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A Study of Pemigatinib in Non-muscle Invasive Bladder Cancer Patients With Recurrent Low- or Intermediate-Risk Tumors

Primary Purpose

Bladder Cancer, NMIBC, Non-Muscle Invasive Bladder Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Pemigatinib
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bladder Cancer focused on measuring Bladder Cancer, Non Muscle Invasive Bladder Cancer, Non-Muscle Invasive Bladder Cancer (NMIBC), NMIBC, Urothelial Carcinoma, Urothelial Cancer, Urinary Bladder Neoplasm, Bladder Neoplasm, Fibroblast inhibitors, Pemigatinib, FGFR inhibitor

Eligibility Criteria

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

Inclusion Criteria:

  • Prior histologically confirmed low- or intermediate-risk non-muscle invasive urothelial carcinoma of the bladder (NMIBC) defined according to the following characteristics:

    • Low Risk

      • Initial tumor with all of the following:
      • Solitary tumor
      • Ta tumor
      • Low-grade
      • <3 cm
      • No CIS
    • Intermediate Risk

      --- All tumors not defined in the two adjacent categories (between the category of low- and high-risk)

    • High Risk

      • T1 tumor
      • High-grade
      • CIS
      • Multiple and recurrent and large (>3 cm) Ta low-grade tumors (all conditions must be met for this point on Ta low-grade tumors)
  • Documented tumor recurrence as noted in standard of care follow up cystoscopy.
  • ECOG (WHO) performance status 0-2
  • Age ≥ 18 years old
  • Patients must have the following laboratory values:

    • White blood cell count (WBC) > 3.0 K/mm3
    • Absolute neutrophil count (ANC) ≥ 1.5 K/mm3
    • Platelets ≥ 100 K/mm3
    • Hemoglobin (Hgb) ≥ 9 g/dL
    • Serum total bilirubin: ≤ 1.5 x ULN
    • ALT and AST ≤ 3.0 x ULN
    • Serum calcium < ULN
    • Serum phosphate < ULN
    • Serum creatinine ≤ 1.5 x ULN or serum creatinine > 1.5 - 3 x ULN if calculated creatinine clearance (CrCl) is ≥ 30 mL/min using the modified Cockcroft-Gault equation
  • Patients who give a written informed consent obtained according to local guidelines

Exclusion Criteria:

  • Patients with concurrent upper urinary tract (i.e. ureter, renal pelvis) non-invasive urothelial carcinoma.
  • Patients with high grade urothelial carcinoma on their most recent urine cytology.
  • Patients with another active second malignancy other than non-melanoma skin cancers and biochemical relapsed prostate cancer. (Patients that have completed all necessary therapy and are considered to be at less than 30% risk of relapse are not considered to have an active second malignancy and are eligible for enrollment.)
  • Patients who have received the last administration of an anti-cancer therapy including chemotherapy, immunotherapy, and monoclonal antibodies ≤ 4 weeks prior to starting study drug, or who have not recovered from the side effects of such therapy
  • Patients who have received prior selective fibroblast growth factor receptor targeting agents (i.e. pemigatinib, dovitinib, BGJ398, AZD4547, JNJ-42756493, etc.).
  • Patients who have had radiotherapy ≤ 4 weeks prior to starting study drug, or who have not recovered from radiotherapy toxicities
  • Patients who have undergone major surgery (e.g. intra-thoracic, intra-abdominal or intra-pelvic), open biopsy or significant traumatic injury ≤ 4 weeks prior to starting study drug, or patients who have had minor procedures (i.e. TURBT), percutaneous biopsies or placement of vascular access device ≤ 1 week prior to starting study drug, or who have not recovered from side effects of such procedure or injury

Sites / Locations

  • Sibley Memorial HospitalRecruiting
  • Johns Hopkins School of Medicine - Sidney Kimmel Comprehensive Cancer CenterRecruiting
  • Associated Medical Professionals UrologyRecruiting
  • Midlantic UrologyRecruiting
  • Keystone UrologyRecruiting
  • Carolina Urologic Research CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment: Pemigatinib

Arm Description

Patients will receive pemigatinib for 4 to 6 weeks prior to standard of care transurethral resection of bladder tumor (TURBT).

Outcomes

Primary Outcome Measures

Complete response rate of pemigatinib therapy
The number of participants with a complete response to pemigatinib therapy. Tumor complete response is defined as the complete absence of any stage bladder tumor on post-treatment Transurethral Resection of a Bladder Tumor (TURBT) and no evidence of recurrent urothelial carcinoma on post-treatment urine cytology.

