A Phase 3 Study of UGN-102 for Low Grade Intermediate Risk Non-Muscle Invasive Bladder Cancer (ATLAS)
Bladder Cancer, Urothelial Carcinoma, Urothelial Carcinoma Bladder
About this trial
This is an interventional treatment trial for Bladder Cancer focused on measuring Non-muscle invasive bladder cancer, Low grade non-muscle invasive bladder cancer, Intermediate risk non-muscle invasive bladder cancer, NMIBC, UGN-102, Mitomycin, Transurethral resection of bladder tumors, TURBT
Eligibility Criteria
Inclusion Criteria:
- Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in the protocol.
- Patient who has newly diagnosed or historic LG NMIBC (Ta) histologically confirmed by cold cup biopsy at screening or within 8 weeks of screening.
Is at intermediate risk for progression, defined as having 1 or 2 of the following:
- Presence of multiple tumors;
- Solitary tumor > 3 cm;
- Recurrence (≥ 1 occurrence of LG NMIBC within 1 year of the current diagnosis).
- Negative voiding cytology for high grade (HG) disease within 6 weeks of screening.
Has adequate organ and bone marrow function as determined by the following routine laboratory tests:
- Leukocytes ≥ 3,000 cells per μL;
- Absolute neutrophil count ≥ 1,500 cells per μL;
- Platelets ≥ 100,000 per μL;
- Hemoglobin ≥ 9.0 g/dL;
- Total bilirubin ≤ 1.5 x upper limit of normal (ULN);
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 × ULN;
- Alkaline phosphatase (ALP) ≤ 2.5 × ULN;
- Estimated glomerular filtration rate (eGFR) ≥ 30 mL/min.
- Has no evidence of active urinary tract infection (UTI).
- Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for clinical study participants. Women of childbearing potential (defined as premenopausal women who have not been sterilized), including female patients and female partners of male patients, must be willing to use 2 acceptable forms of effective contraception from enrollment through 6 months post-treatment.
Exclusion Criteria:
- History of carcinoma in situ (CIS) on preliminary cystoscopy within 5 years of enrollment.
- Received Bacillus Calmette-Guérin (BCG) treatment for urothelial carcinoma (UC) within previous 1 year.
- History of HG papillary UC in the past 2 years.
- Known allergy or sensitivity to mitomycin that in the investigator's opinion cannot be readily managed.
- Clinically significant urethral stricture that would preclude passage of a urethral catheter.
- History of pelvic radiotherapy.
History of:
- Neurogenic bladder;
- Active urinary retention;
- Any other condition that would prohibit normal voiding.
- Past or current muscle invasive (ie, T2, T3, T4) or metastatic UC or concurrent upper tract UC.
- Current tumor grading of T1.
- Has an underlying substance abuse or psychiatric disorder such that, in the opinion of the investigator, the patient would be unable to comply with the protocol.
- History of prior treatment with an intravesical chemotherapeutic agent except for a single dose of chemotherapy immediately post any previous TURBT.
- Has previously participated in a study in which they received UGN-102.
- Has participated in a study with an investigational agent or device within 30 days of randomization.
