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Perioperative Tislelizumab Combined With Nab-Paclitaxel for Muscle-invasive Urothelial Bladder Cancer: A Multicenter Study

Primary Purpose

Muscle Invasive Bladder Cancer Urothelial Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Tislelizumab Nab paclitaxel
Sponsored by
Tianjin Medical University Second Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Muscle Invasive Bladder Cancer Urothelial Carcinoma focused on measuring neoadjuvant treatment

Eligibility Criteria

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

Inclusion Criteria:

  1. Willing and able to provide written informed consent.
  2. Ability to comply with the protocol.
  3. Age ≥ 18 years.
  4. Suitable and planned for complete transurethral resection of bladder tumor or radical cystectomy
  5. At least one measurable lesion meeting RECISTv1.1 criteria prior to transurethral bladder tumor electrosurgery (MR/CT long diameter of ≥10 mm or short diameter of ≥15 mm of enlarged lymph node required for this measurable lesion according to RECISTv1.1)
  6. Histopathologically confirmed urothelial carcinoma. Patients with mixed histologies are required to have a dominant (i.e. 50% at least) urothelial cell pattern.
  7. Clinical stage T2-T4a NxM0 disease by CT (or MRI).
  8. Expected survival time is greater than 12 weeks.
  9. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 1 or 2.
  10. Agree to provide tissue examination specimens (used to detect PD-L1 expression, tumor mutation burden, etc.)
  11. The organ function level must meet the following requirements:

    • Hematological indicators: absolute neutrophil count ≥1.5×10^9/ L, platelet count ≥80×10^9/L, hemoglobin ≥6.0 g/dL (can be maintained by symptomatic treatment);
    • Liver function: total bilirubin ≤ 1.5 times the upper limit of normal value, alanine aminotransferase and aspartate aminotransferase

      ≤ 2.5 times the upper limit of normal value, if there is intrahepatic transaminase ≤ 5 times the upper limit of normal value;

    • Renal function: creatinine ≤ 2 times the upper limit of normal, and creatinine clearance ≥ 30 ml/min;

Exclusion Criteria:

  1. Receive live attenuated vaccines within 4 weeks before treatment or plan to receive live attenuated vaccines during the study period.
  2. Active, known or suspected autoimmune diseases.
  3. Known history of primary immunodeficiency.
  4. Known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation.
  5. Female patients who are pregnant or breastfeeding.
  6. Untreated acute or chronic active hepatitis B or C infection. In the case of patients receiving antiviral therapy, the doctor will judge whether they are eligible for enrollment according to the individual conditions of the patient while monitoring the virus copy number.
  7. Have used immunosuppressive drugs in the past 4 weeks before starting treatment, excluding nasal spray and inhaled corticosteroids or physiological doses of systemic steroids (that is, prednisolone or equivalent physiological doses of no more than 10 mg/day) Other corticosteroids).
  8. Those who are known or suspected to be allergic to tislelizumab and nab paclitaxel.
  9. Have a clear history of active tuberculosis.
  10. Have received PD-1/PD-L1/CTLA-4 antibody or other immunotherapy in the past.
  11. Those who are participating in other clinical research.
  12. Reproductive men or women who are likely to become pregnant have not taken reliable contraceptive measures.
  13. Uncontrolled concurrent diseases include but are not limited to:

    • HIV-infected persons (HIV antibody positive).
    • Serious infections that are active or poorly clinically controlled.
    • There are serious or uncontrollable systemic diseases (such as severe mental, neurological, epilepsy or dementia, unstable or uncompensated respiratory, cardiovascular, liver or kidney diseases, uncontrolled hypertension [ie refers to After drug treatment, it is still greater than or equal to CTCAE Grade 2 hypertension]) evidence.
    • Active bleeding or new thrombotic disease.

Sites / Locations

  • ianjin Medical University Second HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental: Tislelizumab and Nab Paclitaxel

Arm Description

Experimental: Tislelizumab and Nab Paclitaxel Tislelizumab 200mg IV on day 1 in combination with nab paclitaxel 200mg IV on day 2 every 3 weeks for 3 cycles followed by surgery.