Secondary Outcome Measures

Characterize the safety profile of pemigatinib therapy
Number of Common Terminology Criteria for Adverse Events (CTCAE) grade ≥ 3 toxicities
Number of Participants with Complete Response and FGFR3 Mutational Status
Number of Participants with Non-Muscle Invasive Bladder Cancer (NMIBC) and Complete Response
Number of participants with complete response rate and baseline NMIBC risk group (low- vs. intermediate-risk)
Maximal concentration (Cmax, nmol/L) of pemigatinib in urothelial tissue at post-treatment TURBT
Relapse Free Survival (RFS) at 6 months
Number of months from achieving a complete response at initial post-treatment TURBT until relapse.
Relapse Free Survival (RFS) at 12 months
Number of months from achieving a complete response at initial post-treatment TURBT until relapse.
Relapse Free Survival (RFS) at 24 months
Number of months from achieving a complete response at initial post-treatment TURBT until relapse.

Full Information

First Posted
April 11, 2019
Last Updated
April 27, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Incyte Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT03914794
Brief Title
A Study of Pemigatinib in Non-muscle Invasive Bladder Cancer Patients With Recurrent Low- or Intermediate-Risk Tumors
Official Title
Phase 2 Window of Opportunity Study of Pemigatinib in Non-muscle Invasive Bladder Cancer Patients With Recurrent Low- or Intermediate-Risk Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 2, 2020 (Actual)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
May 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Incyte Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase II trial studies how well Pemigatinib (an orally administered inhibitor of fibroblast growth factor receptors 1, 2, and 3) works in non-muscle invasive bladder cancer (NMIBC) patients with recurrent tumors and a prior history of low- or intermediate-risk NMIBC tumors. Participants will receive pemigatinib for 4-6 weeks prior to standard of care transurethral resection of bladder tumor (TURBT).
Detailed Description
It is a single-arm phase 2 window of opportunity study to assess the antineoplastic activity of pemigatinib in non-muscle invasive bladder cancer (NMIBC) patients with recurrent tumors and a prior history of low- or intermediate-risk NMIBC tumors. Enrolled patients will receive pemigatinib for 4-6 weeks prior to standard of care transurethral resection of bladder tumor (TURBT). The primary endpoint will be complete response rate as determined at TURBT. Secondary endpoints will include safety profile, associations between complete response rate and tumor mutation/fusion status (e.g. FGFR3 specifically, others will also be examined) and NMIBC risk group (low- vs. intermediate-risk), and assessment of pemigatinib post-treatment urothelial tissue concentrations. The study will be conducted at 4-5 high volume bladder cancer institutions within the US and managed through the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center clinical research office.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bladder Cancer, NMIBC, Non-Muscle Invasive Bladder Cancer, Urothelial Carcinoma Recurrent
Keywords
Bladder Cancer, Non Muscle Invasive Bladder Cancer, Non-Muscle Invasive Bladder Cancer (NMIBC), NMIBC, Urothelial Carcinoma, Urothelial Cancer, Urinary Bladder Neoplasm, Bladder Neoplasm, Fibroblast inhibitors, Pemigatinib, FGFR inhibitor

