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Phase II Trial of EOquin in High-risk Superficial Bladder Cancer

Primary Purpose

Bladder Neoplasms

Status
Completed
Phase
Phase 2
Locations
Netherlands
Study Type
Interventional
Intervention
Apaziquone
Sponsored by
Spectrum Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bladder Neoplasms focused on measuring Bladder cancer, Superficial, Carcinoma in situ, Intravesical instillation, Chemotherapy, Adjuvant

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 1. Patients with high risk superficial bladder cancer according to EAU criteria defined as: pT1 and/or Grade 2b-3, or multiple and highly recurrent histologically confirmed carcinoma in situ 2. All visible lesions must be completely removed by transurethral resection (TUR) at entry to the study 3. Normal bimanual examination under anesthesia (no palpable masses) 4. Absence of upper urinary tract tumor confirmed by intravenous pyelography (IVP) or CT scan or retrograde urogram within 6 months from the beginning of treatment 5. Patient with ZUBROD-ECOG-WHO performance status of 0-2 (see Appendix 2) 6. Over 18 years of age 7. Patients must be fully informed of the investigational nature of the study and signed written informed consent must be obtained prior to any study specific investigations. Exclusion Criteria: Patients having muscle-invasive disease (T2 or greater) Prior intravesical treatment (chemotherapy or immunotherapy) within the last 3 months Patients with existing urinary tract infection or recurrent severe bacterial cystitis Patients with urogenital tumors with histology other than transitional cell carcinoma (i.e., squamous cell or adenocarcinoma) or with transitional carcinoma involving the upper tract or the prostatic urethra Patients with history of other primary malignancy (other than squamous or basal cell skin cancers or cone biopsied Cis of the uterine cervix or prostate carcinoma treated curatively with normal PSA values at inclusion) in the last five years Patients with active, uncontrolled impairment of the renal, hepatobiliary, cardiovascular, gastrointestinal, urogenital, neurologic or hematopoietic systems which, in the opinion of the investigator, would predispose to the development of complications from the administration of intravesical therapy and or general anesthesia Patients who, in the opinion of the investigator, cannot tolerate intravesical administration or intravesical surgical manipulation (cystoscopy, biopsy) due to the presence of concomitant serious illness (i.e. uncontrolled cardiac or respiratory disorders) Women who are pregnant or lactating. Individuals of reproductive potential may not participate unless agreeing to use an effective contraceptive method for themselves and/or their sexual partner

Sites / Locations

  • St Radboud University Hospital

Arms of the Study

Arm 1

Arm Type

Active Comparator

Arm Label

Apaziquone

Arm Description

Outcomes

Primary Outcome Measures

Time to progression / Duration of remission following transurethral resection of superficial bladder cancer

Secondary Outcome Measures

Additional safety data
Rate of upstaging on recurrence

Full Information

First Posted
August 30, 2005
Last Updated
June 13, 2012
Sponsor
Spectrum Pharmaceuticals, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT00141531
Brief Title
Phase II Trial of EOquin in High-risk Superficial Bladder Cancer
Official Title
Phase II Study of Intravesical Instillation of EOQUIN™ in High Risk Superficial Bladder Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2012
Overall Recruitment Status
Completed
Study Start Date
July 2005 (undefined)
Primary Completion Date
December 2009 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spectrum Pharmaceuticals, Inc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A non-randomized, open-label phase II study to explore the feasibility, time to recurrence, duration of response and safety of the adjuvant intravesical instillation of EOquin (apaziquone) in patients with high-risk superficial bladder tumors, and the response and duration of response in patients with carcinoma in situ of the bladder.
Detailed Description
Endpoints: Time to recurrence, duration of response and safety Number of Patients: 53 patients Study Design: Non-randomized, open-label study. Key Inclusion Criteria: High-risk patients according to EAU criteria defined as pT1 and/or Grade 2b-3, or multiple and highly recurrent histologically confirmed carcinoma in situ (CIS) Key Exclusion Criteria: pTa Grade 1 or pT1 Grade 1 tumors, existing urinary tract infection or recurrent severe bacterial cystitis; those who cannot tolerate intravesical administration or intravesical surgical manipulation due to the presence of concomitant serious illness; no prior intravesical chemotherapy or immunotherapy in the last three months; no prior EOquin treatment (intravenous or intravesical) in last 12 months. Study Treatment: All patients will receive intravesical instillation of EOquin™ 4-mg/40 mL instillate once a week for six consecutive weeks Patient with carcinoma in situ (CIS) will receive further maintenance therapy with 3 consecutive weekly EOquin instillations at the following time points: 3, 6, 12, 18, and 24 months from the date of TUR. At 3-month follow up visit patients will undergo cystoscopic bladder biopsy and urine cytology. If bladder biopsy is negative at 3-month visit, the follow up during the remaining visits will be by cystoscopy and urine cytology only, which will be done prior to the start of maintenance therapy. In case of positive cytology presence of CIS has to be confirmed histologically with biopsies. At 6 months follow-up, if biopsies are positive for CIS, no further maintenance therapy will be given; patient will be taken off-study. Duration of Patient Participation: Intravesical instillation of EOquin™ will be given once a week for six consecutive weeks. All patients will have follow-up evaluations carried out at 3, 6, 9, 12, 15 and 18 months from the TUR date or until progressive disease is observed. In case of recurrence, patients will go off the study and further treatment will be at the investigator's discretion. Off Study: Patients will be taken off the study: Upon first recurrence and or progression Persistent CIS at 6 months follow up Recurrent CIS after biopsy proven complete response

