ClinicalTrials.gg
Not yet recruitingNCT07822373PRESERVEUpdated Sep 16, 2026

A Phase 2 Study Evaluating Bladder Preservation With Enfortumab Vedotin Plus Pembrolizumab in Patients With Muscle-Invasive Urothelial Cancer

A Phase 2 interventional study of Enfortumab vedotin and Pembrolizumab in Muscle-invasive Bladder Urothelial Carcinoma, sponsored by University of Utah. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-16.

Sponsored by University of Utah · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to evaluate whether Enfortumab Vedotin in combination with Pembrolizumab can achieve a clinical response that preserves the bladder and avoids the need for cystectomy or radiation therapy in patients with urothelial cancer.

02

Conditions studied

  • Muscle-invasive Bladder Urothelial Carcinoma
03

In context

Lead sponsor

University of Utah is the lead sponsor of 994 studies on the registry; 175 are open to participants now.

Of its 114 completed or terminated interventional studies of FDA-regulated products, 69 (61%) 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

  • Participant aged ≥ 18 years.
  • Disease criteria:

    • confirmed muscle-invasive urothelial carcinoma (T2-T3N0M0) without small cell variant histology of bladder. Other variant histologies are allowed if urothelial histology is present.
    • No evidence of local or distant on CT scans.
    • Urothelial carcinomas not originating from the bladder (eg, upper tract [ureters, renal pelvis], urethra) are not eligible.
  • Eligible to receive enfortumab vedotin and pembrolizumab.
  • Performance Status ≤ 2.
  • Adequate organ function as defined as:

    • Hematologic:

      • ≥ 1500/mm3
      • count ≥ 100,000/mm3
      • ≥ 10 g/dL
    • Hepatic:

      • Total ≤ 1.5x institutional (ULN), ≤3× ULN for subjects with suspected Gilbert's syndrome with direct bilirubin ≤ ULN.

        ----(SGOT)/ALT(SGPT) ≤ 3 × institutional ULN

      • Renal:

        • Estimated ≥ 30 mL/min by Cockcroft-Gault formula (or measured by 24-hour urine collection).
  • Participants must adhere to the following sex and /barrier requirements:

    • If participant is of , they must have a negative pregnancy test.
    • For participants of non-childbearing potential: The status will be defined as having been amenorrheic for 12 months without an alternative medical cause or having undergone surgical sterilization (bilateral oophorectomy or hysterectomy). The following age-specific requirements apply:
    • \< 50 years of age:

      • Amenorrheic for ≥ 12 months following cessation of exogenous hormonal treatments; and
      • Luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution

        --≥ 50 years of age:

      • Amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments; or
      • Had radiation-induced menopause with last menses >1 year ago; or
      • Had chemotherapy-induced menopause with last menses >1 year ago
      • Luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution
    • Participants of childbearing potential and participants with a sexual partner of childbearing potential must agree to use a highly effective method of contraception and lactation requirements as described in Sections 5.4.2 and 5.4.3.
  • adverse effects from any prior oncologic treatment (e.g. prior surgery, radiotherapy, or other antineoplastic therapy) must have resolved or have been determined to be clinically stable per the Investigator.
  • Able to provide and willing to sign an approved consent form that conforms to federal and institutional guidelines.
  • Participant has been counseled on standard of care treatment options available to them and has expressed they are interested in pursuing bladder preservation without cystectomy or radiation.

The discussion regarding the choice of standard therapy offered, if available, and patient's choice to decline standard therapy should be documented clearly in the research chart.

