Safety and Tolerability of TAR-200 mg in Subjects With Non-Muscle-Invasive Bladder Cancer
Primary Purpose
Urinary Bladder Cancer
Status
Completed
Phase
Phase 1
Locations
Netherlands
Study Type
Interventional
Intervention
Gemcitabine-Releasing Intravesical System (GemRIS)/TAR-200
Sponsored by
About this trial
This is an interventional treatment trial for Urinary Bladder Cancer
Eligibility Criteria
Inclusion Criteria:
- A documented history of histologically-confirmed low or intermediate risk urothelial carcinoma of the bladder, excluding carcinoma in situ (pTis), pathologic stage pT1 (invasive into lamina propria) and high-Grade disease, judged not to be muscle infiltrating (pT2 or greater) and accessible for resection.
- Adequate laboratory parameters.
- Screening urinalysis showing no clinically significant abnormalities except those attributable to bladder cancer.
- Not undergoing active treatment in last 3 months for prior or concurrent neoplastic disease and have fully recovered from treatment effects. Patients undergoing concurrent hormonal therapy treatment for prostate cancer will be allowed to enroll.
Exclusion Criteria:
- Exposure to BCG therapy and/or any other intravesical. chemotherapeutic agent less than 1 year prior to enrollment, except single postoperative instillations.
- Absence of visible tumor at Screening.
- Any previous exposure to intravesical gemcitabine instillations within the past 12 months.
- Presence of any bladder or urethral anatomical feature that in the opinion of the investigator may prevent the safe placement, indwelling use or removal of TAR-200 (i.e. bladder diverticula, complete incontinence).
- Patients with a high-Grade urine cytology at recurrence.
- Currently receiving other systemic or intravesical chemotherapy.
- Pelvic radiotherapy administered within 6 months prior to enrollment. Patients who received radiotherapy ≥ 6 months prior to enrollment must demonstrate no cystoscopic evidence or clinical symptoms of radiation cystitis.
- Bladder Post-Void Residual Volume (PVR) of > 250-mL.
- Active, uncontrolled urogenital bacterial, viral, or fungal infections, including urinary tract infection. Skin/nail fungal infections are not exclusionary. Subjects with active shingles (varicella zoster infection) will be excluded from the study.
- History or presence of any significant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, gynecological, endocrine, immunological, dermatological, neurological or psychiatric disease or disorder that, in the opinion of the investigator, contraindicates participation.
- Concomitant immunosuppressive medications, such as methotrexate or TNF inhibitors, within 2 weeks of Study Day 0, exclusive of steroid doses ≤5 mg daily.
- Female subject who is pregnant (as verified by urine test at time of screening) or lactating, or of childbearing potential and not using acceptable methods of contraception.
- Unwilling or unable to provide informed consent or comply with the requirements of this protocol, including the presence of any condition (physical, mental or social) that is likely to affect the subject's return for scheduled visits and follow-up.
- Other unspecified reasons that, in the opinion of the investigator or TARIS, make the patient unsuitable for enrollment.
Sites / Locations
- Canisius Wilhelmina Ziekenhuis
- Radboudumc
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
7-Day Regimen
21-Day Regimen
Arm Description
TAR-200 is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 7. TAR-200 releases gemcitabine gradually during the 7 day indwelling time. A second TAR-200 is placed in the bladder on Study Day 21 and is removed on Study Day 28, which is the day of the TURBT.
TAR-200 is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 21. TAR-200 releases gemcitabine gradually during the 21 day indwelling time. A second TAR-200 is placed in the bladder on Study Day 21 and is removed on Study Day 42.
Outcomes
Primary Outcome Measures
Safety as defined by the number of participants with treatment emergent adverse events (TEAEs) coded with MedDRA and graded for severity with CTCAE v4.0
Secondary Outcome Measures
Number of participants who are tolerant of TAR-200 indwelling (Arm 1)
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 1)
Number of participants who are tolerant of TAR-200 indwelling (Arm 1)
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 1)
Cmax, plasma dFdU (Arm 1)
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in plasma.