Sites / Locations
- Arizona Institute of Urology, PLLC
- Loma Linda University Medical Center
- Urology Group of Southern California
- San Diego Clinical Trials
- Providence Saint John's Health Center
- Skyline Urology
- University of Chicago Hospital
- Comprehensive Urologic Care
- First Urology, PSC
- Wichita Urology Group
- Regional Urology, LLC
- Chesapeake Urology Research Associates
- Chesapeake Urology Research Associates
- Adult & Pediatric Urology, PC
- Urology Center
- New Jersey Urology
- New Jersey Urology
- Garden State Urology
- Albany Medical Center
- Great Lakes Physician dba WNY Urology Associates
- AccuMed Research Associates
- Manhattan Medical Research
- Stony Brook Cancer Center
- Associated Medical Professionals of NY, PLLC
- UNC Chapel Hill Memorial Hospital
- Clinical Research Solutions
- Centers for Advanced Urology, LLP d.b.a Mid-Atlantic Urology
- Penn State Health Milton S. Hershey Medical Center and College of Medicine
- Fox Chase Cancer Center
- University of Pittsburgh
- Carolina Urologic Research Center
- University of Texas Southwestern Medical Center
- Urology San Antonio
- Multiprofile Hospital for Active Treatment "Puls", Department of Urology
- Multiprofile Hospital for Active Treatment - Blagoevgrad
- Complex Oncology Center - Burgas
- Multiprofile Hospital for Active Treatment "Dr. Tota Venkova", Gabrovo, Department of Urology
- Multiprofile Hospital for Active Treatment "Sveti Nikolai Chudotvorets", Lom
- Multiprofile Hospital for Active Treatment "City Clinic - Sveti Georgi"
- University Multiprofile Hospital for Active Treatment "Dr. Georgi Stranski", Pleven, Urology Clinic
- University Multiprofile Hospital for Active Treatment "Sveta Marina" - Pleven, Department of Urology
- Multiprofile Hospital for Active Treatment Park Hospital
- University Multiprofile Hospital for Active Treatment "Sveti Georgi", Plovdiv, Clinic of Urology
- University Multiprofile Hospital for Active Treatment, Plovdiv, Department of Urology
- University Multiprofile Hospital for Active Treatment 'Kanev', Ruse, Department of Urology
- Multiprofile Hospital for Active Treatment - Shumen, Shumen, Department of Urology
- University Multiprofile Hospital for Active Treatment "Aleksandrovska", Sofia, Urology Clinic
- University Multiprofile Hospital for Active Treatment and Emergency Medicine "N.I. Pirogov", Sofia, Urology Clinic
- Multiprofile Hospital for Active Treatment - Targovishte
- Multiprofile Hospital for Active Treatment, Varna part of Military Medical Academy, Clinic of Urology
- Multiprofile Hospital for Active Treatment "Sveta Anna", Varna, Urology Clinic
- University Multiprofile Hospital for Active Treatment "Sveta Marina"
- Multiprofile Regional Hospital for Active Treatment "Dr. Stefan Cherkezov", Veliko Tarnovo, Department of Urology
- First Private Hospital Vratsa, Department of Urology
- Multiprofile Hospital for Active Treatment "Sveti Pantaleymon", Yambol, Department of Urology
- East Viru Central Hospital, Surgery Clinic
- East Tallinn Central Hospital Ltd., Surgery Clinic, Centre of Urology
- West Tallinn Central Hospital Ltd., Department of Urology
- North Estonia Medical Centre Foundation Ltd., Surgery Clinic, General and Oncology Urology Centre
- Tartu University Hospital, Surgery Clinic, Department of Urology and Kidney Transplantation
- LTD Central University Clinic After Academic N. Kipshidze
- JSC Jerarsi, Department of Urology
- LTD Acad. F. Todua Medical Center - LTD Research Institute of Clinical Medicine, Clinical Research Department
- LTD Gidmedi, Urology Department
- LTD L. Managadze National Center of Urology, Department of Urology
- LTD MMT Hospital, Urology Department
- Malkhaz Katsiashvili Multiprofile Emergency Medicine Center LTD, Department of Urology
- Pineo Medical Ecosystem Ltd., Department of Urology
- Tbilisi State Medical University and Ingorokva High Technology Medical Center University Clinic LTD, Urology Department
- Rambam Health Care Campus
- Lady Davis Carmel Medical Center
- Edith Wolfson Medical Center
- Rabin Medical Center
- Chaim Sheba Medical Center
- Liepajas Regional Hospital, Urology Department
- P. Stradins Clinical University Hospital, Center for Urology
- LLC Riga East University Hospital, Clinic of Urology and Oncologic Urology
- Daugavpils Regional Hospital, Urology Department
- Jan Biziel University Hospital #2 in Bydgoszcz, Teaching Department of Urology
- AKMED
- Prof.E Michalowski Specialist Hospital
- SCM sp. z o.o. (LLC)
- "City Clinic" Limited Liability Company
- Miedzyleski Specialist Hospital in Warsaw, Department of Urology
- Sverdlovsk Regional Clinical Hospital #1
- Krasnoyarsk A.I. Kryzhanovsky Regional Oncology Center
