New drug combo aims to treat bladder cancer without chemo
NCT ID NCT05645692
First seen Jun 25, 2026 · Last updated Jul 29, 2026 · Updated 3 times
Summary
This Phase 2 trial tests two new immunotherapy drugs, tobemstomig alone or with tiragolumab, against the standard drug atezolizumab. It includes 204 people with advanced bladder cancer who cannot have platinum chemotherapy. The main goal is to check safety and side effects.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- tobemstomig (alone or with tiragolumab) compared to atezolizumab
- What this could lead to
- If successful, this could offer a new immunotherapy option for people with advanced bladder cancer who cannot take standard chemotherapy.
- What could go wrong
- This is an early Phase 2 trial with only 204 participants, so results may not confirm benefit. Immunotherapies can cause immune-related side effects.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 2
Tests whether the treatment actually works, and watches for side effects, in a larger group.
- Participants
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204 people
The number who actually took part.
- Started
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Apr 2023
- Expected to finish
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Dec 2026
An estimate. End dates often move.
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2 * Histologically or cytologically documented locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium. Participants with squamous, sarcomatoid, micropapillary, and glandular variant histologies are eligible for inclusion in the study, provided that a urothelial component is present in the tumor specimen. Participants with other variant histologies or pure variant histologies are not eligible for inclusion in this study * Ineligible ("unfit") to receive platinum-based chemotherapy * No prior chemotherapy for inoperable locally advanced or metastatic or recurrent urothelial carcinoma (UC) * Measurable disease; at least one measurable lesion as defined by response evaluation criteria in solid tumors, version 1.1 (RECIST v1.1) * Availability of a representative leftover tumor specimen that is suitable for determination of PD-L1 status as assessed by a central laboratory * Adequate hematologic and end organ function * Negative for hepatitis B and hepatitis C virus (HCV) * Adequate cardiovascular function Exclusion Criteria: * Pregnancy or breastfeeding * GFR \<15 mL/min/1.73 m2 * Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases * History of leptomeningeal disease * Uncontrolled tumor-related pain * Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures * Uncontrolled or symptomatic hypercalcemia * Active or history of autoimmune disease or immune deficiency * History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan * Active tuberculosis (TB) or acute Epstein-Barr virus (EBV) * Significant cardiovascular/cerebrovascular disease within 3 months prior to initiation of study treatment * Major surgical procedure, other than for diagnosis, within 4 weeks prior to initiation of study treatment, or anticipation of need for a major surgical procedure during the study * History of another primary malignancy other than urothelial carcinoma within 2 years prior to initiation of study treatment, with the exception of malignancies with a negligible risk of metastasis or death * Severe infection within 4 weeks prior to initiation of study treatment * Treatment with therapeutic oral or intravenous antibiotics within 2 weeks prior to initiation of study treatment. Participants receiving prophylactic antibiotics (e.g., to prevent a urinary tract infection or chronic obstructive pulmonary disease \[COPD\] exacerbation), or who are receiving oral antibiotics to treat a urinary tract infection are eligible for the study * Prior allogeneic stem cell or solid organ transplantation * Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during treatment or within 5 months after the final dose of atezolizumab, 4 months after the final dose of tobemstomig, or 90 days after the final dose of tiragolumab * Current treatment with anti-viral therapy for HBV * Treatment with any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment * Treatment with investigational therapy within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study treatment * Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-TIGIT and anti-LAG3 therapeutic antibodies or pathways targeting agents * Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives prior to initiation of study treatment * Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment * History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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*X*CEPHO - Centro de Estudos e Pesquisas em Hematologia e Oncologia
Santo André, São Paulo, 09060-650, Brazil
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A.O. Universitaria Ospedale Consorziale Policlinico Di Bari
Bari, Apulia, 70124, Italy
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Aarhus Universitetshospital
Aarhus N, 8200, Denmark
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Adana Baskent University Medical Faculty
Adana, 01220, Turkey (Türkiye)
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Alexandras General Hospital of Athens
Athens, 115 28, Greece
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Ankara City Hospital
Ankara, 06800, Turkey (Türkiye)
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Asan Medical Center
Seoul, 05505, South Korea
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Attikon University General Hospital
Chaïdári, 124 62, Greece
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Azienda Ospedaliera S. Maria - Terni