Outcomes

Primary Outcome Measures

complete response (CR) rate
defined as the percentage of participants having CR. CR is defined as absence of viable tumor in examined tissue

Secondary Outcome Measures

Number of subjects that reach pathological downstaging to <pT2
defined as pT0-T1N0M0 at the time of cystectomy or cTURBT
Objective response rate (ORR)
defined as the proportion of patients who have a partial or complete response to therapy
Event-free survival (EFS)
defined from D1 of neoadjuvant treatment until progression (in those who progress prior to surgery) or until recurrence (post-surgery) or until death as a result of any cause.
Overall Survival (OS)
defined as the number of days from study entry to death. Individuals who are alive at last contact will be censored on the date of last contact.
Number of adverse events and severity by grade (CTCAE)
Safety and toxicity will be characterized according to the reported adverse event (AE) profile using NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0, as well as a patient questionnaire derived from the Patient Reported Outcomes (PRO)-CTCAE and Patient Reported Outcomes Measurement Information System (PROMIS).

Full Information

First Posted
April 6, 2022
Last Updated
June 8, 2022
Sponsor
Tianjin Medical University Second Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05328336
Brief Title
Perioperative Tislelizumab Combined With Nab-Paclitaxel for Muscle-invasive Urothelial Bladder Cancer: A Multicenter Study
Official Title
A Single-arm, Multicenter, Open Clinical Trial of the Efficacy and Safety of Tislelizumab in Combination With Nab-Paclitaxel for the Perioperative Treatment of Muscle-invasive Bladder Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 11, 2021 (Actual)
Primary Completion Date
July 2025 (Anticipated)
Study Completion Date
November 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tianjin Medical University Second Hospital

4. Oversight

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

5. Study Description

Brief Summary
This is a single-arm, open-label, multicenter clinical trial to investigate the safety and efficacy of tislelizumab when given in combination with nab-paclitaxel as perioperative treatment in patients with muscle-invasive bladder cancer (MIBC) prior to cystectomy or complete TURBT. Patients will receive perioperative treatment with tislelizumab in combination with nab-paclitaxel every 3 weeks for 3 treatment cycles over 9 weeks followed by radical cystectomy or complete TURBT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Muscle Invasive Bladder Cancer Urothelial Carcinoma
Keywords
neoadjuvant treatment

