ClinicalTrials.gg
Not yet recruitingNCT07217496Updated Sep 24, 2026

N-803 in Combination With Pembrolizumab and Enfortumab Vedotin for Treatment of Urothelial Cancer

A Phase 1 interventional study of Nogapendekin Alfa Inbakicept (NAI) and enfortumab vedotin (EV) in Metastatic Urothelial Carcinoma, Urothelial Carcinoma and Locally Advanced Urothelial Carcinoma, sponsored by ImmunityBio, Inc.. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by ImmunityBio, Inc. · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
18
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase Ib trial will investigate the effect of N-803 in combination with pembrolizumab and enfortumab vedotin in treating participants with urothelial cancer that has spread to nearby tissue or lymph nodes (locally advanced) or that has spread from where it first started (primary site) to other places in the body (metastatic).

Read the detailed description

This is an open label, phase 1b single arm trial with a safety lead-in cohort to determine the preliminary efficacy and safety of EV plus pembrolizumab and NAI in participants with unresectable locally advanced or mUC who are treatment-naïve in the metastatic setting.

02

Conditions studied

  • Metastatic Urothelial Carcinoma
  • Urothelial Carcinoma
  • Locally Advanced Urothelial Carcinoma
  • Urothelial Cancer
  • Bladder Cancer
03

In context

Carcinoma, Transitional Cell

633 studies on the registry are indexed under Carcinoma, Transitional Cell; 181 are open to participants now.

This study's planned enrollment of 18 is below the median of 50 across 500 interventional studies indexed under Carcinoma, Transitional Cell.

Browse Carcinoma, Transitional Cell studies →

Lead sponsor

ImmunityBio, Inc. is the lead sponsor of 83 studies on the registry; 15 are open to participants now.

Of its 23 completed or terminated interventional studies of FDA-regulated products, 17 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥ 18 years old.
  2. or cytologically confirmed locally advanced/ mUC, including UC originating from the renal pelvis, ureters, bladder, or urethra. Mixed-cell type tumors are eligible as long as >50% urothelial component is present (mixed histology other than small cell/ neuroendocrine are allowed).
  3. No prior systemic treatment for locally advanced/mUC.
  4. (ECOG) performance status (PS) ≤ 2.
  5. according to v1.1.
  6. Prior perioperative systemic therapy including or adjuvant chemotherapy, , and EV is allowed if treatment was completed >12 months before trial enrollment.
  7. Participants enrolling in the trial must agree with discontinuing EV upon demonstrating confirmed CR/PR/SD at the second or third scan timepoint on treatment (after 5.5 to 8 months of intended EV treatment).
  8. Adequate organ and marrow function as defined below:

    1. Leukocytes ≥ institutional lower limit of normal (LLN)
    2. (ANC) ≥ 1,500/μL
    3. ≥ 100,000/μL
    4. Total \< 1.5 × institutional (ULN) (if previously abnormal due to non-malignant causes such as Gilbert's disease bilirubin ≤ 2 × ULN will be permitted.)
    5. (AST) (SGOT)/ alanine aminotransferase (ALT) (SGPT) ≤ 2.5 × institutional upper limit of normal (ULN)
    6. ≥ 30 mL/min/1.73 m2 calculated using the Cockcroft-Gault equation
  9. Must have available or have disease amenable to a fresh biopsy for diagnosis confirmation and correlative studies.
  10. (HIV)-infected individuals with undetectable viral load within 6 months are eligible for this trial. Trial participants who are on antiretroviral therapy (ART) should be on established ART for at least 4 weeks and have an HIV viral load less than 400 copies/mL prior to enrollment.
  11. For participants with history of chronic virus (HBV) infection, the HBV viral load must be undetectable, and the participant should be on suppressive antiviral therapy, if indicated. Participants with a history of virus (HCV) infection must have been treated and cured, with HCV viral load below the level of quantification. A participant who is HCV Ab positive but HCV RNA negative due to prior treatment or natural resolution is eligible for this trial. For individuals with HCV infection who are currently on treatment, they are eligible if HCV viral load is below the level of quantification.
  12. Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
  13. Participants who are on beta blockers can enroll in the trial, but discontinuation of beta-blockers should be strongly considered at the time of initiating NAI. Beta blocker use can continue per physician discretion if necessary.
  14. Agreement to practice effective for female participants of and nonsterile males. Female participants of childbearing potential are defined as any female who has experienced menarche and who is NOT permanently sterile or . Postmenopausal is defined as 12 consecutive months with no menses without an alternative medical cause. Female participants of childbearing potential must have a negative pregnancy test and adhere to using a highly effective method of contraception (refer to Section 4.1.3) prior to screening and agree to continue its use during the study or be surgically sterilized (eg, hysterectomy) while on study and for 7 months post last dose of study drug. Male participants must agree to use barrier methods of birth control while on study and to advise their female partners to use a highly effective method of contraception for 7 months post last dose of study drug.
  15. Able to understand and provide a signed that fulfills the relevant Institutional Review Board (IRB) or Independent Ethics Committee (IEC) guidelines.