Terni, Umbria, 05100, Italy
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Azienda Ospedaliero-Universitaria S.Orsola-Malpighi
Bologna, Emilia-Romagna, 40138, Italy
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Barts and the London NHS Trust
London, E1 2ES, United Kingdom
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Beijing Cancer Hospital
Beijing, 100142, China
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Centre Leon Berard
Lyon, 69373, France
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Cleveland Clinic
Cleveland, Ohio, 44106, United States
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Gachon University Gil Medical Center
Incheon, 21565, South Korea
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Goztepe Prof.Dr. Suleyman Yalcin City Hospital
Kadiköy, 34722, Turkey (Türkiye)
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Gustave Roussy
Villejuif, 94800, France
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Health Pharma Professional Research
Mexico City, Mexico CITY (federal District), 03100, Mexico
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Herlev Hospital
Herlev, 2730, Denmark
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Hospital Alemao Oswaldo Cruz
São Paulo, São Paulo, 01323-903, Brazil
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Hospital Universitario 12 de Octubre
Madrid, 28041, Spain
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Hospital Universitario Clínico San Carlos
Madrid, 28040, Spain
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Hospital Universitario Evangelico De Curitiba
Curitiba, Paraná, 80440-220, Brazil
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Hospital Universitario La Paz
Madrid, 28046, Spain
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Hospital das Clinicas - UFRGS
Porto Alegre, Rio Grande do Sul, 90035-903, Brazil
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Hospital de Amor Amazônia
Porto Velho, Rondônia, 76834-899, Brazil
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Hospital de Madrid Norte Sanchinarro- Centro Integral Oncologico Clara Campal
Madrid, 28050, Spain
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ICON Cancer Care Adelaide
Kurralta Park, South Australia, 5037, Australia
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IRCCS Istituto Oncologico Veneto (IOV)
Padova, Veneto, 35128, Italy
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IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola
Meldola, Emilia-Romagna, 47014, Italy
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Institut Catala d Oncologia Hospital Duran i Reynals
Barcelona, 08908, Spain
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Irccs Ospedale San Raffaele
Milan, Lombardy, 20132, Italy
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Istituto Nazionale Tumori Irccs Fondazione G. Pascale
Naples, Campania, 80131, Italy
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Izmir Medical Point Hospital
Izmir, 35101, Turkey (Türkiye)
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Krankenhaus Martha-Maria Halle-Dölau, Klinik für Urologie
Halle, 06120, Germany
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Lyell McEwin Hospital
Adelaide, South Australia, 5112, Australia
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MD Anderson Cancer Center
Houston, Texas, 77030, United States
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Macquarie University Hospital
Macquarie Park, New South Wales, 2113, Australia
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Martini-Klinik am UKE GmbH
Hamburg, 20246, Germany
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Policlinico Universitario "Agostino Gemelli"
Rome, Lazio, 00168, Italy
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Pratia Poznan
Późna, 60-192, Poland
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Royal Marsden Hospital (Sutton)
Sutton, SM2 5PT, United Kingdom
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Royal Preston Hosptial
Preston, PR2 9HT, United Kingdom
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Ruijin Hospital, Shanghai Jiaotong University School of Medicine
Shanghai, 200025, China
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Samsung Medical Center
Seoul, 06351, South Korea
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Seoul National University Bundang Hospital
Gyeonggi-do, South Korea
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Seoul National University Hospital
Seoul, 03080, South Korea
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Severance Hospital, Yonsei University
Seoul, 03722, South Korea
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Sun yat-sen University Cancer Center
Guangzhou, 510060, China
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Szpital Grochowski im. dr med. Rafa?a Masztaka Sp. z o.o.
Warsaw, 04-073, Poland
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Szpital Uniwersytecki w Krakowie
Krakow, 31-501, Poland
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Szpital Wojewódzki im. Miko?aja Kopernika
Koszalin, 75-581, Poland
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Theageneio Hospital
Thessaloniki, 54007, Greece
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Trakya Universitesi Tip Fakultesi, Medikal Onkoloji Bilim Dali, Balkan Yerleskesi
Edirne, 22030, Turkey (Türkiye)
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Vall d'Hebron Institute of Oncology (VHIO), Barcelona
Barcelona, 08035, Spain
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West China Hospital - Sichuan University
Chengdu, 610047, China
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