Neoadjuvant Immunotherapy Combined With the Anti-GDF-15 Antibody Visugromab to Treat Muscle Invasive Bladder Cancer

CatalYm

Status and phase: Active, not recruiting; Phase 2

Conditions: Bladder Cancer; Adult Solid Tumor

Treatments: Drug: Placebo; Drug: Visugromab (CTL-002); Drug: Nivolumab

Study type: Interventional

Funder types: Industry

Identifiers

NCT06059547

CTL-002-002

Details and patient eligibility

About

This is a multi-center, stratified and single-blinded Phase 2 trial of neoadjuvant immunotherapy in combination with the anti-GDF15 antibody visugromab (CTL-002) for the treatment of participants with MIBC set to undergo radical Cystectomy (RC)/Re-TURBT who cannot receive or refuse to receive cisplatin-based chemotherapy.

Enrollment: 31 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Main Inclusion Criteria:

• Signed and dated informed consent, and able to comply with the study procedures and any locally required authorization.
• Male or female aged ≥ 18 years.
• Histopathologically confirmed urothelial carcinoma.
• Clinical Stage T2-T4aN0M0 MIBC.
• Ineligible for cisplatin therapy per modified Galsky criteria or refuses cisplatin-based chemotherapy.
• Eligible for radical Cystectomy.
• Pretreatment tumor material from transurethral resection of the bladder tumor (TURBT) must be available.
• Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
• Adequate organ function (bone marrow, hepatic, renal function and coagulation).

Main Exclusion Criteria:

• Pregnant or breastfeeding.

• Received prior radiotherapy on the bladder tumor.

• Received a partial cystectomy.

• Any prior systemic anti-cancer therapy including investigational agents and immunotherapy.

• Following cardio-vascular risk factors:

  1. Myocardial infarction in the past 6 months before planned treatment start.
  2. Uncontrolled heart failure.
  3. Uncontrolled ventricular arrhythmia.
  4. A peri/myocarditis in the past 3 months before planned treatment start. Note: Stable atrial fibrillation is permissive with or without anticoagulation if there was no decompensation in the past 3 months before planned treatment start.

• Left ventricular ejection fraction (LVEF) < 50% measured by echocardiogram or MUGA.

• QTcF ≥ 470 ms regardless of sex.

• Any active autoimmune requiring systemic immunosuppressive treatments.

• Any history of non-infectious pneumonitis < 6 months prior to Screening.

• Any active inflammatory bowel disease such as Crohn's disease or ulcerative colitis which are generally excluded or active autoimmunthyroiditis present < 6 months prior to Screening.

• History of CNS disease such as stroke, seizure, encephalitis, or multiple sclerosis (< 6 months prior to Screening).

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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31 participants in 2 patient groups

Combination with Placebo

Active Comparator group

Description:

Placebo + Checkpoint Inhibitor nivolumab

Treatment:

Drug: Nivolumab

Drug: Placebo

Combination with Visugromab/Verum

Experimental group

Description:

visugromab (CTL-002) + Checkpoint Inhibitor nivolumab

Treatment:

Drug: Nivolumab

Drug: Visugromab (CTL-002)