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RecruitingNCT05562830Updated Sep 28, 2026

A Substudy of Investigational Agents in Programmed Cell Death-1/Ligand 1 (PD-1/L1) Refractory Locally Advanced or Metastatic Urothelial Carcinoma (mUC) (MK-3475-04A)

A Phase 1/2 interventional study of Zilovertamab vedotin and Pembrolizumab in Urothelial Carcinoma, sponsored by Merck Sharp & Dohme LLC. Recruiting at 28 sites in 11 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-28.

Sponsored by Merck Sharp & Dohme LLC · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
48
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

This substudy is part of an umbrella platform study which is designed to evaluate investigational agents with or without pembrolizumab in participants with urothelial carcinoma who are in need of new treatment options. Substudy 04A will enroll participants with locally advanced or mUC whose disease is resistant to treatment with programmed cell death-1/ligand 1 (PD-1/L1) inhibitors. The protocol infrastructure will enable the rolling assignment of investigational treatments.

02

Conditions studied

  • Urothelial Carcinoma
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

The main inclusion and exclusion criteria include but are not limited to the following:

  • Histologically or cytologically confirmed diagnosis of locally advanced/unresectable or mUC of the renal pelvis, ureter (upper urinary tract), bladder, or urethra.
  • Arm A: PD-1/L1 refractory locally advanced or mUC as evidenced by: EITHER disease progression while on treatment or after treatment with an anti-PD-1/L1 monoclonal antibody (mAb) for locally advanced/unresectable or mUC administered either as monotherapy, or in combination with other checkpoint inhibitors or other therapies OR disease recurrence while on treatment or after treatment with an anti-PD-1/L1 mAb for muscle-invasive urothelial carcinoma (MIUC) administered as monotherapy.
  • Arm A: Participants 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.
  • Arm B: PD-1/L1 refractory locally advanced or mUC as evidenced by: EITHER disease progression after treatment with an anti-PD-1/L1 mAb for locally advanced/unresectable or mUC administered either as monotherapy, or in combination with other checkpoint inhibitors or other therapies; OR disease recurrence after treatment with an anti-PD-1/L1 mAb for MIUC administered as monotherapy or in combination with other checkpoint therapies >12 months after last dose of treatment with an anti-PD-1/L1 mAb.
  • Arm B: Participants must provide an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion from a metastatic site or from a primary tumor that has become locally advanced and not previously irradiated.

Exclusion criteria

Exclusion Criteria:

  • Known additional nonurothelial malignancy that is progressing or has required active treatment within 3 years prior to study randomization/allocation.
  • Received prior systemic anticancer therapy including investigational agents within 4 weeks before randomization/allocation.
  • Active infection requiring systemic therapy.
  • Received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines are allowed.
  • Known history of human immunodeficiency virus (HIV).
  • Known history of hepatitis B or known hepatitis C virus infection.
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
48 participants (estimated)

Study arms

  • Experimental
    Arm A: Zilovertamab vedotin

    Participants will receive zilovertamab vedotin 2mg/kg administered on Day 1 and Day 8 of each 3 week cycle (Q3W) until documented disease progression or any other discontinuation criterion is met.

    Biological: Zilovertamab vedotin

  • Experimental
    Arm B: Pembrolizumab and MK-3120

    Participants will receive MK-3120 up to 5mg/kg administered on Day 1, Day 15 and Day 29 of each 6 week cycle until documented disease progression or any other discontinuation criterion is met and 400mg pembrolizumab on Day 1 of each 6 week cycle for up to 17 cycles (up to \~2 years).

    Biological: Pembrolizumab · Biological: MK-3120

Interventions

  • BiologicalZilovertamab vedotin

    Administered via intravenous (IV) infusion on day 1 and day 8 of Q3W cycles

    Also known as: MK-2140, VLS-101

  • BiologicalPembrolizumab

    Administered via IV infusion on Day 1 of each 6 week cycle.

    Also known as: MK-3475, KEYTRUDA®

  • BiologicalMK-3120

    Administered as an IV infusion on Day 1, Day 15, and Day 29 of each 6 week cycle.

05

What researchers measure

Primary outcomes

  1. Percentage of Participants Who Experienced At Least One Adverse Event (AE)

    An AE is defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment.

    Time frame: Up to approximately 5 years

  2. Percentage of Participants Who Discontinued Study Treatment Due to an AE

    An AE is defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment

    Time frame: Up to approximately 5 years

  3. Arm A: Objective Response Rate (ORR) as Assessed by Blinded Independent Central Review (BICR)

    ORR is defined as the percentage of participants who achieve a Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1). The percentage of participants who experience CR or PR as assessed by Blinded Independent Central Review (BICR) will be presented.

    Time frame: Up to approximately 2 years

  4. Arm B: ORR as Assessed by Investigator

    ORR is defined as the percentage of participants who achieve a CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1. The percentage of participants who experience CR or PR as assessed by the investigator will be presented.

    Time frame: Up to approximately 2 years

Secondary outcomes

  1. Arm A: Duration of Response (DOR) as Assessed by BICR

    For participants who demonstrate confirmed CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR as assessed by Blinded Independent Central Review (BICR) will be presented.

    Time frame: Up to approximately 2 years

  2. Arm B: DOR as Assessed by Investigator

    For participants who demonstrate confirmed CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until PD or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR as assessed by the investigator will be presented.

