Cis-urocanic Acid (Cis-UCA) in Patients With Primary or Recurrent Non-muscle Invasive Bladder Cancer
Primary Purpose
Non-muscle Invasive Bladder Cancer
Status
Completed
Phase
Phase 1
Locations
Finland
Study Type
Interventional
Intervention
cis-UCA solution
cis-UCA solution
cis-UCA solution
Sponsored by
About this trial
This is an interventional treatment trial for Non-muscle Invasive Bladder Cancer focused on measuring bladder cancer, cis-urocanic acid, primary, recurrent, non-muscle
Eligibility Criteria
Inclusion Criteria:
- Informed consent obtained prior to any screening procedures
- Patients with primary or recurrent non-muscle invasive bladder cancer
- The patient is eligible for intravesical instillation
- Age 18-80 years
- WHO performance status 0-2
- Body weight at least 50 kg for males and 45 kg for females; body mass index (BMI) 18-35 kg/m2
- Diagnostic cystoscopy performed within 30 days prior to screening visit
- Negative pregnancy test (premenopausal female patients) at screening and use of adequate contraceptive measures (both male and female patients) throughout the study and 30 days after the cis-UCA dose oPremenopausal female volunteers should be either surgically sterile or using a reliable contraception method: intrauterine device (hormonal or non-hormonal); oral combination pill or hormonal contraception patch; or two of the following: intra-vaginal hormonal ring, oral contraceptive containing progestin only, spermicidal foam, condom, sterilization of male sexual partner (surgical vasectomy) oPatients with no current heterosexual relationship may be included according to the judgment of the Investigator oIf menopause occurred 2 years ago at the minimum, no contraception is required for female participants, nor pregnancy tests oReliable contraception for male patients is concordant with above listed methods for females, as applicable
- Acceptable liver function, renal function and hematological status at screening
- Urinalysis showing no clinically significant abnormalities except those attributable for bladder cancer
Exclusion Criteria:
- Previously diagnosed bladder fibrosis
- Total bladder capacity estimated by cystoscopy to be less that 150 ml
- Urinary incontinence of that severity that according to the opinion of the Urologist/Investigator would compromise the ability of the patient to retain the study drug intravesical instillation for one hour
- Severe irritative voiding symptoms, such as urgency, frequency and nocturia that could compromise protocol objectives in the opinion of the Urologist/Investigator
- Serious disease (e.g., hydronephrosis, renal or liver failure or other condition) that could compromise protocol objectives in the opinion of the Urologist/Investigator
- Active, uncontrolled bacterial, viral, or fungal infections, including urinary tract infection
- Previous treatment with radiotherapy, or systemic chemotherapy.
- Intravesical instillation(s) within 6 months with BCG or cytostatic agents
- Known allergy to cis-UCA-instillation solution (see Section 5.1 for excipients).
- Having participated in a clinical study with cis-UCA previously
- Known any serious immunodeficiency condition
- Donation of blood or participation in another drug study within 60 days (males) or 90 days (females) before the intravesical instillation in this study
- Any clinically significant laboratory test result (including positive tests for HIV and hepatitis B or C) according to Investigator/Urologist
- Excessive use of alcohol (on average more than 24 units per week for males, and more that 16 units per weeks for females; unit = 4 cl spirits or equivalent)
- Clinically significant illness (except bladder cancer) within 30 days before the screening visit or any other condition, such as vesicourethral reflux (VUR), or complicated urinary stone disease that in the opinion of the Investigator would interfere with the evaluation of the study results or constitute a health hazard for the patient
- Regular use of urine alkalinizing agents/drugs (e.g., acetazolamide, calcium phosphates, aluminium hydroxide, sodium bicarbonate, sodium carbonate, sodium citrate, potassium citrate) that might interfere with the evaluation of the study results
- Unwillingness or doubtful capacity to comply with the protocol
- Doubtful availability, in the opinion of the Investigator, to complete the study
- Poor peripheral venous access -
Sites / Locations
- Tampere University Hospital, Department of Urology
- Turku University Hospital, Department of Surgery, Division of Urology
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Cohort I: 2% cis-UCA solution (50 ml)
Cohort II: 4% cis-UCA solution (50 ml)
Cohort III: 6% cis-UCA solution (50 ml)
Arm Description
Outcomes
