Anetumab Ravtansine and Atezolizumab in Treating Participants With Advanced Non-small Cell Lung Cancer

• Sponsor: Mayo Clinic (Other)
• Overall Status: Terminated
• CT.gov ID: NCT03455556
• Collaborator: National Cancer Institute (NCI) (NIH)
• Enrollment: 1
• Locations: 3
• Arm: 1
• Actual Duration (Months): 16.9
• Patients Per Site: 0.3
• Patients Per Site Per Month: 0

Study Details

Study Description

Brief Summary

This phase I/II trial studies the best dose and side effects of anetumab ravtansine when given together with atezolizumab and how well they work in treating participants with non-small cell lung cancer that has spread to other places in the body. Monoclonal antibodies, such as anetumab ravtansine and atezolizumab, may interfere with the ability of tumor cells to grow and spread.

Condition or Disease	Intervention/Treatment	Phase
Mesothelin Positive; Stage III Non-Small Cell Lung Cancer AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IV Non-Small Cell Lung Cancer AJCC v7	Biological: Anetumab Ravtansine; Biological: Atezolizumab; Other: Laboratory Biomarker Analysis	Phase 1

Detailed Description

PRIMARY OBJECTIVES:

1. To identify the recommended phase II dose of anetumab ravtansine combined with atezolizumab in advanced MSLN+ non-small cell lung cancer (NSCLC). (Phase I) II. To determine the confirmed response rate for the combination of anetumab ravtansine and atezolizumab in MSLN+ 2nd line NSCLC. (Phase II)

SECONDARY OBJECTIVES:

1. To describe adverse events and toxicities of the combination treatment of anetumab ravtansine and atezolizumab. (Phase I) II. To identify preliminary evidence of clinical activity (i.e. response, timed endpoints, etc.) (Phase I) III. To determine the progression-free survival (PFS) and the 1-year PFS rate for the combination of anetumab ravtansine and atezolizumab in 2nd-line NSCLC. (Phase II) IV. To determine the overall survival of anetumab ravtansine combined with atezolizumab in second-line therapy of NSCLC. (Phase II) V. Adverse events will also be summarized as well. (Phase II)

CORRELATIVE OBJECTIVES:

1. To determine using flow cytometry the levels of Bcl-2 interacting mediator of cell death (BIM) in circulating CD8+ CD11a+ PD-1+ T-cells, in peripheral blood samples collected from patients prior to initiation of therapy (baseline) and correlating these with confirmed response rate during and following treatment with the combination regimen.

2. To determine tissue MSLN and PD-L1 expression and correlate with response to combination therapy with atezolizumab and anetumab ravtansine.

3. To correlate baseline serum soluble PDL-1 (sPDL-1) with response to therapy.

OUTLINE: This is a phase I, dose-escalation study of anetumab ravtansine followed by a phase II study.

Participants receive anetumab ravtansine intravenously (IV) over 60 minutes and atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, participants are followed up every 3 months for up to 2 years.

Study Design

• Study Type: Interventional
• Actual Enrollment: 1 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Phase I/II Study of the Human Anti-Mesothelin Antibody Drug Conjugate Anetumab Ravtansine (AR), Combined With the PD-L1 Inhibitor Atezolizumab in Non-Small Cell Lung Cancer
• Actual Study Start Date: Aug 10, 2018
• Actual Primary Completion Date: Sep 11, 2019
• Actual Study Completion Date: Jan 7, 2020

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Treatment (anetumab ravtansine, atezolizumab) Participants receive anetumab ravtansine IV over 60 minutes and atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.	Biological: Anetumab Ravtansine; Given IV; Other Names: BAY 94-9343 ; Biological: Atezolizumab; Given IV; Other Names: MPDL 3280A MPDL 328OA MPDL-3280A MPDL3280A MPDL328OA RG7446 RO5541267 Tecentriq ; Other: Laboratory Biomarker Analysis; Correlative studies

Outcome Measures

Primary Outcome Measures

1. Maximum Tolerated Dose (MTD) (Phase I) [Up to 21 days]

   Maximum tolerated dose (MTD) of anetumab ravtansine combined with atezolizumab defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least one-third of patients (at least 2 of a maximum of 6 new patients) (Phase I)

2. Rate of Confirmed Response (Phase II) [6 months]

   Defined as a patient who has achieved a partial response (PR) or complete response (CR) on two consecutive evaluations at least 4 weeks apart. Will be estimated by the number of successes divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for the true success proportion will be calculated.

