A Clinical Study of Intismeran Autogene (V940) Treatment and Pembrolizumab in People With Bladder Cancer (V940-005/INTerpath-005)

NCT ID: NCT06305767

Last Updated: 2025-12-24

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

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

230 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-28

Study Completion Date

2031-10-20

Brief Summary

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Researchers are looking for new ways to treat people with high-risk muscle-invasive urothelial carcinoma (MIUC). Urothelial carcinoma is a type of bladder cancer that begins in cells that line the inside of the bladder and other parts of the urinary tract, such as part of the kidneys, ureters, and urethra. People with MIUC usually have chemotherapy before surgery, then surgery to remove the cancer. Chemotherapy is a type of medicine to destroy cancer cells or stop them from growing. After surgery, some people receive more treatment to prevent cancer from returning. Pembrolizumab is an immunotherapy, which is a treatment that helps the immune system fight cancer. Enfortumab vedotin (EV) is an antibody drug conjugate (ADC). An ADC attaches to a protein on cancer cells and delivers treatment to destroy those cells. Researchers want to learn if giving intismeran autogene (the study treatment) with pembrolizumab can prevent MIUC from returning after surgery. Intismeran autogene (also called mRNA-4157) is designed to treat each person's cancer by helping the person's immune system identify and kill cancer cells based on certain proteins found on those cancer cells.

The goals of this study are to learn if people who receive intismeran autogene and pembrolizumab are alive and cancer free longer than those who receive placebo and pembrolizumab, and to learn about the safety of intismeran autogene, pembrolizumab, and EV, and if people tolerate them.

Detailed Description

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Enrollment of participants into the Phase 1 Perioperative Cohort of this study is planned to start in approximately April of 2025.

Conditions

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Bladder Cancer

Keywords

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Programmed Cell Death-1 (PD1, PD-1) Programmed Cell Death 1 Ligand 1 (PDL1, PD-L1) Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The Phase 2 Adjuvant Cohort is a placebo- and active-controlled, parallel-group, multicenter, double-blind safety and efficacy study of adjuvant intismeran autogene plus pembrolizumab versus adjuvant placebo plus pembrolizumab in participants with pathologic high-risk MIUC after radical resection. Eligible participants will be randomly assigned in a 1:1 ratio to receive treatment with either intismeran autogene plus pembrolizumab or placebo plus pembrolizumab.

The Phase 1 Perioperative Cohort of this study has a single arm into which eligible participants are allocated. It will evaluate safety and preliminary efficacy of perioperative (neoadjuvant and adjuvant) intismeran autogene in combination with pembrolizumab plus EV for participants with muscle-invasive bladder cancer (MIBC).
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
The Phase 2 Adjuvant Cohort of study will be conducted as a double-blind study under in-house blinding procedures. Intismeran autogene and placebo will be prepared and dispensed by unblinded pharmacists and administered in a blinded fashion by blinded personnel. The participants and the investigators who are involved in the study intervention administration will be unaware of the intervention assignments.

The Phase 1 Perioperative Cohort will be conducted as an open-label study. Participants and investigators will be aware of the intervention assignments.

Study Groups

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Adjuvant Cohort: Pembrolizumab + Intismeran autogene

Adjuvant Cohort participants receive adjuvant treatment with up to 9 cycles of pembrolizumab plus up to a total of 9 doses of intismeran autogene. Intismeran autogene doses may begin as soon as Day 22 of Cycle 1. The total duration of treatment is up to approximately 13 months.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

Administered via intravenous (IV) infusion at a dose of 400 mg on Day 1 of every 6-week cycle for up to 9 adjuvant cycles for Adjuvant Cohort participants, or at a dose of 200 mg on Day 1 of every cycle for up to four 3-week neoadjuvant cycles and up to thirteen 3-week adjuvant cycles for Perioperative Cohort participants.

Intismeran autogene

Intervention Type BIOLOGICAL

Administered via intramuscular (IM) injection at a dose of 1 mg every 3 weeks for a total of up to 9 adjuvant doses for Adjuvant Cohort participants, or at a dose of 1 mg every 3 weeks for a total of up to 9 doses in the neoadjuvant and adjuvant periods for Perioperative Cohort participants.

Adjuvant Cohort: Pembrolizumab + Placebo

Adjuvant Cohort participants receive adjuvant treatment with up to 9 cycles of pembrolizumab plus up to a total of 9 doses of placebo. Placebo doses may begin as soon as Day 22 of Cycle 1. The total duration of treatment is up to approximately 13 months.