Tmax, plasma dFdU (Arm 1)
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in plasma.
Cavg, plasma dFdU (Arm 1)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in plasma.
Cmax, plasma dFdC (Arm 1)
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Tmax, plasma dFdC (Arm 1)
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma
Cavg, plasma dFdC (Arm 1)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Cmax, urine dFdU (Arm 1)
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in urine.
Tmax, urine dFdU (Arm 1)
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in urine
Cavg, urine dFdU (Arm 1)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in urine.
Cmax, urine dFdC (Arm 1)
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Tmax, urine dFdC (Arm 1)
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Cavg, urine dFdC (Arm 1)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine
Preliminary anti-tumor effects will be assessed in tumor material (post-treatment) for assessment of immunohistochemical tissue biomarkers of drug-induced cell death (AKT, CD31, Ki67, TUNEL). (Arm 1)
Number of participants who are tolerant of TAR-200 indwelling (Arm 2)
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 2)
Number of participants who are tolerant of TAR-200 indwelling (Arm 2)
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 2)
Cmax, plasma dFdU (Arm 2)
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in plasma.
Tmax, plasma dFdU (Arm 2)
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in plasma.
Cavg, plasma dFdU (Arm 2)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in plasma.
Cmax, plasma dFdC (Arm 2)
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Tmax, plasma dFdC (Arm 2)
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma
Cavg, plasma dFdC (Arm 2)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Cmax, urine dFdU (Arm 2)
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in urine.
Tmax, urine dFdU (Arm 2)
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in urine
Cavg, urine dFdU (Arm 2)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in urine.
Cmax, urine dFdC (Arm 2)
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Tmax, urine dFdC (Arm 2)
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Cavg, urine dFdC (Arm 2)
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine
Preliminary anti-tumor effects will be assessed in tumor material (post-treatment) for assessment of immunohistochemical tissue biomarkers of drug-induced cell death (AKT, CD31, Ki67, TUNEL). (Arm 2)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02720367
Brief Title
Safety and Tolerability of TAR-200 mg in Subjects With Non-Muscle-Invasive Bladder Cancer
Official Title
A Phase 1b, Multicenter, Open Label Study Evaluating Safety, Tolerability and Preliminary Efficacy of GemRIS 225 mg in Subjects With Non-Muscle-Invasive Urothelial Carcinoma of the Bladder
Study Type
Interventional
2. Study Status
Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
January 2016 (Actual)
Primary Completion Date
January 2018 (Actual)
Study Completion Date
March 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taris Biomedical LLC
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
The purpose of this study is to determine if TAR-200, an investigational drug-delivery system is safe and tolerable in patients with recurrent low or intermediate risk non-muscle-invasive bladder cancer (NMIBC) between diagnosis and transurethral resection of bladder tumors (TURBT)
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urinary Bladder Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
7-Day Regimen
Arm Type
Experimental
Arm Description
TAR-200 is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 7. TAR-200 releases gemcitabine gradually during the 7 day indwelling time. A second TAR-200 is placed in the bladder on Study Day 21 and is removed on Study Day 28, which is the day of the TURBT.
Arm Title
21-Day Regimen
Arm Type
Experimental
Arm Description
TAR-200 is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 21. TAR-200 releases gemcitabine gradually during the 21 day indwelling time. A second TAR-200 is placed in the bladder on Study Day 21 and is removed on Study Day 42.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine-Releasing Intravesical System (GemRIS)/TAR-200
Intervention Description
TAR-200 is a passive, nonresorbable gemcitabine-releasing intravesical system whose primary mode of action is the controlled release of gemcitabine into the bladder over an indwelling period.
Primary Outcome Measure Information:
Title
Safety as defined by the number of participants with treatment emergent adverse events (TEAEs) coded with MedDRA and graded for severity with CTCAE v4.0
Time Frame
From the point of signing the informed consent form through last study visit, up to 59 days.