Primary Outcome Measures
Bladder-related AEs
Urinalysis
Evaluation of the appearance of normal bladder epithelium after the cis-UCA dose by cystoscopy during the planned surgical procedure
cystoscopy descriptions
Secondary Outcome Measures
Area Under Curve (AUC)
Efficacy
Change in tumor size from baseline by cystoscopy, change in tumor proliferation marker Ki-67 by immunohistochemistry, change in caspase-3 expression by immunohistochemistry
Full Information
NCT ID
NCT01458847
First Posted
October 4, 2011
Last Updated
November 9, 2012
Sponsor
BioCis Pharma Ltd
Collaborators
Turku University Hospital, Tampere University Hospital, FinnMedi Oy
1. Study Identification
Unique Protocol Identification Number
NCT01458847
Brief Title
Cis-urocanic Acid (Cis-UCA) in Patients With Primary or Recurrent Non-muscle Invasive Bladder Cancer
Official Title
A Single Dose, Dose-escalating, Phase I Study to Evaluate Safety, Tolerability and Pharmacokinetics of Intravesical Cis-urocanic Acid (Cis-UCA) in Patients With Primary or Recurrent Non-muscle Invasive Bladder Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
November 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioCis Pharma Ltd
Collaborators
Turku University Hospital, Tampere University Hospital, FinnMedi Oy
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate safety, tolerability and pharmacokinetics of intravesical cis-urocanic acid in patients with primary or recurrent non-muscle invasive bladder cancer.
Detailed Description
This is a single dose, dose-escalating, Phase I study to evaluate safety, tolerability and pharmacokinetics of intravesical cis-urocanic acid (cis-UCA) in patients with primary or recurrent non-muscle invasive bladder cancer.
The primary objectives is to evaluate safety and tolerability of cis-UCA after a single intravesical instillation with escalating doses and to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of cis-UCA after a single intravesical instillation with escalating doses.
The secondary objectives are to evaluate pharmacokinetics of cis-UCA after a single intravesical instillation with escalating doses, to obtain preliminary information on possible anti-tumor effects of cis-UCA by cystoscopy and histological evaluation after a single intravesical instillation with escalating doses, and to evaluate the effects of cis-UCA on different surrogate biochemical markers on tumor growth and differentiation after a single intravesical instillation with escalating doses.
The key eligibility criteria are the following: Patients with primary or recurrent non-muscle invasive bladder cancer; eligible for intravesical treatment; age 18-80 years; WHO performance status 0-2; acceptable liver, renal and hematological function within 30 days prior to inclusion.
At minimum 3 patients and at maximum 24 patients is planned to be included in the study. The fixed dose-escalation levels will be used.
Up to three dose cohorts are planned to be included:
Cohort I: 2% cis-UCA solution (50 ml); min 3, max 12 patients
Cohort II: 4% cis-UCA solution (50 ml); min 0, max 12 patients
Cohort III: 6% cis-UCA solution (50 ml); min 0, max 12 patients
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-muscle Invasive Bladder Cancer
Keywords
bladder cancer, cis-urocanic acid, primary, recurrent, non-muscle
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cohort I: 2% cis-UCA solution (50 ml)
Arm Type
Experimental
Arm Title
Cohort II: 4% cis-UCA solution (50 ml)
Arm Type
Experimental
Arm Title
Cohort III: 6% cis-UCA solution (50 ml)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
cis-UCA solution
Intervention Description
Cohort I: 2% cis-UCA solution (50 ml); min 3, max 12 patients
Intervention Type
Drug
Intervention Name(s)
cis-UCA solution
Intervention Description
Cohort II: 4% cis-UCA solution (50 ml); min 0, max 12 patients
Intervention Type
Drug
Intervention Name(s)
cis-UCA solution
Intervention Description
Cohort III: 6% cis-UCA solution (50 ml); min 0, max 12 patients
Primary Outcome Measure Information:
Title
Bladder-related AEs
Time Frame
until resection, max 2 months
Title
Urinalysis
Time Frame
participants will be followed until resection, an expected average of 2 months
Title
Evaluation of the appearance of normal bladder epithelium after the cis-UCA dose by cystoscopy during the planned surgical procedure
Description
cystoscopy descriptions
Time Frame
participants will be followed until resection, an expected average of 2 months
Secondary Outcome Measure Information:
Title
Area Under Curve (AUC)
Time Frame
Predose, 30 min, 45 min, 1 h, 1.5 h, 2 h, 4 h, 6 h, and 24 h post-dose
Title
Efficacy
Description
Change in tumor size from baseline by cystoscopy, change in tumor proliferation marker Ki-67 by immunohistochemistry, change in caspase-3 expression by immunohistochemistry