Group Type ACTIVE_COMPARATOR

Pembrolizumab

Intervention Type BIOLOGICAL

Administered via intravenous (IV) infusion at a dose of 400 mg on Day 1 of every 6-week cycle for up to 9 adjuvant cycles for Adjuvant Cohort participants, or at a dose of 200 mg on Day 1 of every cycle for up to four 3-week neoadjuvant cycles and up to thirteen 3-week adjuvant cycles for Perioperative Cohort participants.

Placebo

Intervention Type OTHER

Intismeran autogene diluent only (saline and/or dextrose) administered via IM injection Q3W for up to 9 doses.

Perioperative Cohort: Pembrolizumab + Intismeran autogene + EV and Surgery

Participants will receive neoadjuvant treatment with up to 4 cycles of pembrolizumab plus EV and 1 to 4 doses of intismeran autogene, followed by radical cystectomy \[RC\] plus pelvic lymph node dissection \[PLND\], and then adjuvant treatment with up to 13 cycles of pembrolizumab plus up to 5 cycles of EV and 5 to 8 doses of intismeran autogene (for a total of 9 neoadjuvant plus adjuvant Intismeran autogene doses), or until any of the protocol-specified criteria for discontinuation of study intervention are met. The total duration of treatment is up to approximately 16 months.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

Administered via intravenous (IV) infusion at a dose of 400 mg on Day 1 of every 6-week cycle for up to 9 adjuvant cycles for Adjuvant Cohort participants, or at a dose of 200 mg on Day 1 of every cycle for up to four 3-week neoadjuvant cycles and up to thirteen 3-week adjuvant cycles for Perioperative Cohort participants.

Intismeran autogene

Intervention Type BIOLOGICAL

Administered via intramuscular (IM) injection at a dose of 1 mg every 3 weeks for a total of up to 9 adjuvant doses for Adjuvant Cohort participants, or at a dose of 1 mg every 3 weeks for a total of up to 9 doses in the neoadjuvant and adjuvant periods for Perioperative Cohort participants.

Enfortumab Vedotin

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 1.25 mg/kg on Day 1 and Day 8 of every cycle for up to four 3-week neoadjuvant cycles and up to five 3-week adjuvant cycles for Perioperative Cohort participants.

Surgery (RC plus PLND)

Intervention Type PROCEDURE

Curative intent surgery (RC plus PLND) will be administered to all participants in the Perioperative Cohort and will be done in accordance with the American Urological Association/American Society for Radiation Oncology/American Society of Clinical Oncology/Society of Urologic Oncology guidelines. RC plus PLND will be performed within 6 weeks of the last dose of neoadjuvant intismeran autogene plus pembrolizumab plus EV treatment. Adjuvant intismeran autogene plus pembrolizumab plus EV treatment will begin within 8 weeks of completing RC plus PLND.

Interventions

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Pembrolizumab

Administered via intravenous (IV) infusion at a dose of 400 mg on Day 1 of every 6-week cycle for up to 9 adjuvant cycles for Adjuvant Cohort participants, or at a dose of 200 mg on Day 1 of every cycle for up to four 3-week neoadjuvant cycles and up to thirteen 3-week adjuvant cycles for Perioperative Cohort participants.

Intervention Type BIOLOGICAL

Intismeran autogene

Administered via intramuscular (IM) injection at a dose of 1 mg every 3 weeks for a total of up to 9 adjuvant doses for Adjuvant Cohort participants, or at a dose of 1 mg every 3 weeks for a total of up to 9 doses in the neoadjuvant and adjuvant periods for Perioperative Cohort participants.

Intervention Type BIOLOGICAL

Placebo

Intismeran autogene diluent only (saline and/or dextrose) administered via IM injection Q3W for up to 9 doses.

Intervention Type OTHER

Enfortumab Vedotin

Administered via IV infusion at a dose of 1.25 mg/kg on Day 1 and Day 8 of every cycle for up to four 3-week neoadjuvant cycles and up to five 3-week adjuvant cycles for Perioperative Cohort participants.

Intervention Type BIOLOGICAL

Surgery (RC plus PLND)

Curative intent surgery (RC plus PLND) will be administered to all participants in the Perioperative Cohort and will be done in accordance with the American Urological Association/American Society for Radiation Oncology/American Society of Clinical Oncology/Society of Urologic Oncology guidelines. RC plus PLND will be performed within 6 weeks of the last dose of neoadjuvant intismeran autogene plus pembrolizumab plus EV treatment. Adjuvant intismeran autogene plus pembrolizumab plus EV treatment will begin within 8 weeks of completing RC plus PLND.