Secondary Outcome Measures

1. Clinical Activity (Phase I) [Up to 6 months]

   Will be summarized by simple descriptive summary statistics delineating complete and partial responses as well as stable and progressive disease in this patient population.

2. Incidence of Adverse Events According to Common Terminology Criteria for Adverse Events Version 4.0 (Phase I) [Up to 21 days after last dose]

   The number and severity of all adverse events (overall and by dose-level) will be tabulated and summarized in this patient population.

3. Overall Survival (Phase II) [Up to 2 years]

   Defined as the time from registration to death due to any cause. The distribution of overall survival will be estimated using the method of Kaplan-Meier.

4. Progression-free Survival (Phase II) [1 year and up to 2 years]

   Defined as the time from registration to the earliest date of documentation of disease progression or death due to any cause. The distribution of progression-free survival will be estimated using the method of Kaplan Meier. Will also report the 1-year progression free survival (PFS) rate for the combination of anetumab ravtansine and atezolizumab in 2nd-line non-small cell lung cancer (NSCLC).

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• PRE REGISTRATION ? INCLUSION CRITERIA: Ability to understand and the willingness to sign a written informed consent document

• PRE REGISTRATION ? INCLUSION CRITERIA: Patient has disease amenable to biopsy if the archival tissue sample is unavailable; note: Archive sample must not be older than 12 months

• REGISTRATION ? INCLUSION CRITERIA

• Phase I only: Diagnosis of advanced/metastatic NSCLC for which no standard treatment option; Phase II only: Advanced NSCLC patients who have received at least 1 platinum-based systemic chemotherapy regimen

• Patients with tumors having actionable genomic alterations should have received prior therapy with Food and Drug Administration (FDA) approved agents targeting these aberrations (ie EGFR, ALK, ROS1, BRAF V600E)

• Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1

• Phase II only: Must have at least one measurable lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria

• Ability to understand and the willingness to sign a written informed consent document

• Histological or cytologically confirmed NSCLC that shows moderate or stronger mesothelin expression in 30% of tumor cells by a companion assay; MSLN expression score using Ventana immunohistochemistry (IHC) SP74 assay; Phase I only: In addition 5- 30% tumor cells and 1, 2, or 3+ MSLN score; Phase II only: 30% tumor cells and either 2+/3+

• Life expectancy of >= 12 weeks

• Absolute neutrophil count >= 1.5 ? 10^9/L =< 14 days prior to registration

• Platelets >= 100 ? 10^9/L =< 14 days prior to registration

• Hemoglobin >= 9 g/dL =< 14 days prior to registration

• Potassium >= lower limit of normal (LLN) range for the institution =< 14 days prior to registration

• NOTE: Supplementation may be given before the first dose of study medication

• Calcium >= LLN (corrected for serum albumin, if albumin abnormal) =< 14 days prior to registration

• NOTE: Supplementation may be given before the first dose of study medication

• Magnesium >= LLN =< 14 days prior to registration

• NOTE: Supplementation may be given before the first dose of study medication

• Sodium >= LLN =< 14 days prior to registration

• NOTE: Supplementation may be given before the first dose of study medication

• Phosphorus >= LLN =< 14 days prior to registration

• NOTE: Supplementation may be given before the first dose of study medication

• International normalized ratio (INR) =< 1.5 =< 14 days prior to registration

• Serum creatinine =< 1.5 mg/dL or creatinine clearance >= 50 mL/min (calculated by Cockcroft Gault equation) =< 14 days prior to registration

• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2.5 x ULN or =< 5 x upper limits of normal (ULN) if liver metastases are present =< 14 days prior to registration

• Total bilirubin =< 1.5 x ULN =< 14 days prior to registration

• Standard 12-lead electrocardiogram (ECG) with the following parameters at screening (defined as the mean of the triplicate ECGs):

• QT corrected by Fridericia's formula (QTcF) interval at screening < 450msec (using Fridericia?s correction)

• Negative pregnancy test performed =< 7 days prior to registration (women of childbearing potential only)

• Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study)

• Willing to provide blood samples for correlative research purposes

Exclusion Criteria:

• REGISTRATION ? EXCLUSION CRITERIA

• Prior treatment with anti-PD-1, or anti-PD-L1 therapeutic antibody or pathway-targeting agents

• Note:

• Patients who have received prior treatment with anti-CTLA-4 may be enrolled, provided the following requirements are met:

• Minimum of 12 weeks from the first dose of anti-CTLA-4 and > 6 weeks from the last dose

• No history of severe immune-related adverse effects from anti-CTLA-4 (National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] grade 3 and 4)

• More than one prior taxane regimen at any stage of the disease under study (?taxane? refers to paclitaxel, docetaxel, abraxane and cabazitaxel); adjuvant and/or neoadjuvant treatments are considered together as one prior regimen

• Treatment with any other investigational agent or investigational device within 4 weeks prior to registration (or within five half-lives of the investigational product, whichever is longer); patients must be >= 2 weeks since any investigational agent administered as part of a phase 0 study (also referred to as an ?early phase I study? or ?pre phase I study? where a sub- therapeutic dose of drug is administered) at the coordinating center principal investigator (PI)?s discretion, and should have recovered to eligibility levels from any toxicities

• Treatment with systemic immunostimulatory agents (including, but not limited to, interferon-alpha or interleukin-2) within 6 weeks or five half-lives of the drug (whichever is shorter) prior to registration

• Received radiotherapy =< 4 weeks or limited field radiation for palliation =< 2 weeks prior to registration, and who has not recovered to grade 1 or better from related side effects of such therapy (exceptions include alopecia) and/or in whom >= 25 percent (%) of the bone marrow was irradiated

• Patients who have a previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study, except

• Cervical carcinoma in situ, non-melanoma skin cancer, superficial noninvasive bladder tumors, ductal carcinoma in situ (DCIS) or any previous cancer curatively treated >3 years before the start of anetumab ravtansine

• Treatment with systemic immunosuppressive medications (including, but not limited to, prednisone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [anti-TNF] agents) =< 2 weeks prior to registration

• Note:

• Patients who have received acute, low dose, systemic immunosuppressant medications (e.g., a one-time dose of dexamethasone for nausea) may be enrolled

• The use of inhaled corticosteroids and mineralocorticoids (e.g., fludrocortisone) for patients with orthostatic hypotension or adrenocortical insufficiency is allowed

• Patients with known primary central nervous system (CNS) malignancy or symptomatic CNS metastases are excluded, with the following exceptions

• Patients with asymptomatic untreated CNS disease may be enrolled, provided all of the following criteria are met:

• Evaluable or measurable disease outside the CNS

• No metastases to brain stem, midbrain, pons, medulla, cerebellum, or within 10 mm of the optic apparatus (optic nerves and chiasm)

• No history of intracranial hemorrhage or spinal cord hemorrhage

• No ongoing requirement for dexamethasone for CNS disease; patients on a stable dose of anticonvulsants are permitted

• No neurosurgical resection or brain biopsy =< 28 days prior to registration

• Patients with asymptomatic treated CNS metastases may be enrolled, provided all the criteria listed above are met as well as the following:

• Radiographic demonstration of improvement upon the completion of CNS-directed therapy and no evidence of interim progression between the completion of CNS-directed therapy and the screening radiographic study

• No stereotactic radiation or whole-brain radiation =< 28 days prior to registration

