Overview

This trial is active, not recruiting.

Condition bladder cancer
Treatments apaziquone, placebo
Phase phase 3
Sponsor Spectrum Pharmaceuticals, Inc
Start date September 2015
End date November 2020
Trial size 1869 participants
Trial identifier NCT02563561, SPI-EOQ-13-305

Summary

This is a Phase 3, randomized, multicenter, multi-arm, placebo-controlled, double-blind study of apaziquone in patients with ≤4 non-muscle invasive bladder tumors, ≤3.5 cm in diameter, all of which must have been fully resected at TURBT.

In addition to Screening, patients will undergo an assessment of urothelial carcinoma of the bladder via cystoscopy for clinically apparent tumor Ta, G1-G2.

Following TURBT on Day 1, eligible patients will be randomized to one of three treatment arms in a 1:1:1 ratio:

Arm 1 : One dose of Apaziquone

Arm 2 : Two Doses of Apaziquone

Arm 3 : Placebo

Primary endpoint is to evaluate the Time to Recurrence with either a one instillation of 4 mg apaziquone or two instillations of 4 mg apaziquone relative to placebo instillation following TURBT in patients with non-muscle invasive bladder cancer (NMIBC) who receive transurethral resection bladder tumor (TURBT).

United States California
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification safety/efficacy study
Intervention model parallel assignment
Masking double blind (subject, caregiver, investigator)
Primary purpose treatment
Arm
(Experimental)
One Dose of Apaziquone and One Dose of Placebo
apaziquone EOquin
The first dose of either 4 mg/40 mL apaziquone or placebo will be administered by intravesical administration into the bladder at 60±30 minutes post TURBT (randomization date, Day 1) via an indwelling 100% Silicone Foley catheter. The second dose of either 4 mg/40 mL apaziquone or placebo will administered by intravesical administration via an indwelling catheter on Day 15 (±5 days).
placebo
Matching placebo containing 12 mg FD&C red #40, 15 mg sodium chloride, and 10 mg mannitol is supplied in identical appearing vials.
(Experimental)
Two Doses of Apaziquone
apaziquone EOquin
The first dose of either 4 mg/40 mL apaziquone or placebo will be administered by intravesical administration into the bladder at 60±30 minutes post TURBT (randomization date, Day 1) via an indwelling 100% Silicone Foley catheter. The second dose of either 4 mg/40 mL apaziquone or placebo will administered by intravesical administration via an indwelling catheter on Day 15 (±5 days).
(Placebo Comparator)
Two Doses of Placebo
placebo
Matching placebo containing 12 mg FD&C red #40, 15 mg sodium chloride, and 10 mg mannitol is supplied in identical appearing vials.

Primary Outcomes

Measure
Time to Recurrence
time frame: 2 Years

Secondary Outcomes

Measure
2-Year Recurrence Rate
time frame: 2 Years
1-Year Recurrence Rate
time frame: 1 Year
Time to progression
time frame: 2 Years
Adverse Events
time frame: 2 Years

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: 1. Patient must have a diagnosis with urothelial carcinoma of the bladder with clinically apparent tumor Ta, G1-G2. 2. Patient will have ≤4 tumors, none of which exceeds 3.5 cm in diameter. 3. Patient must be willing to give written informed consent and must be able to adhere to dosing and visit schedules, and meet all study requirements. 4. Patient is at least 18 years of age at randomization. 5. Patient must be willing to practice two forms of contraception, one of which must be a barrier method, from study entry until at least 35 days after the last dose of the study drug. 6. Females of childbearing potential must have a negative pregnancy test within 30 days prior to randomization. Females who are postmenopausal for at least 1 year (defined as more than 12 months since last menses) or are surgically sterilized do not require this test. Exclusion Criteria: 1. Patient has an active concurrent malignancy/life-threatening disease. If there is a history of prior malignancies/life-threatening diseases, the patient is to be disease free for at least 5 years. Patients with other prior malignancies less than 5 years before study entry may still be enrolled if they have received treatment resulting in complete resolution of the cancer and currently have no clinical, radiologic, or laboratory evidence of active or recurrent disease. 2. Patient has positive urine cytology for malignancy at Screening. 3. Patient has an active uncontrolled infection, including a urinary tract infection, underlying medical condition, or other serious illness that would impair the ability of the patient to receive protocol treatment. 4. Patient has used any investigational drugs, biologics, or devices within 30 days prior to study treatment or plans to use any of these during the course of the study. 5. Patient has had any prior intravesical chemotherapy, immunotherapy, or previous exposure to apaziquone. 6. Patient has or has ever had - Upper tract Transitional Cell Carcinoma (TCC). - Urethral tumor (prostatic urethra included). - Any invasive bladder tumor known to be other than tumor Ta, G1-G2. - Any evidence of lymph node or distant metastasis. - Any bladder tumor with histology other than TCC. - Carcinoma in situ (CIS). 7. Patient has a tumor in a bladder diverticulum. 8. Patient has received any pelvic radiotherapy (including external beam and/or brachytherapy.) 9. Patient has a bleeding disorder or a screening platelet count <100×109/L. 10. Patient has screening hemoglobin <10 mg/dL. 11. Patient has any unstable medical condition that would make it unsafe to undergo TURBT. 12. Patient has a history of interstitial cystitis. 13. Patient has a history of allergy to red color food dye. 14. For patients with recurrent tumor, the patient had at least a 6-month cystoscopically-confirmed tumor-free interval between the last tumor recurrence and screening cystoscopic examination. 15. Patient is pregnant or breast-feeding.

