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Study of Immediate Post-Operative Intravesical Instillation of Chemophase® in Patients With Superficial Bladder Cancer (IPOP)

Primary Purpose

Superficial Bladder Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Chemophase
Sponsored by
Halozyme Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Superficial Bladder Cancer focused on measuring Non-Muscle-Invasive Bladder Cancer, Superficial Bladder Cancer, recombinant human hyaluronidase, rHuPH20, Chemophase®, Mitomycin

Eligibility Criteria

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

Inclusion Criteria:

  • Patient with histologically confirmed or suspected (based on cystoscopy) initial presentation or recurrence of Stage Ta, T1, or Tis transitional cell bladder cancer of any histological grade requiring TURBT.
  • Patient believed to be a candidate for immediate post-operative chemotherapy regardless of the need for additional intravesical therapy.
  • ECOG performance status of Grade 0 or 1.
  • Age ≥ 18 years.
  • A negative urine or serum pregnancy test (if female of child-bearing potential) within 14 days prior to Day 1/Week 1.
  • Acceptable liver function within 14 days prior to Day 1/Week 1 defined as:
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN), and
  • AST (SGOT), ALT (SGPT), and alkaline phosphatase ≤ 2.5 times ULN.
  • Acceptable renal function within 14 days prior to Day 1/Week 1 defined as serum creatinine ≤ 1.5 x ULN.
  • Acceptable hematologic status within 14 days prior to Day 1/Week 1 defined as:
  • Absolute neutrophil count (ANC) ≥ 1,500/dL,
  • Platelet count ≥ 100,000/dL, and
  • Hemoglobin ≥ 10.0 g/dL.
  • Urinalysis showing no clinically significant abnormalities, except those attributable to bladder cancer.
  • For men and women of child-producing potential, agreement to use an effective contraceptive method during the study from enrollment until 2 weeks after the administration of study drug.
  • Signed, written, IRB-approved informed consent.

Exclusion Criteria:

  • Large resected area (estimated total area > 50 cm²) or suspected deep resection, even in the absence of signs of perforation beyond the muscularis propria or ongoing significant bleeding.
  • Known or suspected bladder perforation during TURBT.
  • Failure to completely resect all cancerous lesions or suspected presence of muscle-invasive cancer (Stage T2 or higher).
  • Previous diagnosis or current presence of bladder fibrosis/contracture, or total bladder capacity estimated at cystoscopy or by other means to be < 150 mL.
  • Urinary incontinence or severe irritative voiding symptoms such as urgency, frequency, or nocturia of a severity that would compromise the ability of the patient to retain the study drug intravesical instillation for one hour.
  • Bladder cancer recurrence less than 3 months after a previous TURBT.
  • Major surgery, other than TURBT or diagnostic surgery, within 28 days prior to Day 1/Week 1.
  • Known active, uncontrolled bacterial, viral, or fungal infections, including urinary tract infection.
  • Any intravesical therapy within 3 months prior to Week 1/Day 1.
  • Systemic therapy including radiation therapy, surgery, chemotherapy, or investigational therapy within one month prior to Day 1/Week 1 (two months for nitrosoureas or MMC), unless given as standard treatment for bladder cancer and provided that patient is free of all treatment-related toxicities as of Day 1/Week 1.
  • Known infection with HIV.
  • Known active infection with hepatitis B or hepatitis C virus.
  • Serious disease (e.g., hydronephrosis, liver failure, or other conditions) that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor (Halozyme).
  • History of hypersensitivity or idiosyncratic reaction to, or other contraindication to, MMC.
  • Known allergy to bee or vespid venom.
  • Known coagulation disorder or bleeding tendency.
  • Ongoing treatment with heparin or other anticoagulation therapy, or anticipation of such therapy during the treatment period in this study.
  • Unwillingness or inability to comply with procedures required in this protocol.

Sites / Locations

  • BCG Oncology, PC
  • Advanced Urology Medical Center
  • Medresearch
  • Malcolm Randall Veterans Administration
  • Advanced Research Institute, Inc.

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Single arm, open label, single dose, intravesical instillation of Chemophase (combination of rHuPH20 and mitomycin) for appropriate superficial bladder cancer patients within 6 hours of TURBT.

Outcomes

Primary Outcome Measures

Safety and Tolerability of immediate post-operative instillation of Chemophase.

Secondary Outcome Measures

Assess plasma levels of mitomycin (MMC) after IPOP intravesical instillation.

