Overview
This clinical trial is designed to assess the safety, tolerability, and antitumor activity of Datopotamab Deruxtecan (Dato-DXd) combined with other anticancer agents or as monotherapy in participants with solid tumors.
Description
The study includes 2 independent substudies, which have been defined by tumor type as follows:
- Sub-protocol 1 Urothelial Cancer (UC) - Cohort A: Dato-DXd plus enfortumab vedotin (EV) with and without pembrolizumab in participants with locally advanced (LA)/metastatic (m) UC (LA/mUC).
- Sub-protocol 2 kirsten rat sarcoma viral oncogene-mutant-non-small cell lung cancer (KRAS-mutant NSCLC) - Cohort A: Dato-DXd in combination with KRAS G12C inhibitor, olomorasib in participants with LA/mNSCLC.
Each sub-study will be conducted in 2 phases: Dose finding (Phase 1) and signal finding (Phase 2).
Eligibility
Key Inclusion Criteria:
- Must consent to provide archival tumor tissue sample or newly obtained pretreatment biopsy if clinically feasible and at an acceptable risk as determined by the investigator.
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0 or 1 assessed no more than 14 days prior to Cycle 1 Day 1 (C1D1) (randomization for randomized cohort).
- Has adequate organ and bone marrow function as assessed by local laboratory within 7 days prior to C1D1 (randomization for randomized cohort) as defined in the protocol.
- Has a left ventricular ejection fraction (LVEF) ≥50 percent (%) by either an echocardiogram (ECHO) or multigated acquisition scan (MUGA) scan within 28 days before C1D1 (randomization for randomized cohort).
- Has a life expectancy ≥3 months based on investigator's assessment.
- Female participants must not be pregnant, does not plan to breastfeed during the trial intervention period, agrees to adhere to a contraceptive method that is highly effective and agrees not to donate eggs (ova, oocytes) to others or freeze/store eggs during the intervention period.
- Male participants who intend to be sexually active with a female partner of childbearing potential should use additional barrier methods of contraception or avoid intercourse. Male participants must not freeze or donate sperm at any time during this study.
Key Exclusion Criteria:
- Has unresolved toxicities from previous anticancer therapy.
- Has spinal cord compression or clinically active central nervous system (CNS) metastases.
- Has a history of severe hypersensitivity reactions to either the drug substances or inactive ingredients.
- Has uncontrolled or significant cardiovascular disease.
- Has a history of non-infectious interstitial lung disease (ILD)/pneumonitis, including radiation pneumonitis that required steroids, has current ILD/pneumonitis, or has suspected interstitial lung disease (ILD)/pneumonitis that cannot be ruled out by imaging at screening.
- Has clinically severe pulmonary function compromise resulting from intercurrent pulmonary illnesses.
- Has clinically significant corneal disease.
- Evidence of ongoing uncontrolled systemic bacterial, fungal, or viral infection.
- Has active or uncontrolled HIV infection.
- Has active or uncontrolled hepatitis B or C virus infection.
- Female participants who are pregnant or breastfeeding or intend to become pregnant.
- Live vaccines within 30 days before the first dose of treatment.


