonitis or subjects with other immunotherapy related AEs requiring high doses of steroids (\> 20 mg/day of prednisone or equivalent) are excluded.
  • Subject has prior treatment with EV or other monomethyl auristatin E (MMAE)-based Antibody drug conjugates (ADCs).
  • Subject has received prior chemotherapy for urothelial cancer with all available study therapies in the control arm (i.e., both prior paclitaxel and docetaxel in regions where vinflunine is not an approved therapy, or prior paclitaxel, docetaxel and vinflunine in regions where vinflunine is an approved therapy).
  • Subject has received more than 1 prior chemotherapy regimen for locally advanced or metastatic urothelial cancer, including chemotherapy for adjuvant or neo-adjuvant disease if recurrence occurred within 12 months of completing therapy. The substitution of carboplatin for cisplatin does not constitute a new regimen provided no new chemotherapeutic agents were added to the regimen.
  • Subject has history of another malignancy within 3 years before the first dose of study drug, or any evidence of residual disease from a previously diagnosed malignancy. Subjects with nonmelanoma skin cancer, localized prostate cancer treated with curative intent with no evidence of progression, low-risk or very low-risk (per standard guidelines) localized prostate cancer under active surveillance/watchful waiting without intent to treat, or carcinoma in situ of any type (if complete resection was performed) are allowed.
  • Subject is currently receiving systemic antimicrobial treatment for viral, bacterial, or fungal infection at the time of first dose of EV. Routine antimicrobial prophylaxis is permitted.
  • Subject has 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).
  • Subject has known history of human immunodeficiency virus (HIV) infection (HIV 1 or 2).
  • Subject has documented history of a cerebral vascular event (stroke or transient ischemic attack), unstable angina, myocardial infarction, or cardiac symptoms (including congestive heart failure) consistent with New York Heart Association Class III-IV within 6 months prior to the first dose of study drug.
  • +9 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (158)