Intervention Type PROCEDURE

Other Intervention Names

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MK-3475 Keytruda® V940 PADCEV®

Eligibility Criteria

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Inclusion Criteria

* Has a histological diagnosis of urothelial carcinoma (UC)
* Must provide blood samples per protocol, to enable intismeran autogene production, and circulating tumor deoxyribonucleic acid testing
* Has an Eastern Cooperative Oncology Group performance status of 0 to 2 assessed within 7 days before randomization
* Must provide a formalin-fixed paraffin-embedded tumor tissue sample for next generation sequencing

Adjuvant Cohort:

* Has MIUC
* Has high-risk pathologic disease after radical resection
* For participants who have not received cisplatin-based neoadjuvant chemotherapy, are ineligible to receive cisplatin according to protocol pre-defined criteria

Perioperative Cohort:

* Has MIBC
* Is deemed eligible for RC and PLND and agrees to undergo curative intent standard RC and PLND and neoadjuvant and adjuvant treatment per protocol
* Is ineligible to receive cisplatin according to protocol pre-defined criteria

Exclusion Criteria

* Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention
* Has known additional malignancy that is progressing or has required active treatment ≤3 years prior to study randomization
* Has current pneumonitis/interstitial lung disease
* Has active infection requiring systemic therapy
* Has active hepatitis B and hepatitis C virus infection

Adjuvant Cohort:

* Has received prior systemic anticancer therapy
* Has received prior neoadjuvant therapy, with the exception of neoadjuvant cisplatin-based chemotherapy for MIUC
* Has severe hypersensitivity to either intismeran autogene or pembrolizumab (MK-3475) and/or any of their excipients

Perioperative Cohort:

* Has received any prior systemic treatment, cancer vaccine treatment, chemoradiation, and/or radiation therapy treatment for MIBC
* Has severe hypersensitivity to either intismeran autogene, pembrolizumab, or EV and/or any of their excipients
* Has ongoing sensory or motor neuropathy
* Has active keratitis or corneal ulcerations
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ModernaTX, Inc.

INDUSTRY

Sponsor Role collaborator

Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Locations

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UCLA Hematology/Oncology - Westwood (Building 200 Suite 140)-Department of Urology/Institute of Uro ( Site 0104)

Los Angeles, California, United States

Site Status RECRUITING

AdventHealth Orlando-AdventHealth Medical Group Hematology & Oncology at Orlandoc ( Site 0102)

Orlando, Florida, United States

Site Status RECRUITING

University of Chicago Medical Center ( Site 0109)

Chicago, Illinois, United States

Site Status RECRUITING

University of Iowa ( Site 0110)

Iowa City, Iowa, United States

Site Status ACTIVE_NOT_RECRUITING

Icahn School of Medicine at Mount Sinai ( Site 0101)

New York, New York, United States

Site Status RECRUITING

Duke Cancer Institute ( Site 0107)

Durham, North Carolina, United States

Site Status RECRUITING

Cleveland Clinic Main ( Site 0100)

Cleveland, Ohio, United States

Site Status ACTIVE_NOT_RECRUITING

Fox Chase Cancer Center ( Site 0106)

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

UT Southwestern Medical Center ( Site 0103)

Dallas, Texas, United States

Site Status COMPLETED

Houston Methodist Hospital-Department of Urology ( Site 0111)

Houston, Texas, United States

Site Status ACTIVE_NOT_RECRUITING

Macquarie University-MQ Health Clinical Trials Unit ( Site 1803)

Macquarie University, New South Wales, Australia

Site Status RECRUITING

Westmead Hospital ( Site 1802)

Westmead, New South Wales, Australia

Site Status COMPLETED

Mater Misericordiae Limited ( Site 1808)

South Brisbane, Queensland, Australia

Site Status RECRUITING

One Clinical Research ( Site 1807)

Nedlands, Western Australia, Australia

Site Status ACTIVE_NOT_RECRUITING

BC Cancer Vancouver ( Site 0004)

Vancouver, British Columbia, Canada

Site Status ACTIVE_NOT_RECRUITING

Princess Margaret Cancer Centre ( Site 0003)

Toronto, Ontario, Canada

Site Status RECRUITING

Centre Hospitalier de l'Université de Montréal ( Site 0005)

Montreal, Quebec, Canada

Site Status RECRUITING

Centre intégré de cancérologie du CHU de Québec Université Laval, Hôpital de l'Enfant-Jésus ( Site 0001)

Québec, Quebec, Canada

Site Status RECRUITING

Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Univer ( Site 0002)

Sherbrooke, Quebec, Canada

Site Status RECRUITING

Bradfordhill-Clinical Area ( Site 1501)