Secondary Outcome Measure Information:
Title
Number of participants who are tolerant of TAR-200 indwelling (Arm 1)
Time Frame
From Day 0 up to Day 7
Title
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 1)
Time Frame
From Day 0 up to Day 7
Title
Number of participants who are tolerant of TAR-200 indwelling (Arm 1)
Time Frame
From Day 21 up to Day 28
Title
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 1)
Time Frame
From Day 21 up to Day 28
Title
Cmax, plasma dFdU (Arm 1)
Description
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in plasma.
Time Frame
From Day 0 up to Day 32
Title
Tmax, plasma dFdU (Arm 1)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in plasma.
Time Frame
From Day 0 up to Day 32
Title
Cavg, plasma dFdU (Arm 1)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in plasma.
Time Frame
From Day 0 up to Day 32
Title
Cmax, plasma dFdC (Arm 1)
Description
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Time Frame
From Day 0 up to Day 32
Title
Tmax, plasma dFdC (Arm 1)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma
Time Frame
From Day 0 up to Day 32
Title
Cavg, plasma dFdC (Arm 1)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Time Frame
From Day 0 up to Day 32
Title
Cmax, urine dFdU (Arm 1)
Description
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in urine.
Time Frame
From Day 0 up to Day 32
Title
Tmax, urine dFdU (Arm 1)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in urine
Time Frame
From Day 0 up to Day 32
Title
Cavg, urine dFdU (Arm 1)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in urine.
Time Frame
From Day 0 up to Day 32
Title
Cmax, urine dFdC (Arm 1)
Description
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Time Frame
From Day 0 up to Day 32
Title
Tmax, urine dFdC (Arm 1)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Time Frame
From Day 0 up to Day 32
Title
Cavg, urine dFdC (Arm 1)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine
Time Frame
From Day 0 up to Day 32
Title
Preliminary anti-tumor effects will be assessed in tumor material (post-treatment) for assessment of immunohistochemical tissue biomarkers of drug-induced cell death (AKT, CD31, Ki67, TUNEL). (Arm 1)
Time Frame
Anti-tumor analysis will occur at the following study day visit Day 28
Title
Number of participants who are tolerant of TAR-200 indwelling (Arm 2)
Time Frame
From Day 0 up to Day 21
Title
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 2)
Time Frame
From Day 0 up to Day 21
Title
Number of participants who are tolerant of TAR-200 indwelling (Arm 2)
Time Frame
From Day 21 up to Day 42
Title
Percentage of participants who are tolerant of TAR-200 indwelling (Arm 2)
Time Frame
From Day 21 up to Day 42
Title
Cmax, plasma dFdU (Arm 2)
Description
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in plasma.
Time Frame
From Day 0 up to Day 47
Title
Tmax, plasma dFdU (Arm 2)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in plasma.
Time Frame
From Day 0 up to Day 47
Title
Cavg, plasma dFdU (Arm 2)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in plasma.
Time Frame
From Day 0 up to Day 47
Title
Cmax, plasma dFdC (Arm 2)
Description
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Time Frame
From Day 0 up to Day 47
Title
Tmax, plasma dFdC (Arm 2)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma
Time Frame
From Day 0 up to Day 47
Title
Cavg, plasma dFdC (Arm 2)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in plasma.
Time Frame
From Day 0 up to Day 47
Title
Cmax, urine dFdU (Arm 2)
Description
Analysis of Cmax (maximum concentration achieved over time) of diflourodeoxyuridine (dFdU) in urine.
Time Frame
From Day 0 up to Day 47
Title
Tmax, urine dFdU (Arm 2)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of diflourodeoxyuridine (dFdU) in urine
Time Frame
From Day 0 up to Day 47
Title
Cavg, urine dFdU (Arm 2)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of diflourodeoxyuridine (dFdU) in urine.
