A Study of Efficacy and Safety of Sacituzumab Tirumotecan (MK-2870) Plus Enfortumab Vedotin (EV) With and Without Pembrolizumab in Advanced Urothelial Carcinoma (MK-3475-04C/KEYMAKER-U04)

NCT ID: NCT06483334

Last Updated: 2025-12-23

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

PHASE1/PHASE2

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-17

Study Completion Date

2028-03-31

Brief Summary

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This study is a substudy being conducted under one pembrolizumab umbrella master study KEYMAKER-U04. The substudy will consist of 2 parts. Part 1 will evaluate the safety and preliminary efficacy of sacituzumab tirumotecan plus enfortumab vedotin (EV). Part 2 will be based on Part 1 results and will evaluate the efficacy, pharmacokinetics, and safety of sacituzumab tirumotecan plus EV in combination with pembrolizumab in participants with advanced urothelial carcinoma.

Detailed Description

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The master study for this substudy is MK-3475-U04/KEYMAKER-U04. The master study will not be screening any participants and will not be registered.

As of Amendment 5, Part 2 will not be conducted. No participants will be enrolled in Part 2, and no data for Part 2 will be collected.

Conditions

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Metastatic Urothelial Carcinoma Locally Advanced Urothelial Carcinoma

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

NON_RANDOMIZED

Intervention Model

PARALLEL

Part 1 is non-randomized open-label. Part 2 is randomized open-label (as of Amendment 5, Part 2 will not be conducted).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Sacituzumab tirumotecan plus EV

Participants will receive sacituzumab tirumotecan as an intravenous (IV) infusion and EV as an IV infusion on Days 1 and 8 of every 3-week cycle until disease progression, intolerable toxicity, or investigator decision.

Group Type EXPERIMENTAL

Sacituzumab tirumotecan

Intervention Type BIOLOGICAL

IV infusion at different dose levels

Enfortumab Vedotin

Intervention Type BIOLOGICAL

IV infusion at different dose levels

Supportive care measures

Intervention Type DRUG

Participants are allowed to take supportive care measures at the discretion of the investigator. Prophylactic supportive care measures may include but are not limited to antiemetic agents, antidiarrheal agents, granulocyte and erythroid growth factors, and blood transfusions.

Sacituzumab tirumotecan plus EV and pembrolizumab

Participants will receive sacituzumab tirumotecan as an IV infusion and EV as an IV infusion on Days 1 and 8 of every 3-week cycle until disease progression, intolerable toxicity, or investigator decision. Participants will also receive pembrolizumab 200 mg as an IV infusion on Day 1 of every 3-week cycle for up to \~2 years (35 cycles).

Group Type EXPERIMENTAL

Sacituzumab tirumotecan

Intervention Type BIOLOGICAL

IV infusion at different dose levels

Enfortumab Vedotin

Intervention Type BIOLOGICAL

IV infusion at different dose levels

Pembrolizumab

Intervention Type BIOLOGICAL

200 mg IV infusion

Supportive care measures

Intervention Type DRUG

Participants are allowed to take supportive care measures at the discretion of the investigator. Prophylactic supportive care measures may include but are not limited to antiemetic agents, antidiarrheal agents, granulocyte and erythroid growth factors, and blood transfusions.

Interventions

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Sacituzumab tirumotecan

IV infusion at different dose levels

Intervention Type BIOLOGICAL

Enfortumab Vedotin

IV infusion at different dose levels

Intervention Type BIOLOGICAL

Pembrolizumab

200 mg IV infusion

Intervention Type BIOLOGICAL

Supportive care measures

Participants are allowed to take supportive care measures at the discretion of the investigator. Prophylactic supportive care measures may include but are not limited to antiemetic agents, antidiarrheal agents, granulocyte and erythroid growth factors, and blood transfusions.

Intervention Type DRUG

Other Intervention Names

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MK-2870 SKB264 PADCEV™ MK-3475 KEYTRUDA

Eligibility Criteria

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Inclusion Criteria

* Must have histologically documented, locally advanced/metastatic urothelial carcinoma (la/mUC).
* Must provide an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion demonstrating UC, not previously irradiated, and adequate for biomarker evaluation. A newly obtained biopsy is strongly preferred, but not required if archival tissue is evaluable.
* Any AEs due to previous anticancer therapies must have recovered to ≤Grade 1 or baseline. Endocrine-related AEs adequately treated with hormone replacement are eligible.
* PART 1 ONLY: Participants must have received platinum-based chemotherapy for treatment of la/mUC.
* PART 1 ONLY: Participants must not have received \>2 lines of therapy for la/mUC. Platinum-based chemotherapy followed by avelumab maintenance is considered 2 lines of therapy.
* PART 2 ONLY: Participants must not have received prior systemic therapy for la/mUC.

