Efficacy and Safety of Multi-Instillations of Apaziquone in Patients With Non-Muscle Invasive Bladder Cancer
This trial has been terminated.
|Sponsor||Spectrum Pharmaceuticals, Inc|
|Start date||July 2011|
|End date||March 2014|
|Trial size||66 participants|
|Trial identifier||NCT01410565, SPI-1011|
This is an international, multicenter, double-blind, placebo-controlled, randomized study. All eligible patients entering the open label phase of the study will receive a single immediate instillation of apaziquone (4 mg in 40 mL diluent), post transurethral resection-bladder tumor (TURBT). Following Central Pathology review of histology and Double Blind Phase qualification, patients with confirmed eligibility will be randomized to receive either 6 weekly intravesical instillations of apaziquone or matching placebo and undergo cystoscopic and safety assessments every 3 months for 24 months from randomization. Patients with histologic evidence of recurrent disease during the study will be treated according to current treatment guidelines or local standard of care. Safety and efficacy assessments will be performed at 3 month intervals for all randomized patients throughout the study. Patients who receive single dose of apaziquone immediately following TURBT and are not eligible for randomization will be followed for 3 months by cystoscopic exam and safety assessments.
|United States||No locations recruiting|
|Other countries||No locations recruiting|
|Glendale, AZ||Valley Urologic Associates||terminated|
|Phoenix, AZ||Precision Trials, LLC||terminated|
|Laguna Woods, CA||South Orange County Medical Research Center||terminated|
|Denver, CO||The Urology Center of Colorado||terminated|
|Middlebury, CT||Connecticut Clinical Research Center||terminated|
|Marietta, GA||Urology Enterprises||terminated|
|Coeur d'Alene, ID||North Idaho Urology||terminated|
|Meridian, ID||Idaho Urologic Institute, P.A.||terminated|
|Ft. Wayne, IN||Northeast Indiana Research, LLC||terminated|
|Jeffersonville, IN||First Urology, PSC||terminated|
|Shreveport, LA||Regional Urology, LLC||terminated|
|Annapolis, MD||Anne Arundel Urology||terminated|
|Grand Rapids, MI||Spectrum Health Medical Group||terminated|
|Minneapolis, MN||University of Minnesota||terminated|
|Missoula, MT||Five Valleys Urology||terminated|
|Voorhees, NJ||Delaware Valley Urology, LLC - Voorhees||terminated|
|Westampton, NJ||Delaware Valley Urology, LLC-Westampton||terminated|
|New York, NY||University Urology Associates||terminated|
|Rochester, NY||Urology Associates of Rochester, LLC||terminated|
|Cincinnati, OH||TriState Urologic Services PSC, Inc.||terminated|
|Bala Cynwyd, PA||Urologic Consultants of Southeastern Pennsylvania, LLP||terminated|
|Bryn Mawr, PA||Urology Health Specialists||terminated|
|Lancaster, PA||Urological Associates of Lancaster||terminated|
|Myrtle Beach, SC||Carolina Urologic Research Center||terminated|
|McAllen, TX||Urology Associates of South Texas||terminated|
|Virginia Beach, VA||Urology of Virginia, PC||terminated|
|Virginia Beach, VA||Urology of Virginia, PLLC||terminated|
|Mountlake Terrace, WA||Integrity Medical Research, LLC||terminated|
|Victoria, Canada||G. Steinhoff Clinical Research Pacific Urologic Research||terminated|
|Halifax, Canada||Queen Elizabeth II Health Science Center||terminated|
|Barrie, Canada||The Male/Female Health and Research Centre - Royal Court Medical Centre||terminated|
|Brantford, Canada||Brantford Urology Research||terminated|
|Burlington, Canada||G. Kenneth Jansz Medicine Professional Corporation||terminated|
|Burlington, Canada||Urology Resource Centre||terminated|
|Kingston, Canada||Kingston General Hospital / Queen's University||terminated|
|Kitchener, Canada||Urology Associates, Urologic Medical Research||terminated|
|Newmarket, Canada||Mor Urology, Inc.||terminated|
|North Bay, Canada||Office of Bernard Goldfarb||terminated|
|North York, Canada||Stanley Flax Medical Professional Corporation||terminated|
|Oakville, Canada||The Fe/Male Health Centre||terminated|
|Scarborough, Canada||Urology/Male Infertility||terminated|
|Toronto, Canada||Sunnybrook Health Sciences Centre||terminated|
|Toronto, Canada||University Health Network Princess Margaret Hospital||terminated|
|Montreal, Canada||Centre universitaire de sante McGill||terminated|
|Sherbrooke, Canada||Centre Hospitalier Universitaire de Sherbrooke||terminated|
|Quebec, Canada||Centre Hospitalier Universitaire de Quebec||terminated|
|Endpoint classification||safety/efficacy study|
|Intervention model||parallel assignment|
|Masking||double blind (subject, caregiver, investigator, outcomes assessor)|
Time to Recurrence
time frame: Recurrence of cancer in the bladder during 24 months of follow-up
Recurrence Rate at 24 Months
time frame: 24 months
Participants With Treatment Emergent Adverse Events (TEAEs)
time frame: 24 Months from Randomization
Male or female participants at least 18 years old.