Full Information

First Posted
October 29, 2008
Last Updated
February 5, 2010
Sponsor
Halozyme Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT00782587
Brief Title
Study of Immediate Post-Operative Intravesical Instillation of Chemophase® in Patients With Superficial Bladder Cancer
Acronym
IPOP
Official Title
Phase I Safety and Tolerability Study of Immediate Post-Operative Intravesical Instillation of Chemophase® (Recombinant Human Hyaluronidase in Combination With Mitomycin) in Patients With Non-Muscle-Invasive Bladder Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2010
Overall Recruitment Status
Completed
Study Start Date
October 2008 (undefined)
Primary Completion Date
March 2009 (Actual)
Study Completion Date
August 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Halozyme Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this research study is to test the safety and tolerability of an experimental drug, Chemophase, a combination of recombinant human hyaluronidase, (an investigational synthetic enzyme also known as rHuPH20), and mitomycin (MMC) in the treatment of superficial bladder cancer when instilled intravesically immediately after TURBT (transurethral resection of bladder tumor).
Detailed Description
Patients will be screened and enrolled prior to undergoing standard of care TURBT for known or suspected Stage Ta, T1 or Tis bladder cancer of any histological grade requiring TURBT and who are believed to be candidates for IPOP intravesical chemotherapy regardless of the need for further intravesical therapy. Within 6 hours after completion of TURBT, patients will be administered a single IPOP intravesical instillation of Chemophase with a one-hour dwell time. At the end of the one-hour dwell time, the patient will be asked to fully void or, if an intravesical catheter has been left in place, the bladder will be fully drained via the catheter. Patients will return at 1 and 2 weeks post instillation for follow up visits for safety and for a cystoscopy at day 85 (per standard of care). Safety and tolerability will be assessed through physical examinations, vital signs, cystoscopy, hematology (CBC), adverse event reporting, and measurements of plasma levels of MMC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Superficial Bladder Cancer
Keywords
Non-Muscle-Invasive Bladder Cancer, Superficial Bladder Cancer, recombinant human hyaluronidase, rHuPH20, Chemophase®, Mitomycin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Single arm, open label, single dose, intravesical instillation of Chemophase (combination of rHuPH20 and mitomycin) for appropriate superficial bladder cancer patients within 6 hours of TURBT.
Intervention Type
Drug
Intervention Name(s)
Chemophase
Intervention Description
40 mg mitomycin with 800,000 U rHuPH20 total volume of 40 mL instilled
Primary Outcome Measure Information:
Title
Safety and Tolerability of immediate post-operative instillation of Chemophase.
Time Frame
Day 1 instillation, and weeks 1, 2, and 12
Secondary Outcome Measure Information:
Title
Assess plasma levels of mitomycin (MMC) after IPOP intravesical instillation.
Time Frame
Hours 1, 2 and 3 post-instillation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient with histologically confirmed or suspected (based on cystoscopy) initial presentation or recurrence of Stage Ta, T1, or Tis transitional cell bladder cancer of any histological grade requiring TURBT. Patient believed to be a candidate for immediate post-operative chemotherapy regardless of the need for additional intravesical therapy. ECOG performance status of Grade 0 or 1. Age ≥ 18 years. A negative urine or serum pregnancy test (if female of child-bearing potential) within 14 days prior to Day 1/Week 1. Acceptable liver function within 14 days prior to Day 1/Week 1 defined as: Total bilirubin ≤ 1.5 times upper limit of normal (ULN), and AST (SGOT), ALT (SGPT), and alkaline phosphatase ≤ 2.5 times ULN. Acceptable renal function within 14 days prior to Day 1/Week 1 defined as serum creatinine ≤ 1.5 x ULN. Acceptable hematologic status within 14 days prior to Day 1/Week 1 defined as: Absolute neutrophil count (ANC) ≥ 1,500/dL, Platelet count ≥ 100,000/dL, and Hemoglobin ≥ 10.0 g/dL. Urinalysis showing no clinically significant abnormalities, except those attributable to bladder cancer. For men and women of child-producing potential, agreement to use an effective contraceptive method during the study from enrollment until 2 weeks after the administration of study drug. Signed, written, IRB-approved informed consent. Exclusion Criteria: Large resected area (estimated total area > 50 cm²) or suspected deep resection, even in the absence of signs of perforation beyond the muscularis propria or ongoing significant bleeding. Known or suspected bladder perforation during TURBT. Failure to completely resect all cancerous lesions or suspected presence of muscle-invasive cancer (Stage T2 or higher). Previous diagnosis or current presence of bladder fibrosis/contracture, or total bladder capacity estimated at cystoscopy or by other means to be < 150 mL. Urinary incontinence or severe irritative voiding symptoms such as urgency, frequency, or nocturia of a severity that would compromise the ability of the patient to retain the study drug intravesical instillation for one hour. Bladder cancer recurrence less than 3 months after a previous TURBT. Major surgery, other than TURBT or diagnostic surgery, within 28 days prior to Day 1/Week 1. Known active, uncontrolled bacterial, viral, or fungal infections, including urinary tract infection. Any intravesical therapy within 3 months prior to Week 1/Day 1. Systemic therapy including radiation therapy, surgery, chemotherapy, or investigational therapy within one month prior to Day 1/Week 1 (two months for nitrosoureas or MMC), unless given as standard treatment for bladder cancer and provided that patient is free of all treatment-related toxicities as of Day 1/Week 1. Known infection with HIV. Known active infection with hepatitis B or hepatitis C virus. Serious disease (e.g., hydronephrosis, liver failure, or other conditions) that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor (Halozyme). History of hypersensitivity or idiosyncratic reaction to, or other contraindication to, MMC. Known allergy to bee or vespid venom. Known coagulation disorder or bleeding tendency. Ongoing treatment with heparin or other anticoagulation therapy, or anticipation of such therapy during the treatment period in this study. Unwillingness or inability to comply with procedures required in this protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald Lamm, M.D.
Organizational Affiliation
BCG Oncology, PC
Official's Role
Principal Investigator
Facility Information:
Facility Name
BCG Oncology, PC
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85032
Country
United States
Facility Name
Advanced Urology Medical Center
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Medresearch
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
Malcolm Randall Veterans Administration
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Advanced Research Institute, Inc.
City
New Port Richey
State/Province
Florida
ZIP/Postal Code
34655
Country
United States

12. IPD Sharing Statement

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Study of Immediate Post-Operative Intravesical Instillation of Chemophase® in Patients With Superficial Bladder Cancer

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