Exclusion criteria

Exclusion Criteria:

An individual who meets any of the following criteria will be excluded from participation in this study:

  1. Symptomatic or untreated central nervous system (CNS) . Note: Participants with previously treated brain or are eligible if the participant have recovered from any acute effects of surgery or radiotherapy and do not require (prednisone equivalent ≥ 10 mg daily), and any whole brain radiation therapy or any stereotactic radiosurgery was completed at least 2 weeks prior to initiation of therapy.
  2. History of active disease and on active management with agents within the past 2 years.
  3. History of interstitial lung disease.
  4. Congestive heart failure ( class III or IV)
  5. Participants on systemic intravenous (IV) or oral corticosteroid therapy (prednisone equivalent ≥ 10 mg daily) or other immunosuppressive agents such as azathioprine or cyclosporin A. For these participants, these excluded treatments must be discontinued at least 1 week prior to enrollment for recent short course use (≤ 14 days) or discontinued at least 4 weeks prior to enrollment for long term use (> 14 days).

    Note: The use of corticosteroids as premedication for contrast-enhanced studies is allowed prior to enrollment and on study. Participants requiring hormone replacement with corticosteroids if the steroids are administered only for the purpose of hormonal replacement or participants treated at doses ≤ 10 mg of prednisone or equivalent per day are allowed.

  6. History of uncontrolled diabetes mellitus defined as (HbA1c) ≥ 8%.
  7. Grade ≥ 2 peripheral neuropathy at baseline.
  8. Radiotherapy or major surgery within 2 weeks prior to treatment start.
  9. History of another significant life-limiting within 2 years prior to the first dose of study drug. Participants with nonmelanoma skin cancer, curatively treated localized prostate cancer, or carcinoma in situ of any type (if complete resection was done) are allowed.
  10. History of severe allergic reactions attributed to compounds of similar chemical or biologic composition to EV and/or pembrolizumab and/or NAI.
  11. Received hematopoietic stem cell transplantation or solid organ transplantation.
  12. Known active keratitis or corneal ulcerations.
  13. Received or will receive a within 30 days prior to the first administration of study intervention.

    Note: Seasonal flu vaccines that do not contain a live virus are permitted. Locally approved COVID-19 vaccines are permitted.

  14. Pregnant and nursing women.
  15. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
  16. Severe uncontrolled intercurrent illness that would limit compliance with study requirements in the judgement of the Investigator.
Terms in these criteria, in plain language(29)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
18 participants (estimated)

Study arms

  • Experimental
    Treatment

    Participants will start combined treatment with EV/Pembrolizumab (P) and NAI. Treatment will consist of up to 12 cycles of EV and up to 35 cycles of NAI and pembrolizumab (2 years).

