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Trial of Mitomycin C During Nephroureterectomy for Urothelial Carcinoma

Primary Purpose

Urothelial Carcinoma

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Mitomycin c
Sponsored by
University of Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urothelial Carcinoma

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Both males and females ≥ eighteen years of age
  • Clinical diagnosis of urothelial carcinoma of the renal pelvis and/or ureter. Clinical diagnosis of urothelial carcinoma may be based upon radiographic, pathologic or cytological findings alone or in combination with one another. No other histology is allowed.
  • The TNM stage of the subject's disease (using the American Joint Committee on Cancer [AJCC] Cancer Staging Manual, 8th Edition) must be Tis, Ta, T1, T2, or T3, N0, M0. Subjects may have either a high-grade or low-grade tumor.
  • ECOG performance status of 0-2
  • Written informed consent obtained from the subject and the ability for the subject to comply with all the study-related procedures.
  • Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy prior to and for at least 3 months after mitomycin C instillation to minimize the risk of pregnancy. Prior to study enrollment, women of childbearing potential must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy.
  • Males with female partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) should avoid conceiving children prior to and for 3 months following mitomycin C instillation
  • Subjects must have hemoglobin ≥ 9 g/dL and a platelet count ≥ 100,000/μL.

Exclusion Criteria:

  • Active urothelial carcinoma of the bladder within 12 months prior to enrollment
  • History of adverse reaction to mitomycin C
  • Evidence of regional or metastatic disease.
  • History of radical cystectomy
  • Planned radical cystectomy at the time of nephroureterectomy
  • Females or males of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy prior to and for at least 3 months after mitomycin C instillation.
  • Females who are pregnant or breastfeeding.
  • History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician.
  • Prisoners or subjects who are involuntarily incarcerated.
  • Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.
  • Subjects demonstrating an inability to comply with the study and/or follow-up procedures

Sites / Locations

  • University of Florida

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Mitomycin C

Arm Description

Outcomes

Primary Outcome Measures

Bladder Tumor Recurrence Rate
The bladder tumor recurrence rate will be measured by the percentage of subjects who are confirmed by bladder biopsy to have a recurrence of urothelial carcinoma in the bladder following nephroureterectomy

Secondary Outcome Measures

Time to Bladder Tumor Recurrence
The time to bladder tumor recurrence will be characterized using Kapalan-Meier plots.
Bladder Tumor Recurrence Rate
The bladder tumor recurrence rate will be measured by the proportion of subjects who are confirmed by bladder biopsy to have a recurrence of urothelial carcinoma in the bladder following nephroureterectomy

Full Information

First Posted
August 31, 2018
Last Updated
December 6, 2022
Sponsor
University of Florida
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1. Study Identification

Unique Protocol Identification Number
NCT03658304
Brief Title
Trial of Mitomycin C During Nephroureterectomy for Urothelial Carcinoma
Official Title
A Single Arm Phase II Trial of the Intraoperative Intravesical Instillation of Mitomycin C During Nephroureterectomy for Urothelial Carcinoma of the Upper Urinary Tract
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 5, 2018 (Actual)
Primary Completion Date
November 10, 2021 (Actual)
Study Completion Date
September 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Florida

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Results of previous studies suggest that the timing of intravesical mitomycin C administration may impact bladder tumor recurrence rate following radical nephroureterectomy. This is the first study of its kind to attempt to identify the importance of timing of mitomycin C administration relative to bladder tumor recurrence rate following radical nephroureterectomy.This study will investigate the one year bladder tumor recurrence rate in patients with urothelial carcinoma of the upper urinary tract following intraoperative administration of mitomycin C during a nephroureterectomy, as well as the time to bladder tumor recurrence in this patient population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urothelial Carcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Mitomycin C
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Mitomycin c
Intervention Description
All participants will receive a single 40 mg dose of mitomycin C intraoperatively during their scheduled nephroureterectomy. This single dose will be given through a catheter in the subject's bladder.
Primary Outcome Measure Information:
Title
Bladder Tumor Recurrence Rate
Description
The bladder tumor recurrence rate will be measured by the percentage of subjects who are confirmed by bladder biopsy to have a recurrence of urothelial carcinoma in the bladder following nephroureterectomy
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Time to Bladder Tumor Recurrence
Description
The time to bladder tumor recurrence will be characterized using Kapalan-Meier plots.
Time Frame
3 years
Title
Bladder Tumor Recurrence Rate
Description
The bladder tumor recurrence rate will be measured by the proportion of subjects who are confirmed by bladder biopsy to have a recurrence of urothelial carcinoma in the bladder following nephroureterectomy
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Both males and females ≥ eighteen years of age Clinical diagnosis of urothelial carcinoma of the renal pelvis and/or ureter. Clinical diagnosis of urothelial carcinoma may be based upon radiographic, pathologic or cytological findings alone or in combination with one another. No other histology is allowed. The TNM stage of the subject's disease (using the American Joint Committee on Cancer [AJCC] Cancer Staging Manual, 8th Edition) must be Tis, Ta, T1, T2, or T3, N0, M0. Subjects may have either a high-grade or low-grade tumor. ECOG performance status of 0-2 Written informed consent obtained from the subject and the ability for the subject to comply with all the study-related procedures. Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy prior to and for at least 3 months after mitomycin C instillation to minimize the risk of pregnancy. Prior to study enrollment, women of childbearing potential must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. Males with female partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) should avoid conceiving children prior to and for 3 months following mitomycin C instillation Subjects must have hemoglobin ≥ 9 g/dL and a platelet count ≥ 100,000/μL. Exclusion Criteria: Active urothelial carcinoma of the bladder within 12 months prior to enrollment History of adverse reaction to mitomycin C Evidence of regional or metastatic disease. History of radical cystectomy Planned radical cystectomy at the time of nephroureterectomy Females or males of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy prior to and for at least 3 months after mitomycin C instillation. Females who are pregnant or breastfeeding. History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician. Prisoners or subjects who are involuntarily incarcerated. Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness. Subjects demonstrating an inability to comply with the study and/or follow-up procedures
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Crispen, MD
Organizational Affiliation
University of Florida
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Trial of Mitomycin C During Nephroureterectomy for Urothelial Carcinoma

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