- Has the patient given written informed consent and is the patient willing and able to abide by the protocol?
- Is the patient 18 years old or above?
- If the patient is a female of childbearing potential, is she using an acceptable/effective method of contraception?
- Does the female patient of childbearing potential have a negative serum pregnancy test at screening?
- Does the patient with clinically apparent primary or recurrent low grade Ta NMIBC have :
- multiple tumors (2-7)
- No single Tumor > 3 cm
- No history / evidence of Tis Or does the patient with clinically apparent primary or recurrent high grade Ta NMIBC have:
- A single tumor that is ≤ 3 cm
- No history / evidence of Tis
- Is the patient able to retain bladder instillations for a minimum of 60 minutes?
- Did the patient have upper urinary tract evaluation to exclude urothelial carcinoma, hydronephrosis or renal cell carcinoma or other renal cancers in the 6 months prior to study screening?
- Is patient's urethra (including prostatic urethra in men) endoscopically free of any visible TCC?
- For patients with recurrent tumor, did the patient have at least a 6-month cystoscopically-confirmed tumor-free interval between the last tumor recurrence and the time of screening?
- Has the male patient with a prostate specific antigen (PSA) between 4 and 10 ng/mL had a diagnostic evaluation that reasonably excludes the diagnosis of prostate cancer in the opinion of the Investigator? Double-Blind Phase Inclusion Criteria:
- Was all visible tumor resected at the initial TURBT?
- Does Central Pathology review of the patient's bladder tumor confirm:
- Low grade Ta disease for multiple tumors (2 - 7) or
- High Grade Ta disease for single tumor
- No microscopic evidence of lymphovascular invasion and/or evidence of tumor thromboemboli Exclusion Criteria: Open Phase
- Has the patient received any previous pelvic radiotherapy (includes external beam and/or brachytherapy)?
- Has the patient ever received apaziquone?
- Has the patient received an induction course (completed 5 of 6 scheduled weekly instillations) of intravesical BCG (± interferon) with the last dose given less than 12 months ago?
- Has the patient had any prior intravesical chemotherapy, exclusive of single-dose adjuvant intravesical chemotherapy immediately post-TURBT?
- Does the patient have a history of urinary retention or a post void residual ≥ 250 cc by bladder scan or ultrasound (post void residual test may be repeated up to 3 times)?
- Does the patient have or has the patient had any bladder tumor with histology other than transitional cell carcinoma?
- Does the patient have or has the patient had micro-papillary transitional cell carcinoma?
- If the patient has recurrent papillary disease of the bladder, has the pathology been anything other than pTa in the past?
- Does the patient have an active urinary tract infection confirmed by culture or a documented history of recurrent UTI (≥ 6 for females and ≥2 for males per year) in the prior 2 years?
- Does the patient have a bleeding disorder or a screening platelet count < 50 x 109/L?
- Does the patient have a screening hemoglobin < 10 mg/dL?
- Does the male patient have a serum PSA > 10 ng/mL?
- Does the patient have a history of Acquired Immunodeficiency Syndrome or HIV positive?
- Does the patient have a condition or a concurrent severe and/or uncontrolled medical or psychiatric disease (e.g., uncontrolled diabetes, decompensated congestive heart failure, myocardial infarction within 6 months of study, unstable and uncontrolled hypertension, or an active uncontrolled infection), which could compromise participation, compliance with scheduled visits and/or completion of the study?
- Has the patient participated in an investigational protocol within the past 90 days?
- Is the patient pregnant or breast feeding?
- Does the patient have a life expectancy of <3 years?
- Has the patient had any other malignancy or received therapy for any malignancy in the last five years except
- non-melanoma skin tumors
- stage 0 (in situ) cervical carcinoma
- undetectable PSA for ≥1 year following definitive therapy for localized prostate cancer?
- Does the patient have documented vesicoureteral reflux or an indwelling ureteral stent?
- Does the patient have tumor in a bladder diverticulum?
- Does the patient have a known allergy to red color food dye?
|Official title||A Phase 3 International, Multicenter, Double-Blind, Placebo-Controlled, Randomized Trial Evaluating the Efficacy and Safety of Multiple Instillations of Intravesical Apaziquone vs. Placebo in Patients With Low-Intermediate Risk Non-Muscle Invasive Bladder Cancer (NMIBC)|
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