• Screening CNS radiographic study >= 4 weeks from completion of radiotherapy and >= 2 weeks from discontinuation of corticosteroids

• History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins

• Patients who have a history or current evidence of bleeding disorder, i.e., any hemorrhage/bleeding event of CTCAE grade >= 2, =< 28 days prior to registration

• History or current evidence of uncontrolled cardiovascular disease including, but not limited to, the following conditions:

• Congestive heart failure of New York Heart Association (NYHA) class III or IV

• Unstable angina (symptoms of angina at rest) or new-onset angina =< 6 months before the start of anetumab ravtansine

• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

• Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with atezolizumab

• Patients on supraphysiologic doses of steroids or use of such =< 6weeks prior to registration

• Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; cirrhosis; fatty liver; and inherited liver disease

• Note:

• Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen [HBsAg] test and a positive anti-HBc [antibody to hepatitis B core antigen] antibody test) are eligible

• Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV ribonucleic acid (RNA)

• History or risk of autoimmune disease, including, but not limited to, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener?s granulomatosis, Sjogren?s syndrome, Bell?s palsy, Guillain-Barre syndrome, multiple sclerosis, autoimmune thyroid disease, vasculitis, or glomerulonephritis

• Note:

• Patients with a history of autoimmune hypothyroidism on a stable dose of thyroid replacement hormone are eligible

• Patients with controlled type 1 diabetes mellitus on a stable insulin regimen are eligible

• Patients with eczema, psoriasis, lichen simplex chronicus of vitiligo with dermatologic manifestations only (e.g., patients with psoriatic arthritis would be excluded) are permitted provided that they meet the following conditions:

• Patients with psoriasis must have a baseline ophthalmologic exam to rule out ocular manifestations

• Rash must cover less than 10% of body surface area (BSA)

• Disease is well controlled at baseline and only requiring low potency topical steroids (e.g., hydrocortisone 2.5%, hydrocortisone butyrate 0.1%, flucinolone 0.01%, desonide 0.05%, aclometasone dipropionate 0.05%)

• No acute exacerbations of underlying condition within the last 12 months (not requiring psoralen plus ultraviolet A radiation [PUVA], methotrexate, retinoids, biologic agents, oral calcineurin inhibitors; high potency or oral steroids)

• History of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest computed tomography (CT) scan; note: History of radiation pneumonitis in the radiation field (fibrosis) is permitted

• Severe infections =< 4 weeks prior to registration, including, but not limited to, hospitalization for complications of infection, bacteremia, or severe pneumonia

• Signs or symptoms of infection =< 2 weeks prior to registration

• Major surgical procedure =< 28 days prior to registration or anticipation of need for a major surgical procedure during the course of the study

• Patients with corneal epitheliopathy or any eye disorder that may predispose the patients to this condition as judged by an ophthalmologist

• Note: Low grades of superficial punctate keratitis, within the range seen in the normal population, should not lead to the exclusion of the patient

• Non-healing serious wound, ulcer, or bone fracture unrelated to the primary tumor

• Previous assignment to treatment during this study; patients permanently withdrawn from study participation will not be allowed to re-enter the study

• Substance abuse, psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Mayo Clinic Hospital	Phoenix	Arizona	United States	85054
2	Mayo Clinic in Florida	Jacksonville	Florida	United States	32224-9980
3	Mayo Clinic	Rochester	Minnesota	United States	55905

Sponsors and Collaborators

• Mayo Clinic
• National Cancer Institute (NCI)

Investigators

• Principal Investigator: Alex Adjei, Mayo Clinic

Study Documents (Full-Text)

• Study Protocol and Statistical Analysis Plan - Jul 24, 2019

More Information

Publications

None provided.