    Drug: Nogapendekin Alfa Inbakicept (NAI) · Drug: enfortumab vedotin (EV) · Drug: Pembrolizumab

Interventions

  • 1.2mg given subcutaneously (SC) every 3 weeks, for a maximum of 35 cycles (2 years). Known HIV-positive participants will receive a weight-based dose of 6 µg/kg

    Also known as: ANKTIVA, NAI, N-803

  • 1.25 mg/kg given intravenously (IV) on Day 1 and Day 8 of each 3-week cycle, for approximately 5.5 to 8 months (8 to 12 cycles), but no more than 12 cycles.

    Also known as: Enfortumab Vedotin, Padcev

  • 200 mg given intravenously (IV) every 3 weeks, for a maximum of 35 cycles (2 years)

    Also known as: Keytruda

06

What researchers measure

Primary outcomes

  1. Assess the safety and tolerability of the treatment regimen (NAI, EV, and pembrolizumab).

    The proportion of participants with treatment-emergent adverse events (TEAEs), as graded by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 6.0.

    Time frame: From the date of first dose of study product to 30 days after the last dose of study product.

  2. 12-month progression-free survival (PFS) of participants with locally advanced or metastatic urothelial carcinoma (mUC) receiving EV plus pembrolizumab and NAI

    Percentage of participants alive and progression free at 12 months, defined as the time from the date of first dose of study drugs (C1D1) to the date of disease progression or death (any cause), whichever occurs first, by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.

    Time frame: From the date of first dose of study drugs to the date of disease progression or death (any cause)

Secondary outcomes

  1. To evaluate the preliminary efficacy of the treatment regimen (EV, pembrolizumab, and NAI)

    To evaluate the preliminary efficacy of the treatment regimen (EV, pembrolizumab, and NAI) as measured by complete response rate (CRR), objective response rate (ORR), clinical benefit rate (CBR), 12-month overall survival (12-OS), median duration of response (mDOR), median progression free survival (mPFS) and median overall survival (mOS).

    Time frame: 12 months

  2. To evaluate PFS, ORR, DOR, and CBR using immune RECIST (iRECIST).

    PFS will be defined as the time from the date of first dose of study drugs (C1D1) to the date of disease progression or death (any cause), by RECIST v1.1 whichever occurs first. ORR is defined as the portion of participants who experience an objective response (confirmed CR or confirmed PR) per RECIST v1.1. DOR will be defined as the time from the first date of documented response (confirmed CR or confirmed PR) to the date of disease progression or death (any cause), by RECIST v1.1 whichever occurs first. CBR is defined as the portion of participants who experience clinical benefit (confirmed CR, confirmed PR, or SD for at least 24 weeks) per RECIST v1.1.

    Time frame: From date of first dose of study drugs to the end of the follow up period, up to five years.

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Dec 2026; primary completion for Jan 2028, 13 months later.

Of 62 industry-sponsored phase 1 interventional studies under Carcinoma, Transitional Cell, half reached primary completion within 44 months of starting (the median), counting those still running; a quarter within 34 and three quarters within 57. This study's planned 13 months is below that.

Counting every sponsor, half of 99 studies reached it within 44 months; a quarter within 31 and three quarters within 63.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 14, 2025
First posted
Oct 16, 2025
StartEst.
Dec 2026
Primary completionEst.
Jan 2028
CompletionEst.
Jan 2032
Last update
Sep 24, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07217496
Lead sponsor
ImmunityBio, Inc.
Responsible party
Sponsor
First posted
Oct 16, 2025
Start date
Dec 2026 (estimated)
Primary completion
Jan 2028 (estimated)
Completion
Jan 2032 (estimated)
Last update
Sep 24, 2026

Study contacts

Kayleigh Russell
Contact
kayleigh.russell@immunitybio.com
424-539-2412
Mark Nelson
Contact
mark.nelson@immunitybio.com

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drugs tested here: Nogapendekin alfa inbakicept · Enfortumab vedotin

Start the discussion