Recoleta, Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

FALP ( Site 1500)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

Pontificia Universidad Catolica de Chile ( Site 1503)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

CIDO SpA ( Site 1509)

Temuco, Región de la Araucanía, Chile

Site Status RECRUITING

ONCOCENTRO APYS-ACEREY ( Site 1506)

Viña del Mar, Región de Valparaíso, Chile

Site Status RECRUITING

Clínica Universitaria Colombia ( Site 1600)

Bogotá, Bogota D.C., Colombia

Site Status ACTIVE_NOT_RECRUITING

Sociedad De Oncologia Y Hematologia Del Cesar-Oncology ( Site 1605)

Valledupar, Cesar Department, Colombia

Site Status ACTIVE_NOT_RECRUITING

Instituto Nacional De Cancerologia-Oncología Clínica ( Site 1606)

Bogota, Cundinamarca, Colombia

Site Status ACTIVE_NOT_RECRUITING

Fundacion Valle del Lili- CIC-Oncology CIC ( Site 1608)

Cali, Valle del Cauca Department, Colombia

Site Status ACTIVE_NOT_RECRUITING

Oncopole Claudius Regaud ( Site 0302)

Toulouse, Haute-Garonne, France

Site Status ACTIVE_NOT_RECRUITING

Institut de Cancérologie de l'Ouest ( Site 0300)

Angers, Maine-et-Loire, France

Site Status ACTIVE_NOT_RECRUITING

Hopital Claude Huriez - CHU de Lille ( Site 0301)

Lille, Nord, France

Site Status ACTIVE_NOT_RECRUITING

Hôpital Saint-Louis ( Site 0304)

Paris, , France

Site Status ACTIVE_NOT_RECRUITING

Gustave Roussy ( Site 0303)

Villejuif, Île-de-France Region, France

Site Status ACTIVE_NOT_RECRUITING

klinikum rechts der isar der technischen universität münchen-Urologische Klinik und Poliklinik ( Site 0401)

Munich, Bavaria, Germany

Site Status RECRUITING

Caritas-Krankenhaus St. Josef-Klinik fuer Urologie ( Site 0404)

Regensburg, Bavaria, Germany

Site Status RECRUITING

Universitaetsklinikum Carl Gustav Carus Dresden-Klinik und Poliklinik für Urologie ( Site 0405)

Dresden, Saxony, Germany

Site Status RECRUITING

Universitätsklinikum Halle-Universitätsklinik und Poliklinik für Urologie ( Site 0402)

Halle, Saxony-Anhalt, Germany

Site Status ACTIVE_NOT_RECRUITING

Charité Universitaetsmedizin Berlin - Campus Mitte ( Site 0400)

Berlin, , Germany

Site Status ACTIVE_NOT_RECRUITING

Fondazione Policlinico Universitario Agostino Gemelli IRCCS -Medical Oncology ( Site 0504)

Rome, Lazio, Italy

Site Status ACTIVE_NOT_RECRUITING

Ospedale San Martino-U.O. Oncologia Medica 1 ( Site 0500)

Genoa, Liguria, Italy

Site Status ACTIVE_NOT_RECRUITING

Fondazione IRCCS Istituto Nazionale dei Tumori-Struttura Complessa Oncologia Medica 1 ( Site 0502)

Milan, Lombardy, Italy

Site Status ACTIVE_NOT_RECRUITING

Azienda Ospedaliera Di Rilievo Nazionale A. Cardarelli-UOSC Oncologia ( Site 0503)

Naples, Napoli, Italy

Site Status ACTIVE_NOT_RECRUITING

Ospedale San Raffaele-Oncologia Medica ( Site 0501)

Milan, , Italy

Site Status ACTIVE_NOT_RECRUITING

Auckland City Hospital ( Site 1901)

Auckland, , New Zealand

Site Status ACTIVE_NOT_RECRUITING

IPOR Instituto Peruano de Oncología & Radioterapia ( Site 1702)

Lima, , Peru

Site Status ACTIVE_NOT_RECRUITING

Oncosalud ( Site 1701)

Lima, , Peru

Site Status ACTIVE_NOT_RECRUITING

Hospital Militar Central Luis Arias Schereiber ( Site 1700)

Lima, , Peru

Site Status ACTIVE_NOT_RECRUITING

Clinical Research Center Spółka z ograniczoną odpowiedzialnością MEDIC-R Sp.k ( Site 0805)

Poznan, Greater Poland Voivodeship, Poland

Site Status ACTIVE_NOT_RECRUITING

Centrum Onkologii im. Prof. Franciszka Lukaszczyka-Ambulatorium Chemioterapii ( Site 0801)