UCI Chao Family Comprehensive Cancer Center

Orange, California, 92868, United States

Location

University of California

Sacramento, California, 95817, United States

Location

Innovative Clinical Research

Whittier, California, 90606, United States

Location

University of Colorado

Denver, Colorado, 80045, United States

Location

Smilow Cancer Hospital at Yale-New Haven

New Haven, Connecticut, 06510, United States

Location

Sylvester Comprehensive Cancer Center

Miami, Florida, 33136, United States

Location

Florida Hospital

Orlando, Florida, 32804, United States

Location

Rush University Medical Center

Chicago, Illinois, 60612, United States

Location

Norton Cancer Institute

Louisville, Kentucky, 40207, United States

Location

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215, United States

Location

Nebraska Cancer Specialists

Omaha, Nebraska, 68130, United States

Location

Roswell Park Cancer Institute

Buffalo, New York, 14263, United States

Location

Long Island Jewish Medical Center

Lake Success, New York, 11042, United States

Location

Sidney Kimmel Center for Prostate and Urologic Cancers

New York, New York, 10065, United States

Location

Montefiore Medical Center

The Bronx, New York, 10467, United States

Location

White Plains Hospital Center for Cancer Care - Oncology Site

White Plains, New York, 10601, United States

Location

Toledo Clinic Cancer Center

Toledo, Ohio, 43623, United States

Location

Providence Portland Med Center

Portland, Oregon, 97213, United States

Location

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Fox Chase Cancer Center

Philadelphia, Pennsylvania, 19111, United States

Location

Lifespan Rhode Island Hospital

Providence, Rhode Island, 02903, United States

Location

Saint Francis Hospital

Greenville, South Carolina, 29607, United States

Location

HOPE Cancer Center of East Texas

Tyler, Texas, 75701, United States

Location

Benaroya Research Institute at Virginia Mason

Seattle, Washington, 98101, United States

Location

Medical College of Wisconsin

Milwaukee, Wisconsin, 53226, United States

Location

Site AR54001

Buenos Aires, Argentina

Location

Site AU61006

Adelaide, Australia

Location

Site AU61001

Miranda, Australia

Location

Site AU61004

St Leonards, Australia

Location

Site AU61002

Sydney, Australia

Location

Site AT43005

Linz, Austria

Location

Site AT43001

Salzburg, Austria

Location

Site AT43004

Vienna, Austria

Location

Site BE32011

Aalst, Belgium

Location

Site BE32007

Brussels, Belgium

Location

Site BE32013

Brussels, Belgium

Location

Site BE32010

Charleroi, Belgium

Location

Site BE32001

Ghent, Belgium

Location

Site BE32008

Ghent, Belgium

Location

Site BE32005

Hasselt, Belgium

Location

Site BE32003

Leuven, Belgium

Location

Site BE32009

Liège, Belgium

Location

Site CA15015

Calgary, Canada

Location

Site CA15012

Edmonton, Canada

Location

Site CA15014

London, Canada

Location

Site CA15002

Montreal, Canada

Location

Site CA15007

Montreal, Canada

Location

Site CA15011

Oshawa, Canada

Location

Site CA15004

Québec, Canada

Location

Site CA15008

Saskatoon, Canada

Location

Site CA15001

Sherbrooke, Canada

Location

Site CA15005

Toronto, Canada

Location

Site CA15013

Vancouver, Canada

Location

Site DK45003

Aalborg, Denmark

Location

Site DK45004

Copenhagen, Denmark

Location

Site DK45001

Herlev, Denmark

Location

Site FR33021

Besançon, France

Location

Site FR33009

Bordeaux, France

Location

Site FR33018

Bordeaux, France

Location

Site FR33001

Brest, France

Location

Site FR33016

Caen, France

Location

Site FR33015

Lyon, France

Location

Site FR33014

Marseille, France

Location

Site FR33003

Nice, France

Location

Site FR33022

Paris, France

Location

Site FR33005

Pierre-Bénite, France

Location

Site FR33004

Saint-Mandé, France

Location

Site FR33002

Strasbourg, France

Location

Site FR33019

Toulouse, France

Location

Site FR33006

Villejuif, France

Location

Site DE49011

Essen, Germany

Location

Site DE49008

Heidelberg, Germany

Location

Site DE49010

Münster, Germany

Location

Site DE49003

Tübingen, Germany

Location

Site DE49009

Würzburg, Germany

Location

Site IT39008

Arezzo, Italy

Location

Site IT39019

Cremona, Italy

Location

Site IT39010

Milan, Italy

Location

Site IT39025

Modena, Italy

Location

Site IT39013

Pisa, Italy

Location

Site IT39014

Reggio Emilia, Italy

Location

Site IT39004

Terni, Italy

Location

Site JP81010

Hirosaki, Aomori, Japan

Location

Site JP81014

Kashiwa, Chiba, Japan

Location

Site JP81007

Sapporo, Hokkaido, Japan

Location

Site JP81026

Sapporo, Hokkaido, Japan

Location

Site JP81020

Tsukuba, Ibaraki, Japan

Location

Site JP81018

Morioka, Iwate, Japan

Location

Site JP81009

Kita-gun, Kagawa-ken, Japan

Location

Site JP81002

Yokohama, Kanagawa, Japan

Location

Site JP81005

Sendai, Miyagi, Japan

Location

Site JP81016

Sayama, Osaka, Japan

Location

Site JP81024

Takatsuki, Osaka, Japan

Location

Site JP81008

Bunkyo-ku, Tokyo, Japan

Location

Site JP81012

Koto-ku, Tokyo, Japan

Location

Site JP81013