Time Frame
Predose, up to 2 months post-dose
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Informed consent obtained prior to any screening procedures
Patients with primary or recurrent non-muscle invasive bladder cancer
The patient is eligible for intravesical instillation
Age 18-80 years
WHO performance status 0-2
Body weight at least 50 kg for males and 45 kg for females; body mass index (BMI) 18-35 kg/m2
Diagnostic cystoscopy performed within 30 days prior to screening visit
Negative pregnancy test (premenopausal female patients) at screening and use of adequate contraceptive measures (both male and female patients) throughout the study and 30 days after the cis-UCA dose oPremenopausal female volunteers should be either surgically sterile or using a reliable contraception method: intrauterine device (hormonal or non-hormonal); oral combination pill or hormonal contraception patch; or two of the following: intra-vaginal hormonal ring, oral contraceptive containing progestin only, spermicidal foam, condom, sterilization of male sexual partner (surgical vasectomy) oPatients with no current heterosexual relationship may be included according to the judgment of the Investigator oIf menopause occurred 2 years ago at the minimum, no contraception is required for female participants, nor pregnancy tests oReliable contraception for male patients is concordant with above listed methods for females, as applicable
Acceptable liver function, renal function and hematological status at screening
Urinalysis showing no clinically significant abnormalities except those attributable for bladder cancer
Exclusion Criteria:
Previously diagnosed bladder fibrosis
Total bladder capacity estimated by cystoscopy to be less that 150 ml
Urinary incontinence of that severity that according to the opinion of the Urologist/Investigator would compromise the ability of the patient to retain the study drug intravesical instillation for one hour
Severe irritative voiding symptoms, such as urgency, frequency and nocturia that could compromise protocol objectives in the opinion of the Urologist/Investigator
Serious disease (e.g., hydronephrosis, renal or liver failure or other condition) that could compromise protocol objectives in the opinion of the Urologist/Investigator
Active, uncontrolled bacterial, viral, or fungal infections, including urinary tract infection
Previous treatment with radiotherapy, or systemic chemotherapy.
Intravesical instillation(s) within 6 months with BCG or cytostatic agents
Known allergy to cis-UCA-instillation solution (see Section 5.1 for excipients).
Having participated in a clinical study with cis-UCA previously
Known any serious immunodeficiency condition
Donation of blood or participation in another drug study within 60 days (males) or 90 days (females) before the intravesical instillation in this study
Any clinically significant laboratory test result (including positive tests for HIV and hepatitis B or C) according to Investigator/Urologist
Excessive use of alcohol (on average more than 24 units per week for males, and more that 16 units per weeks for females; unit = 4 cl spirits or equivalent)
Clinically significant illness (except bladder cancer) within 30 days before the screening visit or any other condition, such as vesicourethral reflux (VUR), or complicated urinary stone disease that in the opinion of the Investigator would interfere with the evaluation of the study results or constitute a health hazard for the patient
Regular use of urine alkalinizing agents/drugs (e.g., acetazolamide, calcium phosphates, aluminium hydroxide, sodium bicarbonate, sodium carbonate, sodium citrate, potassium citrate) that might interfere with the evaluation of the study results
Unwillingness or doubtful capacity to comply with the protocol
Doubtful availability, in the opinion of the Investigator, to complete the study
Poor peripheral venous access -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Juha Peltonen, MD
Organizational Affiliation
CRST (Clinical Research Services Turku)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Liisa Pylkkänen, MD, PhD
Organizational Affiliation
BioCis Pharma Ltd
Official's Role
Study Chair
Facility Information:
Facility Name
Tampere University Hospital, Department of Urology
City
Tampere
ZIP/Postal Code
33520
Country
Finland
Facility Name
Turku University Hospital, Department of Surgery, Division of Urology
City
Turku
ZIP/Postal Code
20520
Country
Finland
12. IPD Sharing Statement
Learn more about this trial
Cis-urocanic Acid (Cis-UCA) in Patients With Primary or Recurrent Non-muscle Invasive Bladder Cancer
We'll reach out to this number within 24 hrs