Exclusion criteria

Exclusion Criteria:

  • Prior systemic therapy for urothelial cancer.
  • Receiving other systemic agents for urothelial cancer.
  • > 8% or 7-8% with associated diabetes symptoms.
  • disease requiring systemic or agents in the last 2 years.
  • Neuropathy Grade ≥2.
  • Prior radiotherapy for urothelial cancer.
  • Major surgery within 4 weeks prior to starting study therapy or participant has not fully recovered from major surgery per clinical investigator.
  • The diagnosis of another which, in the opinion of the Investigator, is likely to negatively impact study objectives or the participant's safety or ability to participate in the study.
  • Known disease.
  • Current evidence of uncontrolled, significant intercurrent illness including, but not limited to, the following conditions:

    • Cardiovascular disorders:

      • Congestive heart failure Class III or IV, unstable angina pectoris, serious cardiac arrhythmias per clinical investigator.
      • Stroke (including [TIA]), myocardial infarction (MI), or other significant ischemic events per clinical investigator, within 3 months before the first dose. Subjects with pulmonary embolism or deep vein thrombosis if adequately managed can be enrolled.
    • Any other condition that would, in the Investigator's judgment, contraindicate the participant's participation in the clinical study due to safety concerns or compliance with clinical study procedures (e.g., infection/inflammation, intestinal obstruction, social/ psychological issues, etc.)
  • Active infection expected to interfere with study treatment in the opinion of the investigator.
  • Known infection with a detectable viral load within 6 months of the anticipated start of treatment.

    --Note: Participants on effective antiretroviral therapy with an undetectable viral load within 6 months of the anticipated start of treatment are eligible for this trial.

  • (known positive HBV surface antigen (HBsAg) result), or .

Note: Participants with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible. Participants positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA.

  • Medical, psychiatric, cognitive, or other conditions that may compromise the participant's ability to understand the participant information, give , comply with the study protocol or complete the study.
  • Known prior severe to investigational product or any component in its formulations ( v6.0 Grade ≥ 3).
  • Participants taking prohibited medications as described in Section 6.8.2.
Terms in these criteria, in plain language(28)

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.

Metastases

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

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

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).

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

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.

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.

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.

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.

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.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    Treatment: All Patients

    All patients will be treated with enfortumab vedotin in combination with pembrolizumab.

    Drug: Enfortumab vedotin · Drug: Pembrolizumab

Interventions

  • Enfortumab vedotin 1.25 mg/kg, IV on days 1 and 8 on a 21day cycle for 9 cycles

  • Subjects will receive one year of treatment with pembrolizumab IV or pembrolizumab and berahyaluronidase alfa-pmph (Keytruda Qlex) SC. Treatment will be administered per institutional standards every 3 weeks or 6 weeks, at the physician's discretion.

06

What researchers measure

Primary outcomes

  1. cT0 or cTa low-grade disease as assessed by cystoscopy and bladder biopsy, including all visually abnormal sites in addition to reTURBT or biopsy of the known site of MIBC before neo- adjuvant therapy

    To assess the proportion of patients who have achieved a clinical complete response and have maintained bladder preservation without undergoing definitive treatment of cystectomy or radiation after 4 cycles of study treatment.

    Time frame: 6 years

  2. Negative tumor-informed ctDNA

    To assess the proportion of patients who have achieved a clinical complete response and have maintained bladder preservation without undergoing definitive treatment of cystectomy or radiation after 4 cycles of study treatment.

    Time frame: 6 years

  3. The absence of malignant cells on urine cytology

    To assess the proportion of patients who have achieved a clinical complete response and have maintained bladder preservation without undergoing definitive treatment of cystectomy or radiation after 4 cycles of study treatment.

    Time frame: 6 years

  4. No definitive evidence of new local or metastatic disease at cross-sectional imaging per investigator judgement

    To assess the proportion of patients who have achieved a clinical complete response and have maintained bladder preservation without undergoing definitive treatment of cystectomy or radiation after 4 cycles of study treatment.

    Time frame: 6 years

Secondary outcomes

  1. The frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by type.

    To assess the safety and tolerability of enfortumab vedotin in combination with pembrolizumab in the study population.

    Time frame: 6 years

  2. The frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by severity (as defined by the NIH CTCAE, version 6.0).

    To assess the safety and tolerability of enfortumab vedotin in combination with pembrolizumab in the study population.

