A Study Evaluating Different Immunotherapies (LAG-3 and PD-1 With or Without TIGIT, Compared to PD-L1 Alone) in Participants With Untreated Locally Advanced Metastatic Urothelial Cancer

NCT ID: NCT05645692

Last Updated: 2026-01-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

204 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-13

Study Completion Date

2026-12-31

Brief Summary

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This study will evaluate the safety of tobemstomig alone or in combination with tiragolumab compared with atezolizumab in participants with previously untreated, locally advanced or metastatic urothelial cancer (mUC) who are ineligible to receive a platinum containing chemotherapy.

Detailed Description

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Conditions

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Urothelial Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A

Participants will receive intravenous (IV) atezolizumab every 3 weeks (Q3W).

Group Type ACTIVE_COMPARATOR

Atezolizumab

Intervention Type DRUG

Participants will receive 1200 mg IV atezolizumab Q3W.

Arm B

Participants will receive IV tobemstomig Q3W.

Group Type EXPERIMENTAL

Tobemstomig

Intervention Type DRUG

Participants will receive 600 mg IV tobemstomig Q3W.

Arm C

Participants will receive IV tobemstomig + IV tiragolumab Q3W.

Group Type EXPERIMENTAL

Tobemstomig

Intervention Type DRUG

Participants will receive 600 mg IV tobemstomig Q3W.

Tiragolumab

Intervention Type DRUG

Participants will receive 600 mg IV tiragolumab Q3W.

Interventions

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Atezolizumab

Participants will receive 1200 mg IV atezolizumab Q3W.

Intervention Type DRUG

Tobemstomig

Participants will receive 600 mg IV tobemstomig Q3W.

Intervention Type DRUG

Tiragolumab

Participants will receive 600 mg IV tiragolumab Q3W.

Intervention Type DRUG

Other Intervention Names

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RO7247669

Eligibility Criteria

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Inclusion Criteria

* Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2
* Histologically or cytologically documented locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium. Participants with squamous, sarcomatoid, micropapillary, and glandular variant histologies are eligible for inclusion in the study, provided that a urothelial component is present in the tumor specimen. Participants with other variant histologies or pure variant histologies are not eligible for inclusion in this study
* Ineligible ("unfit") to receive platinum-based chemotherapy
* No prior chemotherapy for inoperable locally advanced or metastatic or recurrent urothelial carcinoma (UC)
* Measurable disease; at least one measurable lesion as defined by response evaluation criteria in solid tumors, version 1.1 (RECIST v1.1)
* Availability of a representative leftover tumor specimen that is suitable for determination of PD-L1 status as assessed by a central laboratory
* Adequate hematologic and end organ function
* Negative for hepatitis B and hepatitis C virus (HCV)
* Adequate cardiovascular function

Exclusion Criteria

* Pregnancy or breastfeeding
* GFR \<15 mL/min/1.73 m2
* Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
* History of leptomeningeal disease
* Uncontrolled tumor-related pain
* Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
* Uncontrolled or symptomatic hypercalcemia
* Active or history of autoimmune disease or immune deficiency
* History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
* Active tuberculosis (TB) or acute Epstein-Barr virus (EBV)
* Significant cardiovascular/cerebrovascular disease within 3 months prior to initiation of study treatment
* Major surgical procedure, other than for diagnosis, within 4 weeks prior to initiation of study treatment, or anticipation of need for a major surgical procedure during the study
* History of another primary malignancy other than urothelial carcinoma within 2 years prior to initiation of study treatment, with the exception of malignancies with a negligible risk of metastasis or death
* Severe infection within 4 weeks prior to initiation of study treatment
* Treatment with therapeutic oral or intravenous antibiotics within 2 weeks prior to initiation of study treatment. Participants receiving prophylactic antibiotics (e.g., to prevent a urinary tract infection or chronic obstructive pulmonary disease \[COPD\] exacerbation), or who are receiving oral antibiotics to treat a urinary tract infection are eligible for the study
* Prior allogeneic stem cell or solid organ transplantation
* Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during treatment or within 5 months after the final dose of atezolizumab, 4 months after the final dose of tobemstomig, or 90 days after the final dose of tiragolumab
* Current treatment with anti-viral therapy for HBV
* Treatment with any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment
* Treatment with investigational therapy within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study treatment
* Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-TIGIT and anti-LAG3 therapeutic antibodies or pathways targeting agents
* Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives prior to initiation of study treatment
* Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment
* History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hoffmann-La Roche

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trials

Role: STUDY_DIRECTOR

Hoffmann-LaRoche

Locations

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Cleveland Clinic

Cleveland, Ohio, United States

Site Status

MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Macquarie University Hospital