Exclusion Criteria

* Known additional malignancy that is progressing or has required active treatment within the past 3 years.
* Known active central nervous system metastases and/or carcinomatous meningitis.
* Has Grade ≥2 peripheral neuropathy.
* Has history of documented severe dry eye syndrome, severe Meibomian gland disease and/or blepharitis, or severe corneal disease that prevents/delays corneal healing.
* Has active inflammatory bowel disease requiring immunosuppressive medication or previous history of inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis, or chronic diarrhea).
* Has uncontrolled, significant cardiovascular disease or cerebrovascular disease and/or serious cardiovascular and cerebrovascular diseases within the 6 months preceding study intervention.
* Has active keratitis or corneal ulcerations. Superficial punctate keratitis is allowed if the disorder is being adequately treated in the opinion of the investigator.
* Has a history of uncontrolled diabetes.
* Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration.
* Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention.
* PART 2 ONLY: Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days before the first dose of study intervention. Inhaled or topical steroids are permitted in the absence of active autoimmune disease. Physiologic replacement doses of corticosteroids are permitted for participants with adrenal insufficiency.
* PART 2 ONLY: Has an active autoimmune disease that has required systemic treatment in past 2 years except replacement therapy.
* Is human immunodeficiency virus (HIV)-infected and has a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease.
* Has active Hepatitis B or Hepatitis C virus infection.
* Has a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
* Has an active infection requiring systemic therapy.
* PART 2 ONLY: History of allogeneic tissue/solid organ transplant.
* Has not adequately recovered from major surgery or has ongoing surgical complications.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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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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University of California San Francisco HDFCCC ( Site 4044)

San Francisco, California, United States

Site Status

University of Chicago Medical Center ( Site 4037)

Chicago, Illinois, United States

Site Status

Indiana University Melvin and Bren Simon Cancer Center ( Site 4011)

Indianapolis, Indiana, United States

Site Status

Dana-Farber Cancer Institute ( Site 4047)

Boston, Massachusetts, United States

Site Status

Siteman Cancer Center ( Site 4038)

St Louis, Missouri, United States

Site Status

Icahn School of Medicine at Mount Sinai ( Site 4018)

New York, New York, United States

Site Status

Cleveland Clinic-Taussig Cancer Center ( Site 4036)

Cleveland, Ohio, United States

Site Status

Huntsman Cancer Institute-HCI Clinical Trials Office ( Site 4041)

Salt Lake City, Utah, United States

Site Status

The Ottawa Hospital - General Campus ( Site 4105)

Ottawa, Ontario, Canada

Site Status

Princess Margaret Cancer Centre ( Site 4106)

Toronto, Ontario, Canada

Site Status

Centre Hospitalier Lyon Sud ( Site 4606)

Pierre-Bénite, Auvergne-Rhône-Alpes, France

Site Status

Rambam Health Care Campus ( Site 4501)

Haifa, , Israel

Site Status

Rabin Medical Center-Oncology ( Site 4504)

Petah Tikva, , Israel

Site Status

Sheba Medical Center-ONCOLOGY ( Site 4503)

Ramat Gan, , Israel

Site Status

Ospedale San Raffaele-Oncologia Medica ( Site 4403)

Milan, Lombardy, Italy

Site Status

Fondazione IRCCS Istituto Nazionale dei Tumori ( Site 4405)

Milan, , Italy

Site Status

Istituto Nazionale Tumori IRCCS Fondazione Pascale ( Site 4406)

Napoli, , Italy

Site Status

Nederlands Kanker Instituut - Antoni van Leeuwenhoek - NKI-AVL ( Site 4302)

Amsterdam, North Holland, Netherlands

Site Status

Severance Hospital, Yonsei University Health System-Medical oncology ( Site 4903)

Seoul, , South Korea

Site Status

Asan Medical Center-Department of Oncology ( Site 4901)

Seoul, , South Korea

Site Status

Samsung Medical Center ( Site 4902)

Seoul, , South Korea

Site Status

Hospital Universitari Vall d'Hebron-Oncology ( Site 4767)

Barcelona, , Spain

Site Status

Hospital Clinico San Carlos ( Site 4765)

Madrid, , Spain

Site Status

National Cheng Kung University Hospital-Clinical Trial Center ( Site 4803)

Tainan, , Taiwan

Site Status

St Bartholomew s Hospital ( Site 4206)

London, London, City of, United Kingdom

Site Status

Countries

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United States Canada France Israel Italy Netherlands South Korea Spain Taiwan United Kingdom

Related Links

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Other Identifiers

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MK-3475-04C

Identifier Type: OTHER

Identifier Source: secondary_id

2023-506387-14-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1293-7631

Identifier Type: REGISTRY

Identifier Source: secondary_id

3475-04C

Identifier Type: -

Identifier Source: org_study_id