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment: Pemigatinib
Arm Type
Experimental
Arm Description
Patients will receive pemigatinib for 4 to 6 weeks prior to standard of care transurethral resection of bladder tumor (TURBT).
Intervention Type
Drug
Intervention Name(s)
Pemigatinib
Other Intervention Name(s)
INCB054828, FGFR inhibitor INCB054828
Intervention Description
Participants will take Pemigatinib once daily on days 1 through 28 of each cycle prior to standard of care TURBT.
Primary Outcome Measure Information:
Title
Complete response rate of pemigatinib therapy
Description
The number of participants with a complete response to pemigatinib therapy. Tumor complete response is defined as the complete absence of any stage bladder tumor on post-treatment Transurethral Resection of a Bladder Tumor (TURBT) and no evidence of recurrent urothelial carcinoma on post-treatment urine cytology.
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Characterize the safety profile of pemigatinib therapy
Description
Number of Common Terminology Criteria for Adverse Events (CTCAE) grade ≥ 3 toxicities
Time Frame
4 years
Title
Number of Participants with Complete Response and FGFR3 Mutational Status
Time Frame
Up to 4 weeks
Title
Number of Participants with Non-Muscle Invasive Bladder Cancer (NMIBC) and Complete Response
Description
Number of participants with complete response rate and baseline NMIBC risk group (low- vs. intermediate-risk)
Time Frame
Up to 4 years
Title
Maximal concentration (Cmax, nmol/L) of pemigatinib in urothelial tissue at post-treatment TURBT
Time Frame
Up to 4 weeks
Title
Relapse Free Survival (RFS) at 6 months
Description
Number of months from achieving a complete response at initial post-treatment TURBT until relapse.
Time Frame
6 months
Title
Relapse Free Survival (RFS) at 12 months
Description
Number of months from achieving a complete response at initial post-treatment TURBT until relapse.
Time Frame
12 months
Title
Relapse Free Survival (RFS) at 24 months
Description
Number of months from achieving a complete response at initial post-treatment TURBT until relapse.
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Prior histologically confirmed low- or intermediate-risk non-muscle invasive urothelial carcinoma of the bladder (NMIBC) defined according to the following characteristics: Low Risk Initial tumor with all of the following: Solitary tumor Ta tumor Low-grade <3 cm No CIS Intermediate Risk --- All tumors not defined in the two adjacent categories (between the category of low- and high-risk) High Risk T1 tumor High-grade CIS Multiple and recurrent and large (>3 cm) Ta low-grade tumors (all conditions must be met for this point on Ta low-grade tumors) Documented tumor recurrence as noted in standard of care follow up cystoscopy. ECOG (WHO) performance status 0-2 Age ≥ 18 years old Patients must have the following laboratory values: White blood cell count (WBC) > 3.0 K/mm3 Absolute neutrophil count (ANC) ≥ 1.5 K/mm3 Platelets ≥ 100 K/mm3 Hemoglobin (Hgb) ≥ 9 g/dL Serum total bilirubin: ≤ 1.5 x ULN ALT and AST ≤ 3.0 x ULN Serum calcium < ULN Serum phosphate < ULN Serum creatinine ≤ 1.5 x ULN or serum creatinine > 1.5 - 3 x ULN if calculated creatinine clearance (CrCl) is ≥ 30 mL/min using the modified Cockcroft-Gault equation Patients who give a written informed consent obtained according to local guidelines Exclusion Criteria: Patients with concurrent upper urinary tract (i.e. ureter, renal pelvis) non-invasive urothelial carcinoma. Patients with high grade urothelial carcinoma on their most recent urine cytology. Patients with another active second malignancy other than non-melanoma skin cancers and biochemical relapsed prostate cancer. (Patients that have completed all necessary therapy and are considered to be at less than 30% risk of relapse are not considered to have an active second malignancy and are eligible for enrollment.) Patients who have received the last administration of an anti-cancer therapy including chemotherapy, immunotherapy, and monoclonal antibodies ≤ 4 weeks prior to starting study drug, or who have not recovered from the side effects of such therapy Patients who have received prior selective fibroblast growth factor receptor targeting agents (i.e. pemigatinib, dovitinib, BGJ398, AZD4547, JNJ-42756493, etc.). Patients who have had radiotherapy ≤ 4 weeks prior to starting study drug, or who have not recovered from radiotherapy toxicities Patients who have undergone major surgery (e.g. intra-thoracic, intra-abdominal or intra-pelvic), open biopsy or significant traumatic injury ≤ 4 weeks prior to starting study drug, or patients who have had minor procedures (i.e. TURBT), percutaneous biopsies or placement of vascular access device ≤ 1 week prior to starting study drug, or who have not recovered from side effects of such procedure or injury
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Amber Michalik, BA
Phone
667-306-8336
Email
amichal2@jhmi.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Rana Sullivan, RN
Phone
410-614-6337
Email
tomalra@jhmi.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Noah M Hahn, MD
Organizational Affiliation
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sibley Memorial Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20016
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jan Powers
Facility Name
Johns Hopkins School of Medicine - Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Individual Site Status
Recruiting
Facility Name
Associated Medical Professionals Urology
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christopher Pieczonka
Phone
(315) 478-4185
Facility Name
Midlantic Urology
City
Bala-Cynwyd
State/Province
Pennsylvania
ZIP/Postal Code
19004
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laurence Belkoff
Phone
610-667-0458
First Name & Middle Initial & Last Name & Degree
Laurence
Facility Name
Keystone Urology
City
Lancaster
State/Province
Pennsylvania
ZIP/Postal Code
17604
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Sieber
Phone
717-431-2285
Facility Name
Carolina Urologic Research Center
City
Myrtle Beach
State/Province
South Carolina
ZIP/Postal Code
29572
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neal Shore
Phone
843-449-1010

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of Pemigatinib in Non-muscle Invasive Bladder Cancer Patients With Recurrent Low- or Intermediate-Risk Tumors

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