Macquarie Park, New South Wales, Australia

Site Status

Lyell McEwin Hospital

Adelaide, South Australia, Australia

Site Status

ICON Cancer Care Adelaide

Kurralta Park, South Australia, Australia

Site Status

Hospital Universitario Evangelico De Curitiba

Curitiba, Paraná, Brazil

Site Status

Hospital das Clinicas - UFRGS

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Hospital de Amor Amazônia

Porto Velho, Rondônia, Brazil

Site Status

*X*CEPHO - Centro de Estudos e Pesquisas em Hematologia e Oncologia

Santo André, São Paulo, Brazil

Site Status

Hospital Alemao Oswaldo Cruz

São Paulo, São Paulo, Brazil

Site Status

Beijing Cancer Hospital

Beijing, , China

Site Status

West China Hospital - Sichuan University

Chengdu, , China

Site Status

Sun yat-sen University Cancer Center

Guangzhou, , China

Site Status

Ruijin Hospital, Shanghai Jiaotong University School of Medicine

Shanghai, , China

Site Status

Aarhus Universitetshospital

Aarhus N, , Denmark

Site Status

Herlev Hospital

Herlev, , Denmark

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Gustave Roussy

Villejuif, , France

Site Status

Krankenhaus Martha-Maria Halle-Dölau, Klinik für Urologie

Halle, , Germany

Site Status

Martini-Klinik am UKE GmbH

Hamburg, , Germany

Site Status

Alexandras General Hospital of Athens

Athens, , Greece

Site Status

Attikon University General Hospital

Chaïdári, , Greece

Site Status

Theageneio Hospital

Thessaloniki, , Greece

Site Status

A.O. Universitaria Ospedale Consorziale Policlinico Di Bari

Bari, Apulia, Italy

Site Status

Istituto Nazionale Tumori Irccs Fondazione G. Pascale

Napoli, Campania, Italy

Site Status

Azienda Ospedaliero-Universitaria S.Orsola-Malpighi

Bologna, Emilia-Romagna, Italy

Site Status

IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola

Meldola, Emilia-Romagna, Italy

Site Status

Policlinico Universitario "Agostino Gemelli"

Rome, Lazio, Italy

Site Status

Irccs Ospedale San Raffaele

Milan, Lombardy, Italy

Site Status

Azienda Ospedaliera S. Maria - Terni

Terni, Umbria, Italy

Site Status

IRCCS Istituto Oncologico Veneto (IOV)

Padua, Veneto, Italy

Site Status

Health Pharma Professional Research

Mexico City, Mexico CITY (federal District), Mexico

Site Status

Szpital Wojewódzki im. Miko?aja Kopernika

Koszalin, , Poland

Site Status

Szpital Uniwersytecki w Krakowie

Krakow, , Poland

Site Status

Pratia Poznan

Późna, , Poland

Site Status

Szpital Grochowski im. dr med. Rafa?a Masztaka Sp. z o.o.

Warsaw, , Poland

Site Status

Seoul National University Bundang Hospital

Gyeonggi-do, , South Korea

Site Status

Gachon University Gil Medical Center

Incheon, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Severance Hospital, Yonsei University

Seoul, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Samsung Medical Center

Seoul, , South Korea

Site Status

Vall d'Hebron Institute of Oncology (VHIO), Barcelona

Barcelona, , Spain

Site Status

Institut Catala d Oncologia Hospital Duran i Reynals

Barcelona, , Spain

Site Status

Hospital Universitario Clínico San Carlos

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Hospital de Madrid Norte Sanchinarro- Centro Integral Oncologico Clara Campal

Madrid, , Spain

Site Status

Adana Baskent University Medical Faculty

Adana, , Turkey (Türkiye)

Site Status

Ankara City Hospital

Ankara, , Turkey (Türkiye)

Site Status

Trakya Universitesi Tip Fakultesi, Medikal Onkoloji Bilim Dali, Balkan Yerleskesi

Edirne, , Turkey (Türkiye)

Site Status

Izmir Medical Point Hospital

Izmir, , Turkey (Türkiye)

Site Status

Goztepe Prof.Dr. Suleyman Yalcin City Hospital

Kadiköy, , Turkey (Türkiye)

Site Status

Barts and the London NHS Trust

London, , United Kingdom

Site Status

Royal Preston Hosptial

Preston, , United Kingdom

Site Status

Royal Marsden Hospital (Sutton)

Sutton, , United Kingdom

Site Status

Countries

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United States Australia Brazil China Denmark France Germany Greece Italy Mexico Poland South Korea Spain Turkey (Türkiye) United Kingdom

Other Identifiers

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BO44157

Identifier Type: -

Identifier Source: org_study_id

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