Time Frame
From Day 0 up to Day 47
Title
Cmax, urine dFdC (Arm 2)
Description
Analysis of Cmax (maximum concentration achieved over time) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Time Frame
From Day 0 up to Day 47
Title
Tmax, urine dFdC (Arm 2)
Description
Analysis of Tmax (Day at which maximum concentration was achieved) of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine.
Time Frame
From Day 0 up to Day 47
Title
Cavg, urine dFdC (Arm 2)
Description
Analysis of Descriptive statistics (e.g. sample size, mean and median, quartiles, minimum and maximum and box plots) of the concentration of gemcitabine (deoxydifluorocytidine hydrochloride - dFdC) in urine
Time Frame
From Day 0 up to Day 47
Title
Preliminary anti-tumor effects will be assessed in tumor material (post-treatment) for assessment of immunohistochemical tissue biomarkers of drug-induced cell death (AKT, CD31, Ki67, TUNEL). (Arm 2)
Time Frame
Anti-tumor analysis will occur at the following study day visit Day 42
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
A documented history of histologically-confirmed low or intermediate risk urothelial carcinoma of the bladder, excluding carcinoma in situ (pTis), pathologic stage pT1 (invasive into lamina propria) and high-Grade disease, judged not to be muscle infiltrating (pT2 or greater) and accessible for resection.
Adequate laboratory parameters.
Screening urinalysis showing no clinically significant abnormalities except those attributable to bladder cancer.
Not undergoing active treatment in last 3 months for prior or concurrent neoplastic disease and have fully recovered from treatment effects. Patients undergoing concurrent hormonal therapy treatment for prostate cancer will be allowed to enroll.
Exclusion Criteria:
Exposure to BCG therapy and/or any other intravesical. chemotherapeutic agent less than 1 year prior to enrollment, except single postoperative instillations.
Absence of visible tumor at Screening.
Any previous exposure to intravesical gemcitabine instillations within the past 12 months.
Presence of any bladder or urethral anatomical feature that in the opinion of the investigator may prevent the safe placement, indwelling use or removal of TAR-200 (i.e. bladder diverticula, complete incontinence).
Patients with a high-Grade urine cytology at recurrence.
Currently receiving other systemic or intravesical chemotherapy.
Pelvic radiotherapy administered within 6 months prior to enrollment. Patients who received radiotherapy ≥ 6 months prior to enrollment must demonstrate no cystoscopic evidence or clinical symptoms of radiation cystitis.
Bladder Post-Void Residual Volume (PVR) of > 250-mL.
Active, uncontrolled urogenital bacterial, viral, or fungal infections, including urinary tract infection. Skin/nail fungal infections are not exclusionary. Subjects with active shingles (varicella zoster infection) will be excluded from the study.
History or presence of any significant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, gynecological, endocrine, immunological, dermatological, neurological or psychiatric disease or disorder that, in the opinion of the investigator, contraindicates participation.
Concomitant immunosuppressive medications, such as methotrexate or TNF inhibitors, within 2 weeks of Study Day 0, exclusive of steroid doses ≤5 mg daily.
Female subject who is pregnant (as verified by urine test at time of screening) or lactating, or of childbearing potential and not using acceptable methods of contraception.
Unwilling or unable to provide informed consent or comply with the requirements of this protocol, including the presence of any condition (physical, mental or social) that is likely to affect the subject's return for scheduled visits and follow-up.
Other unspecified reasons that, in the opinion of the investigator or TARIS, make the patient unsuitable for enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Johannes Witjes, MD
Organizational Affiliation
Radboud University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Canisius Wilhelmina Ziekenhuis
City
Nijmegen
Country
Netherlands
Facility Name
Radboudumc
City
Nijmegen
Country
Netherlands
12. IPD Sharing Statement
Learn more about this trial
Safety and Tolerability of TAR-200 mg in Subjects With Non-Muscle-Invasive Bladder Cancer
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