    Time frame: 6 years

  3. The frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by seriousness.

    To assess the safety and tolerability of enfortumab vedotin in combination with pembrolizumab in the study population.

    Time frame: 6 years

  4. The frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by duration.

    To assess the safety and tolerability of enfortumab vedotin in combination with pembrolizumab in the study population.

    Time frame: 6 years

  5. The frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by their relationship to the study treatment.

    To assess the safety and tolerability of enfortumab vedotin in combination with pembrolizumab in the study population.

    Time frame: 6 years

  6. Residual or recurrent MIBC, as assessed by biopsy

    To assess bladder intact event-free survival (EFS), defined as the time from treatment initiation to the first occurrence of any of the following events: 1. residual or recurrent MIBC, as assessed by biopsy; 2. local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns; 3. cystectomy or radiation to bladder; 4. death from any cause

    Time frame: 6 years

  7. Local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns.

    To assess bladder intact event-free survival (EFS), defined as the time from treatment initiation to the first occurrence of any of the following events: 1. residual or recurrent MIBC, as assessed by biopsy; 2. local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns; 3. cystectomy or radiation to bladder; 4. death from any cause

    Time frame: 6 years

  8. Cystectomy or radiation to bladder

    To assess bladder intact event-free survival (EFS), defined as the time from treatment initiation to the first occurrence of any of the following events: 1. residual or recurrent MIBC, as assessed by biopsy; 2. local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns; 3. cystectomy or radiation to bladder; 4. death from any cause

    Time frame: 6 years

  9. Death from any cause

    To assess bladder intact event-free survival (EFS), defined as the time from treatment initiation to the first occurrence of any of the following events: 1. residual or recurrent MIBC, as assessed by biopsy; 2. local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns; 3. cystectomy or radiation to bladder; 4. death from any cause

    Time frame: 6 years

  10. The time to NMIBC defined as the time from treatment initiation to the first occurrence of NMIBC (cTa, cT1, or carcinoma in situ) as assessed by biopsy.

    To assess time to non-muscle invasive bladder cancer (NMIBC) defined as the time from treatment initiation to the first occurrence of NMIBC (cTa, cT1, or carcinoma in situ) as assessed by biopsy.

    Time frame: 6 years

  11. Local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns.

    To assess distant disease-free survival (DDFS) defined as the time from treatment initiation to the first occurrence of any of the following events: 1. local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns; 2. death from any cause

    Time frame: 6 years

  12. Death from any cause

    To assess distant disease-free survival (DDFS) defined as the time from treatment initiation to the first occurrence of any of the following events: 1. local or distant disease (N1, N2, N3 or M1) disease as confirmed histologically or as assessed by imaging if biopsy is not feasible due to safety concerns; 2. death from any cause

    Time frame: 6 years

  13. Overall survival (OS) as defined as the time from initiation of treatment until death from any cause.

    To assess overall survival in this study population.

    Time frame: 6 years

07

Study locations

1 site
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Nov 2026; primary completion for Nov 2034, 96 months later.

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

Registered
Sep 10, 2026
First posted
Sep 16, 2026
StartEst.
Nov 2026
Primary completionEst.
Nov 2034
CompletionEst.
Nov 2035
Last update
Sep 16, 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 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07822373
Lead sponsor
University of Utah
Responsible party
Sponsor
First posted
Sep 16, 2026
Start date
Nov 2026 (estimated)
Primary completion
Nov 2034 (estimated)
Completion
Nov 2035 (estimated)
Last update
Sep 16, 2026

Study contacts

Kristen Jewkes
Contact
Kristen.Jewkes@hci.utah.edu
801-585-1753
Umang Swami, MD
Contact
Umang.Swami@hci.utah.edu
801-585-0255

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 Sep 2026. You cannot join it, but the record below documents what was studied.

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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.

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Studies of the drugs tested here: Enfortumab vedotin · Pembrolizumab

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