Memorial Sloan Kettering Cancer Center
The purpose of this study is to test the safety of the study drug 2141-V11 in people whose NMIBC did not respond to standard treatment, and who will not have the standard surgical procedure to remove the bladder. The researchers will test different doses of 2141-V11 to see which dose is safest in people. The researchers will also do tests to see how the body absorbs, distributes, and gets rid of 2141-V11. This study is one of the first to test 2141-V11 in people, and the first to test 2141-V11 delivered through a catheter into the bladder.
If during Period 1 treatment, the treating physician notices recurrent disease in the bladder, the patient should undergo a biopsy or TURBT. If the pathology returns as HG Ta or CIS, the patient can resume treatment. If pathology returns as HG T1, the patient will be removed from treatment. If a high-grade recurrence occurs during period 2 or 3 treatments, the patient will be removed from treatment. Cohort B is organized into two parts. Cohort B Part 1 is the completed safety assessment of fixed-dose intratumoral 2141-V11 (10 mg) monotherapy. Cohort B Part 2 is a randomized, open-label, pilot…
Inclusion Criteria: Cohorts A and B Part 1 * High-grade (HG) NMIBC (HG Ta, CIS, and/or T1) of urothelial histology that is unresponsive to adequate BCG therapy. * Stage, grade, and histology must be confirmed by the MSK Department of Pathology * Subjects with tumors of mixed urothelial/non-urothelial histology may be included, but urothelial carcinoma must be the predominant histology; subjects with predominant or exclusively non-urothelial histology are excluded * In those subjects with CIS, the CIS must be present on the tumor sample from the most recent cystoscopy/TURBT * In this context,…
Cohort A Eligible subjects will receive the anti-CD40 antibody 2141-V11 administered by intravesical instillation once weekly for 3 consecutive weeks (weeks 1, 2, and 3) for a total of 3 doses. As discussed further below, depending on disease status at week 13 and week 25 evaluations, subjects may be eligible for re-treatment (once weekly for 3 doses) at these time points.
Cohort B Part 1 Eligible subjects will receive the anti-CD40 antibody 2141-V11 administered by intratumoral injection once every 3 weeks (weeks 1, 4, 7, and 10) for a total of 4 doses. As discussed further below, depending on disease status at week 14 and week 26 evaluations, subjects may be eligible for re-treatment (once every 3 weeks for a total of 4 doses) at these time points.
Cohort C Eligible subjects will receive the anti-CD40 antibody 2141-V11 administered by intratumoral injection as a single 10mg during standard of care cystoscopy and examination no sooner than 22 days of the last cycle of neoadjuvant therapy with enfortumab vedotin and pembrolizumab and prior to and within 4 weeks of planned radical cystectomy.
Cohort B Part 2 is a nonblinded, randomized prospective trial to determine whether the combination of gemcitabine with 2141-V11 is more efficacious than gemcitabine monotherapy in patients with BCG-naïve HG Ta NMIBC
Cohort B Part 2 is a nonblinded, randomized prospective trial to determine whether the combination of gemcitabine with 2141-V11 is more efficacious than gemcitabine monotherapy in patients with BCG-naïve HG Ta NMIBC