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Experimental: Tislelizumab and Nab Paclitaxel
Arm Type
Experimental
Arm Description
Experimental: Tislelizumab and Nab Paclitaxel Tislelizumab 200mg IV on day 1 in combination with nab paclitaxel 200mg IV on day 2 every 3 weeks for 3 cycles followed by surgery.
Intervention Type
Drug
Intervention Name(s)
Tislelizumab Nab paclitaxel
Intervention Description
Drug: Tislelizumab Tislelizumab 200mg will be administered on Day 1 every 3 weeks for 3 cycles Other Names: • BGB-A317 Drug: Nab paclitaxel Nab paclitaxel 200mg will
Primary Outcome Measure Information:
Title
complete response (CR) rate
Description
defined as the percentage of participants having CR. CR is defined as absence of viable tumor in examined tissue
Time Frame
At the time of complete transurethral resection of bladder tumor or radical cystectomy (within 12 weeks of the first dose of tislelizumab)
Secondary Outcome Measure Information:
Title
Number of subjects that reach pathological downstaging to <pT2
Description
defined as pT0-T1N0M0 at the time of cystectomy or cTURBT
Time Frame
At the time of complete transurethral resection of bladder tumor or radical cystectomy (within 12 weeks of the first dose of tislelizumab)
Title
Objective response rate (ORR)
Description
defined as the proportion of patients who have a partial or complete response to therapy
Time Frame
At the time of complete transurethral resection of bladder tumor or radical cystectomy (within 12 weeks of the first dose of tislelizumab)
Title
Event-free survival (EFS)
Description
defined from D1 of neoadjuvant treatment until progression (in those who progress prior to surgery) or until recurrence (post-surgery) or until death as a result of any cause.
Time Frame
up to 3 years
Title
Overall Survival (OS)
Description
defined as the number of days from study entry to death. Individuals who are alive at last contact will be censored on the date of last contact.
Time Frame
up to 3 years
Title
Number of adverse events and severity by grade (CTCAE)
Description
Safety and toxicity will be characterized according to the reported adverse event (AE) profile using NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0, as well as a patient questionnaire derived from the Patient Reported Outcomes (PRO)-CTCAE and Patient Reported Outcomes Measurement Information System (PROMIS).
Time Frame
up to 1 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent. Ability to comply with the protocol. Age ≥ 18 years. Suitable and planned for complete transurethral resection of bladder tumor or radical cystectomy At least one measurable lesion meeting RECISTv1.1 criteria prior to transurethral bladder tumor electrosurgery (MR/CT long diameter of ≥10 mm or short diameter of ≥15 mm of enlarged lymph node required for this measurable lesion according to RECISTv1.1) Histopathologically confirmed urothelial carcinoma. Patients with mixed histologies are required to have a dominant (i.e. 50% at least) urothelial cell pattern. Clinical stage T2-T4a NxM0 disease by CT (or MRI). Expected survival time is greater than 12 weeks. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 1 or 2. Agree to provide tissue examination specimens (used to detect PD-L1 expression, tumor mutation burden, etc.) The organ function level must meet the following requirements: Hematological indicators: absolute neutrophil count ≥1.5×10^9/ L, platelet count ≥80×10^9/L, hemoglobin ≥6.0 g/dL (can be maintained by symptomatic treatment); Liver function: total bilirubin ≤ 1.5 times the upper limit of normal value, alanine aminotransferase and aspartate aminotransferase ≤ 2.5 times the upper limit of normal value, if there is intrahepatic transaminase ≤ 5 times the upper limit of normal value; Renal function: creatinine ≤ 2 times the upper limit of normal, and creatinine clearance ≥ 30 ml/min; Exclusion Criteria: Receive live attenuated vaccines within 4 weeks before treatment or plan to receive live attenuated vaccines during the study period. Active, known or suspected autoimmune diseases. Known history of primary immunodeficiency. Known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation. Female patients who are pregnant or breastfeeding. Untreated acute or chronic active hepatitis B or C infection. In the case of patients receiving antiviral therapy, the doctor will judge whether they are eligible for enrollment according to the individual conditions of the patient while monitoring the virus copy number. Have used immunosuppressive drugs in the past 4 weeks before starting treatment, excluding nasal spray and inhaled corticosteroids or physiological doses of systemic steroids (that is, prednisolone or equivalent physiological doses of no more than 10 mg/day) Other corticosteroids). Those who are known or suspected to be allergic to tislelizumab and nab paclitaxel. Have a clear history of active tuberculosis. Have received PD-1/PD-L1/CTLA-4 antibody or other immunotherapy in the past. Those who are participating in other clinical research. Reproductive men or women who are likely to become pregnant have not taken reliable contraceptive measures. Uncontrolled concurrent diseases include but are not limited to: HIV-infected persons (HIV antibody positive). Serious infections that are active or poorly clinically controlled. There are serious or uncontrollable systemic diseases (such as severe mental, neurological, epilepsy or dementia, unstable or uncompensated respiratory, cardiovascular, liver or kidney diseases, uncontrolled hypertension [ie refers to After drug treatment, it is still greater than or equal to CTCAE Grade 2 hypertension]) evidence. Active bleeding or new thrombotic disease.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hailong Hu, MD,PhD
Phone
+86-13662096232
Email
hhllove2004@163.com
Facility Information:
Facility Name
ianjin Medical University Second Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300211
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hailong Hu, MD,PhD
Phone
+86-13662096232
Email
hhllove2004@163.com

12. IPD Sharing Statement

Learn more about this trial

Perioperative Tislelizumab Combined With Nab-Paclitaxel for Muscle-invasive Urothelial Bladder Cancer: A Multicenter Study

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