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bladder Neoplasms
Keywords
Bladder cancer, Superficial, Carcinoma in situ, Intravesical instillation, Chemotherapy, Adjuvant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
53 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Apaziquone
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Apaziquone
Other Intervention Name(s)
EOquin
Intervention Description
Apaziquone (EOquinTM) 4 mg/40 mL was administered by intravesical instillation once a week for 6 consecutive weeks. In addition, patients with CIS were to receive further maintenance therapy of 3 weekly apaziquone (EOquinTM) instillations at 3, 6, and 12 months from the date of histological diagnosis.
Primary Outcome Measure Information:
Title
Time to progression / Duration of remission following transurethral resection of superficial bladder cancer
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Additional safety data
Time Frame
18 months
Title
Rate of upstaging on recurrence
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Patients with high risk superficial bladder cancer according to EAU criteria defined as: pT1 and/or Grade 2b-3, or multiple and highly recurrent histologically confirmed carcinoma in situ 2. All visible lesions must be completely removed by transurethral resection (TUR) at entry to the study 3. Normal bimanual examination under anesthesia (no palpable masses) 4. Absence of upper urinary tract tumor confirmed by intravenous pyelography (IVP) or CT scan or retrograde urogram within 6 months from the beginning of treatment 5. Patient with ZUBROD-ECOG-WHO performance status of 0-2 (see Appendix 2) 6. Over 18 years of age 7. Patients must be fully informed of the investigational nature of the study and signed written informed consent must be obtained prior to any study specific investigations. Exclusion Criteria: Patients having muscle-invasive disease (T2 or greater) Prior intravesical treatment (chemotherapy or immunotherapy) within the last 3 months Patients with existing urinary tract infection or recurrent severe bacterial cystitis Patients with urogenital tumors with histology other than transitional cell carcinoma (i.e., squamous cell or adenocarcinoma) or with transitional carcinoma involving the upper tract or the prostatic urethra Patients with history of other primary malignancy (other than squamous or basal cell skin cancers or cone biopsied Cis of the uterine cervix or prostate carcinoma treated curatively with normal PSA values at inclusion) in the last five years Patients with active, uncontrolled impairment of the renal, hepatobiliary, cardiovascular, gastrointestinal, urogenital, neurologic or hematopoietic systems which, in the opinion of the investigator, would predispose to the development of complications from the administration of intravesical therapy and or general anesthesia Patients who, in the opinion of the investigator, cannot tolerate intravesical administration or intravesical surgical manipulation (cystoscopy, biopsy) due to the presence of concomitant serious illness (i.e. uncontrolled cardiac or respiratory disorders) Women who are pregnant or lactating. Individuals of reproductive potential may not participate unless agreeing to use an effective contraceptive method for themselves and/or their sexual partner
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alfred Witjes, MD, Prof.
Organizational Affiliation
Urology Division, St Radboud University Hospital, Nijmegen, the Netherlands
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Kees Hendricksen, MD
Organizational Affiliation
St Radboud University Hospital, Nijmegen, the Netherlands
Official's Role
Study Director
Facility Information:
Facility Name
St Radboud University Hospital
City
Nijmegen
Country
Netherlands

12. IPD Sharing Statement

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Phase II Trial of EOquin in High-risk Superficial Bladder Cancer

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