    Time frame: Up to approximately 2 years

06

Study locations

25 of 28 sites recruiting
  • University of California, Irvine (UCI) Health - UC Irvine Medical Center ( Site 1045)
    Orange, California 92868, United States
    • Study Coordinator · Contact · 714-509-2371
    Recruiting
  • University of California San Francisco ( Site 1044)
    San Francisco, California 94158, United States
    • Study Coordinator · Contact · 415-476-4616
    Recruiting
  • Anschutz Cancer Pavilion ( Site 1017)
    Aurora, Colorado 80045, United States
    Completed
  • University of Chicago Medical Center ( Site 1037)
    Chicago, Illinois 60637, United States
    • Study Coordinator · Contact · 855-702-8222
    Recruiting
  • Indiana University Melvin and Bren Simon Cancer Center ( Site 1011)
    Indianapolis, Indiana 46202, United States
    • Study Coordinator · Contact · 888-600-4822
    Recruiting
  • Siteman Cancer Center ( Site 1038)
    St Louis, Missouri 63108, United States
    Active, not recruiting
  • Memorial Sloan Kettering Cancer Center ( Site 1031)
    New York, New York 10065, United States
    • Study Coordinator · Contact · 646-888-4770
    Recruiting
  • Cleveland Clinic-Taussig Cancer Center ( Site 1036)
    Cleveland, Ohio 44195, United States
    • Study Coordinator · Contact · 216-445-7728
    Recruiting
  • UPMC Hillman Cancer Center ( Site 1014)
    Pittsburgh, Pennsylvania 15232, United States
    • Study Coordinator · Contact · 412-623-4759
    Recruiting
  • Huntsman Cancer Institute ( Site 1041)
    Salt Lake City, Utah 84112-5500, United States
    • Study Coordinator · Contact · 801-585-0155
    Recruiting
  • Royal Brisbane and Women's Hospital-Medical Oncology Clinical Trials Unit, Cancer Care Services ( Site 1952)
    Brisbane, Queensland 4029, Australia
    Completed
  • Princess Margaret Cancer Centre ( Site 1106)
    Toronto, Ontario M5G 2M9, Canada
    • Study Coordinator · Contact · 4169464501 2662
    Recruiting
  • FALP-UIDO ( Site 1151)
    Santiago, Region M. de Santiago 7500921, Chile
    • Study Coordinator · Contact · 56224205098
    Recruiting
  • Bradford Hill ( Site 1155)
    Santiago, Region M. de Santiago 8420383, Chile
    • Study Coordinator · Contact · +56229490970
    Recruiting
  • Rigshospitalet-Dept. of Oncology ( Site 1701)
    Copenhagen, Capital Region 2100, Denmark
    • Study Coordinator · Contact · 00 45 35 45 35 45
    Recruiting
  • Rambam Health Care Campus-Oncology ( Site 1501)
    Haifa, 3109601, Israel
    • Study Coordinator · Contact · +972-4-7776234
    Recruiting
  • Rabin Medical Center-Oncology ( Site 1504)
    Petah Tikva, 4941492, Israel
    • Study Coordinator · Contact · 972 393 78077
    Recruiting
  • Sheba Medical Center-ONCOLOGY ( Site 1503)
    Ramat Gan, 5265601, Israel
    • Study Coordinator · Contact · 03-5304498
    Recruiting
  • Fondazione IRCCS Istituto Nazionale dei Tumori-Struttura Complessa Oncologia Medica 1 ( Site 1408)
    Milan, Lombardy 20133, Italy
    • Study Coordinator · Contact · +390223904449
    Recruiting
  • Istituto Nazionale Tumori IRCCS Fondazione Pascale-S.C. Sperimentazioni Cliniche ( Site 1406)
    Naples, 80131, Italy
    • Study Coordinator · Contact · 00393331891929
    Recruiting
  • Nederlands Kanker Instituut - Antoni van Leeuwenhoek (NKI-AVL)-medical oncology ( Site 1302)
    Amsterdam, North Holland 1066 CX, Netherlands
    • Study Coordinator · Contact · +31 20 512 9111
    Recruiting
  • Severance Hospital, Yonsei University Health System ( Site 1903)
    Seoul, 03722, South Korea
    • Study Coordinator · Contact · +82222288138
    Recruiting
  • Asan Medical Center ( Site 1901)
    Seoul, 05505, South Korea
    • Study Coordinator · Contact · +82230105977
    Recruiting
  • Samsung Medical Center ( Site 1902)
    Seoul, 06351, South Korea
    • Study Coordinator · Contact · +82234103459
    Recruiting
  • Hospital Universitari Vall d'Hebron ( Site 1767)
    Barcelona, Catalonia 08035, Spain
    • Study Coordinator · Contact · +34934894158
    Recruiting
  • Hospital Clinico San Carlos ( Site 1765)
    Madrid, 28040, Spain
    • Study Coordinator · Contact · +34913303546
    Recruiting
  • St Bartholomew's Hospital ( Site 1206)
    London, London, City of EC1A 7BE, United Kingdom
    • Study Coordinator · Contact · +44 0203 416 5000
    Recruiting
  • ROYAL MARSDEN HOSPITAL (CHELSEA) ( Site 1201)
    London, London, City of SW3 6JJ, United Kingdom
    • Study Coordinator · Contact · +44 20 7352 8171
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — https://trialstransparency.msdclinicaltrials.com/pdf/ProcedureAccessClinicalTrialData.pdf

08

Registry details

Key details

Study ID
NCT05562830
Lead sponsor
Merck Sharp & Dohme LLC
Responsible party
Sponsor
First posted
Oct 3, 2022
Start date
Nov 16, 2022
Primary completion
Feb 26, 2029 (estimated)
Completion
Feb 26, 2029 (estimated)
Last update
Sep 28, 2026

Study contacts

Toll Free Number
Contact
Trialsites@msd.com
1-888-577-8839
Medical Director
study director · Merck Sharp & Dohme LLC

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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