- D.D. Pletnyov City Clinical Hospital, Department of Oncourology
- Moscow City Oncology Hospital #62
- Murmansk Bayandin Regional Clinical Hospital
- Privolzhsky Regional Medical Center, Urology Department
- Tsyb Medical Radiology Research Center, Oncourology Department
- Clinical Oncology Center, Department of Urology and Oncology
- N.N. Burdenko Penza Regional Clinical Hospital, Department of Urology
- Pyatigorsk City Clinical Hospital, Department of Urology
- Leningrad Regional Clinical Oncology Center, Department of Chemotherapy
- Aleksandrovskaya City Hospital, Department of Urology
- St. Petersburg Clinical Hospital under the Russian Academy of Sciences, Department of Urology
- A.M. Nikiforov Russian Center for Emergency and Radiology Medicine, Department of Urology
- St. Luka Clinical Hospital, Department of Urology
- St.-Petersburg Scientific Research Institute of Phthisiopulmonology
- Medical and Sanitary Unit #70 of "Passazhiravtotrans"
- I.I. Mechnikov North-Western State Medical University, Department of Urology
- Railway Clinical Hospital under OAO Russian Railways
- First I.P. Pavlov State Medical University of St. Petersburg
- N.N. Petrov National Medical Research Center of Oncology, Oncourology Department
- City Hospital #15, Urology Department #12
- Siberian State Medical University
- Regional Oncology Center, Tyumen, Oncology Department
- Republican Clinical Oncology Center
- Volgograd Regional Center for Urology and Nephrology, Urology Department
- Medical Center for Diagnostics and Prevention Plus
- Clinical Center of Serbia, Clinic of Urology
- Clinical Hospital Center Bezanijska Kosa, Clinic of Surgery, Department of Urology
- Clinical Hospital Center Zemun, Urology unit
- Clinical Center Kragujevac, Clinic of Urology, Nephrology and Dialysis
- Chernihiv Medical Center of Modern Oncology
- Regional Communal Noncommercial Enterprise: Chernivtsi Regional Clinical Hospital
- Regional Municipal Non-commercial Enterprise "Chernivtsi Emergency Medical Hospital", Urology Department
- Public Enterprise "Dnipropetrovsk I.I. Mechnikov Regional Clinical Hospital" under Dnipropetrovsk Regional Council, Urology Department #2
- Public Non-Profit Enterprise "City Clinical Hospital #6" under Dnipro City Council, Department of Urology
- Public Non-Profit Enterprise "City Clinical Hospital #4" under Dnipro City Council, Department of Geriatric Urology Care
- Public Non-Profit Enterprise "Regional Clinical Hospital under Ivano-Frankivsk Regional Council", Department of Urology
- Prykarpattia Clinical Oncology Center under Ivano-Frankivsk Regional Council
- Public Non-Profit Enterprise under Kharkiv Regional Council "V.I. Shapoval Regional Medical Clinical Center for Urology and Nephrology", Urology Department #5
- Communal Non-Profit Enterprise "Regional Center of Oncology", Department of Oncourology
- Public Non-Profit Enterprise under Kharkiv Regional Council "Regional Clinical Specialized Center for Radiation Protection of Population", Department of Surgery
- Communal non-commercial enterprise of Kherson regional council "Kherson regional oncological dispensary"
- State Institution: Institute of Urology under the National Academy of Medical Sciences of Ukraine
- Volyn Regional Medical Oncology Centre
- Communal Noncommercial Enterprise of Lviv Regional Council "Lviv Regional Clinical Hospital", Department of Urology
- Public Non-profit Enterprise under Lviv Regional Council: Lviv Regional Treatment and Diagnostics Oncology Center
- Municipal Non-Profit Enterprise "Lviv Clinical Emergency Care Hospital", Department of Urology
- Public Non-Profit Enterprise "Odesa Regional Clinical Hospital" under Odesa Regional Council
- Public Non-Profit Enterprise "City Clinical Hospital #10" under Odesa City Council, Department of Urology and Nephrology
- Sumy Regional Clinical Oncology Center
- Public Non-Profit Enterprise Ternopil Regional Clinical Oncology Center, Department of Chemotherapy
- Municipal non-profit enterprise "Transcarpathian antitumor center" of the Transcarpathian Regional Council
- Communal Nonprofit Enterprise "Podilsky Regional Center of Oncology of Vinnytsia Regional Council"
- Municipal Nonprofit Enterprise: Zaporizhia Regional Clinical Hospital under Zaporizhia Regional Council, Department of Urology
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
UGN-102 ± TURBT
TURBT Alone
6 weekly intravesical instillations of UGN-102 (75 mg mitomycin) starting on Day 1 + TURBT for patients who have a NCR at the 3-month Visit (3 months after the start of treatment with UGN-102).
TURBT on Day 1 + repeat TURBT for patients who have a NCR at the 3-month Visit (3 months after the initial TURBT).