Shinjuku-ku, Tokyo, Japan

Location

Site JP81011

Ube, Yamaguchi, Japan

Location

Site JP81015

Chiba, Japan

Location

Site JP81019

Fukuoka, Japan

Location

Site JP81023

Fukuoka, Japan

Location

Site JP81004

Hiroshima, Japan

Location

Site JP81001

Kyoto, Japan

Location

Site JP81017

Niigata, Japan

Location

Site JP81003

Okayama, Japan

Location

Site JP81022

Osaka, Japan

Location

Site JP81021

Tokushima, Japan

Location

Site JP81006

Toyama, Japan

Location

Site NL31002

Amsterdam, Netherlands

Location

Site NL31003

Amsterdam, Netherlands

Location

Site NL31009

Nijmegen, Netherlands

Location

Site NL31001

Tilburg, Netherlands

Location

Site PT35102

Lisbon, Portugal

Location

Site PT35105

Lisbon, Portugal

Location

Site PT35106

Porto, Portugal

Location

Site RU70002

Ivanovo, Russia

Location

Site RU70009

Obninsk, Russia

Location

Site RU70005

Omsk, Russia

Location

Site RU70015

Vologda, Russia

Location

Site KR82006

Daejeon, South Korea

Location

Site KR82007

Goyang-si, South Korea

Location

Site KR82012

Hwasun-gun, South Korea

Location

Site KR82002

Incheon, South Korea

Location

Site KR82001

Seongnam-si, South Korea

Location

Site KR82003

Seoul, South Korea

Location

Site KR82004

Seoul, South Korea

Location

Site KR82008

Seoul, South Korea

Location

Site KR82009

Seoul, South Korea

Location

Site KR82010

Seoul, South Korea

Location

Site KR82005

Shin, South Korea

Location

Site ES34010

Badajoz, Spain

Location

Site ES34002

Badalona, Spain

Location

Site ES34001

Barcelona, Spain

Location

Site ES34012

Barcelona, Spain

Location

Site ES34023

Barcelona, Spain

Location

Site ES34014

Córdoba, Spain

Location

Site ES34003

Madrid, Spain

Location

Site ES34013

Madrid, Spain

Location

Site ES34015

Madrid, Spain

Location

Site ES34017

Madrid, Spain

Location

Site ES34011

Manresa, Spain

Location

Site ES34019

Pamplona, Spain

Location

Site ES34005

Seville, Spain

Location

Site ES34007

Valencia, Spain

Location

Site ES34008

Valencia, Spain

Location

Site CH41002

Bern, Switzerland

Location

Site CH41001

Chur, Switzerland

Location

Site TW88602

Kaohsiung City, Taiwan

Location

Site TW88605

Kaohsiung City, Taiwan

Location

Site TW88606

Taichung, Taiwan

Location

Site TW88601

Tainan, Taiwan

Location

Site TW88604

Taipei, Taiwan

Location

Site TW88607

Taoyuan District, Taiwan

Location

Site GB44005

London, United Kingdom

Location

Site GB44006

London, United Kingdom

Location

Site GB44004

Metropolitan Borough of Wirral, United Kingdom

Location

Site GB44002

Sheffield, United Kingdom

Location

Site GB44011

Southampton, United Kingdom

Location

Site GB44013

Sutton, United Kingdom

Location

Related Publications (2)

  • Rosenberg JE, Mamtani R, Sonpavde GP, Loriot Y, Duran I, Lee JL, Matsubara N, Vulsteke C, Castellano D, Sridhar SS, Pappot H, Gurney H, Bedke J, van der Heijden MS, Galli L, Keam B, Masumori N, Meran J, O'Donnell PH, Park SH, Grande E, Sengelov L, Uemura H, Skaltsa K, Campbell M, Matsangou M, Wu C, Hepp Z, McKay C, Powles T, Petrylak DP. Health-related Quality of Life in Patients with Previously Treated Advanced Urothelial Carcinoma from EV-301: A Phase 3 Trial of Enfortumab Vedotin Versus Chemotherapy. Eur Urol. 2024 Jun;85(6):574-585. doi: 10.1016/j.eururo.2024.01.007. Epub 2024 Feb 28.

  • Powles T, Rosenberg JE, Sonpavde GP, Loriot Y, Duran I, Lee JL, Matsubara N, Vulsteke C, Castellano D, Wu C, Campbell M, Matsangou M, Petrylak DP. Enfortumab Vedotin in Previously Treated Advanced Urothelial Carcinoma. N Engl J Med. 2021 Mar 25;384(12):1125-1135. doi: 10.1056/NEJMoa2035807. Epub 2021 Feb 12.

MeSH Terms

Conditions

Ureteral NeoplasmsUrinary Bladder Neoplasms

Interventions

enfortumab vedotinDocetaxelvinfluninePaclitaxel

Condition Hierarchy (Ancestors)

Urologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteNeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesUreteral DiseasesUrologic DiseasesMale Urogenital DiseasesUrinary Bladder Diseases

Intervention Hierarchy (Ancestors)

TaxoidsCyclodecanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsDiterpenesTerpenes

Results Point of Contact

Title
Clinical Trial Disclosure
Organization
Astellas Pharma Global Development, Inc.

Study Officials

  • Medical Director

    Astellas Pharma Global Development, Inc.

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR
Expanded Access
Yes

Study Record Dates

First Submitted

March 16, 2018

First Posted

March 22, 2018

Study Start

June 27, 2018

Primary Completion

July 15, 2020

Study Completion

November 27, 2025

Last Updated

January 9, 2026

Results First Posted

August 24, 2021

Record last verified: 2025-12

Data Sharing

IPD Sharing
Will share

Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as products terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.

Shared Documents
STUDY PROTOCOL, SAP, CSR
Time Frame
Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
Access Criteria
Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
More information

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