• Responsible Party: Mayo Clinic
• ClinicalTrials.gov Identifier: NCT03455556
• Other Study ID Numbers: MC1711; NCI-2018-00307; MC1711; P30CA015083
• First Posted: Mar 6, 2018
• Last Update Posted: May 15, 2020
• Last Verified: Feb 1, 2020

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Additional relevant MeSH terms: Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Atezolizumab; Maytansine; Antibodies, Monoclonal

Study Results

Participant Flow

Recruitment Details	One (1) patient was recruited from August 2018 to September 2019 at Mayo Clinic. This trial was permanently closed on September 11, 2019. Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Period Title: Overall Study
STARTED	1
COMPLETED	1
NOT COMPLETED	0

Baseline Characteristics

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Overall Participants	0
Age () []
<=18 years
Between 18 and 65 years
>=65 years
Sex: Female, Male () []
Female
Male
Race (NIH/OMB) () []
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
More than one race
Unknown or Not Reported
Histologic type () []

Outcome Measures

1. Primary Outcome

Title	Maximum Tolerated Dose (MTD) (Phase I)
Description	Maximum tolerated dose (MTD) of anetumab ravtansine combined with atezolizumab defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least one-third of patients (at least 2 of a maximum of 6 new patients) (Phase I)
Time Frame	Up to 21 days

Outcome Measure Data

Analysis Population Description

Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Measure Participants	0

2. Primary Outcome

Title	Rate of Confirmed Response (Phase II)
Description	Defined as a patient who has achieved a partial response (PR) or complete response (CR) on two consecutive evaluations at least 4 weeks apart. Will be estimated by the number of successes divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for the true success proportion will be calculated.
Time Frame	6 months

Outcome Measure Data

Analysis Population Description

Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Measure Participants	0

3. Secondary Outcome

Title	Clinical Activity (Phase I)
Description	Will be summarized by simple descriptive summary statistics delineating complete and partial responses as well as stable and progressive disease in this patient population.
Time Frame	Up to 6 months

Outcome Measure Data

Analysis Population Description

Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Measure Participants	0

4. Secondary Outcome

Title	Incidence of Adverse Events According to Common Terminology Criteria for Adverse Events Version 4.0 (Phase I)
Description	The number and severity of all adverse events (overall and by dose-level) will be tabulated and summarized in this patient population.
Time Frame	Up to 21 days after last dose

Outcome Measure Data

Analysis Population Description

Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Measure Participants	0

5. Secondary Outcome

Title	Overall Survival (Phase II)
Description	Defined as the time from registration to death due to any cause. The distribution of overall survival will be estimated using the method of Kaplan-Meier.
Time Frame	Up to 2 years

Outcome Measure Data

Analysis Population Description

Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Measure Participants	0

6. Secondary Outcome

Title	Progression-free Survival (Phase II)
Description	Defined as the time from registration to the earliest date of documentation of disease progression or death due to any cause. The distribution of progression-free survival will be estimated using the method of Kaplan Meier. Will also report the 1-year progression free survival (PFS) rate for the combination of anetumab ravtansine and atezolizumab in 2nd-line non-small cell lung cancer (NSCLC).
Time Frame	1 year and up to 2 years

Outcome Measure Data

Analysis Population Description

Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.

Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Measure Participants	0

Adverse Events

Time Frame	Up to 21 days after last dose
Adverse Event Reporting Description	Since only one patient was accrued, patient confidentiality prevents the reporting of this patient.
Arm/Group Title	Treatment (Anetumab Ravtansine, Atezolizumab)
Arm/Group Description	Participants receive 5.5 mg/kg anetumab ravtansine IV over 60 minutes and 1200 mg atezolizumab IV over 30-60 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
All Cause Mortality
	Treatment (Anetumab Ravtansine, Atezolizumab)
	Affected / at Risk (%)	# Events
Total	0/0 (NaN)
Serious Adverse Events
	Treatment (Anetumab Ravtansine, Atezolizumab)
	Affected / at Risk (%)	# Events
Total	0/0 (NaN)
Other (Not Including Serious) Adverse Events
	Treatment (Anetumab Ravtansine, Atezolizumab)
	Affected / at Risk (%)	# Events
Total	0/0 (NaN)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.