Bydgoszcz, Kuyavian-Pomeranian Voivodeship, Poland

Site Status ACTIVE_NOT_RECRUITING

Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - P-Klinika Nowotworów Układu Moczowego ( Site 0800)

Warsaw, Masovian Voivodeship, Poland

Site Status ACTIVE_NOT_RECRUITING

Oddzial Onkologii Klinicznej z Pododdzialem Chemioterapii Jednodniowej ( Site 0802)

Koszalin, West Pomeranian Voivodeship, Poland

Site Status ACTIVE_NOT_RECRUITING

Swietokrzyskie Centrum Onkologii, Samodzielny Publiczny Zaklad Opieki Zdrowotnej ( Site 0806)

Kielce, Świętokrzyskie Voivodeship, Poland

Site Status ACTIVE_NOT_RECRUITING

Korea University Anam Hospital ( Site 2002)

Seoul, , South Korea

Site Status ACTIVE_NOT_RECRUITING

Seoul National University Hospital-Urology ( Site 2000)

Seoul, , South Korea

Site Status ACTIVE_NOT_RECRUITING

Samsung Medical Center-Urology ( Site 2001)

Seoul, , South Korea

Site Status ACTIVE_NOT_RECRUITING

Hospital Germans Trias i Pujol-Instituto Catalán de Oncología de Badalona ( Site 1006)

Badalona, Barcelona, Spain

Site Status ACTIVE_NOT_RECRUITING

HOSPITAL UNIVERSITARIO QUIRONSALUD MADRID-ONCOLOGIA MEDICA ( Site 1003)

Pozuelo de Alarcón, Madrid, Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Ramón y Cajal-Medical Oncology ( Site 1005)

Madrid, Madrid, Comunidad de, Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitari Vall d'Hebron-Oncology ( Site 1002)

Barcelona, , Spain

Site Status ACTIVE_NOT_RECRUITING

HOSPITAL UNIVERSITARIO VIRGEN DEL ROCIO-Medical Oncology ( Site 1001)

Seville, , Spain

Site Status ACTIVE_NOT_RECRUITING

Karolinska Universitetssjukhuset Solna ( Site 1101)

Stockholm, Stockholm County, Sweden

Site Status ACTIVE_NOT_RECRUITING

Akademiska sjukhuset-Blod- och tumörsjukdomar ( Site 1102)

Uppsala, Uppsala County, Sweden

Site Status ACTIVE_NOT_RECRUITING

Hacettepe Universite Hastaneleri-oncology hospital ( Site 1200)

Ankara, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

Memorial Ankara Hastanesi-Medical Oncology ( Site 1204)

Ankara, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

Ankara Bilkent Şehir Hastanesi-Medical Oncology ( Site 1201)

Ankara, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

Koc Universitesi Hastanesi ( Site 1206)

Istanbul, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

T.C. Saglik Bakanligi Turkiye Kamu Hastaneleri Kurumu - Baki-Istanbul Bakirkoy Sadi Konuk Training ( Site 1205)

Istanbul, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi-oncology ( Site 1202)

Istanbul, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

Ege Universitesi Hastanesi-Medical Oncology ( Site 1203)

Izmir, , Turkey (Türkiye)

Site Status ACTIVE_NOT_RECRUITING

Torbay Hospital ( Site 1303)

Torquay, Devon, United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Royal Free Hospital ( Site 1300)

London, England, United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Gartnavel General Hospital-Clinical Trials Unit ( Site 1301)

Glasgow, Glasgow City, United Kingdom

Site Status ACTIVE_NOT_RECRUITING

St Bartholomew's Hospital-Centre for Experimental Cancer Medicine ( Site 1302)

London, London, City of, United Kingdom

Site Status ACTIVE_NOT_RECRUITING

The Christie NHS Foundation Trust ( Site 1306)

Manchester, , United Kingdom

Site Status COMPLETED

Countries

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United States Australia Canada Chile Colombia France Germany Italy New Zealand Peru Poland South Korea Spain Sweden Turkey (Türkiye) United Kingdom

Central Contacts

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Toll Free Number

Role: CONTACT

Phone: 1-888-577-8839

Email: [email protected]

Facility Contacts

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Study Coordinator

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Related Links

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Other Identifiers

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V940-005

Identifier Type: OTHER

Identifier Source: secondary_id

U1111-1292-1952

Identifier Type: REGISTRY

Identifier Source: secondary_id

2023-505658-17-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

INTerpath-005

Identifier Type: OTHER

Identifier Source: secondary_id

V940-005

Identifier Type: -

Identifier Source: org_study_id