Additional Information

Official title A Multicenter, Multi-Arm, Randomized, Multi-Dose, Placebo-Controlled, Double-Blind, Phase 3 Study of Intravesical Apaziquone (EOquin®) as a Surgical Adjuvant in the Immediate Postoperative Period in Patients Undergoing TURBT
Description This is a Phase 3, randomized, multicenter, multi-arm, placebo-controlled, double-blind study of apaziquone in patients with ≤4 non-muscle invasive bladder tumors, ≤3.5 cm in diameter, all of which must have been fully resected at TURBT. In addition to Screening, patients will undergo an assessment of urothelial carcinoma of the bladder via cystoscopy for clinically apparent tumor Ta, G1-G2. Following TURBT on Day 1, eligible patients will be randomized to one of three treatment arms in a 1:1:1 ratio : Arm 1 : One Dose of Apaziquone: - Day 1: administration of 4 mg of apaziquone 60±30 minutes post-TURBT - Day 15 (±5 days): administration of placebo Arm 2 : Two Doses of Apaziquone : - Day 1 : administration of 4 mg of apaziquone 60±30 minutes post-TURBT - Day 15 (±5 days): administration of 4 mg of apaziquone Arm 3: Placebo : - Day 1 : administration of placebo 60±30 minutes post-TURBT - Day 15 (±5 days) : administration of placebo Once randomized, Day 1 study drug instillation will occur 60 ±30 minutes post TURBT. Patients will return on Day 15 (±5 days) for a second instillation unless their pathology results are available and show non Ta, G1-G2 histology; in the absence of local pathology results by the Day 15 visit, patients will receive a second instillation of study drug. All histology specimens will be reviewed by a local pathology laboratory and all clinical treatment decisions and study analyses will be based on the local pathology review. Patients whose pathology is other than Ta, G1-G2 will be followed for safety at Day 35 (±5 days) from the last dose of study drug and then discontinued from the study. Patients with pathology confirmed Ta, G1-G2 disease will be followed according to the schedule below : - Cystoscopic examination and urine cytology every 90 days (±10 days) (calculated from date of TURBT) through 24 months for tumor recurrence and progression. - If at any time during the 24 month follow up period there is a tumor recurrence, the patient will continue on study with follow-up cystoscopic examination and urine cytology every 90 days (±10 days) (calculated from date of TURBT) through the end of 24 months. Patients with a recurrence are permitted to have a follow-up TURBT. - If at any time during the 24 month follow up period there is a tumor recurrence and/or patient is started on another therapy, the patient will be followed by telephone, for safety every 90 days (±10 days) (calculated from date of TURBT) through the end of 24 months. Duration of Study: The duration of the study for each patient will be approximately 24 months including: - Screening Period : 30-days - Treatment Period : Day 1 and Day 15 (±5 days) - Safety and Follow-up Period: 24-months
Trial information was received from ClinicalTrials.gov and was last updated in December 2016.
Information provided to ClinicalTrials.gov by Spectrum Pharmaceuticals, Inc.