Neoadjuvant Ifosfamide, Doxorubicin, Gemcitabine, and Cisplatin in Treating Patients Who Are Undergoing Radical Cystectomy for Locally Advanced Carcinoma (Cancer) of the Urothelium

NCT ID: NCT00080795

Last Updated: 2012-10-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-07-31

Study Completion Date

2006-05-31

Brief Summary

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RATIONALE: Drugs used in chemotherapy, such as ifosfamide, doxorubicin, gemcitabine, and cisplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug, and giving them before surgery, may shrink the tumor so that it can be removed.

PURPOSE: This phase II trial is studying how well neoadjuvant combination chemotherapy works in treating patients undergoing radical cystectomy for locally advanced carcinoma of the urothelium.

Detailed Description

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OBJECTIVES:

Primary

* Determine the response rate and 4-year disease-free survival of patients with locally advanced carcinoma of the urothelium undergoing radical cystectomy treated with neoadjuvant chemotherapy comprising ifosfamide, doxorubicin, and gemcitabine followed by cisplatin, gemcitabine, and ifosfamide.

Secondary

* Compare perioperative morbidity and mortality of patients treated with this regimen vs historical standards.

OUTLINE: Patients receive neoadjuvant chemotherapy comprising ifosfamide IV over 3 hours on days 1-4, doxorubicin IV on day 3, gemcitabine IV over 30 minutes on days 2 and 4, and filgrastim (G-CSF) subcutaneously on days 7-12 or until blood counts recover. Treatment repeats every 3 weeks for a total of 3 courses. Patients then receive cisplatin IV, gemcitabine IV over 90 minutes, and ifosfamide IV over 30 minutes on day 1. Treatment repeats every 2 weeks for a total of 4-6 courses. Four to six weeks after the completion of all neoadjuvant chemotherapy, patients undergo cystectomy.

Patients are followed at 9, 12, 15, 18, 24, and 30 months and then annually thereafter.

PROJECTED ACCRUAL: A total of 31-49 patients will be accrued for this study within 16-25 months.

Conditions

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Bladder Cancer Transitional Cell Cancer of the Renal Pelvis and Ureter Urethral Cancer

Keywords

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stage III bladder cancer regional transitional cell cancer of the renal pelvis and ureter anterior urethral cancer posterior urethral cancer urethral cancer associated with invasive bladder cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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filgrastim

Intervention Type BIOLOGICAL

cisplatin

Intervention Type DRUG

doxorubicin hydrochloride

Intervention Type DRUG

gemcitabine hydrochloride

Intervention Type DRUG

ifosfamide

Intervention Type DRUG

conventional surgery

Intervention Type PROCEDURE

neoadjuvant therapy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed carcinoma of the urothelium, meeting 1 of the following criteria for locally advanced disease:

* Clinical stage T3b disease, defined by presence of a mass on examination under anesthesia
* Clinical stage T4a disease, defined by direct invasion of prostatic stroma, vagina, or rectum
* Lymphovascular invasion on transurethral resection specimen
* Upper tract disease or micropapillary histology allowed
* No evidence of disease outside the pelvis

PATIENT CHARACTERISTICS:

Age

* Any age

Performance status

* 0-2

Life expectancy

* Not specified

Hematopoietic

* Bone marrow function adequate

Hepatic

* Liver function adequate

Renal

* Creatinine clearance ≥ 45 mL/min

Cardiovascular

* Ejection fraction ≥ 50%

Other

* Not pregnant
* No other malignancy likely to be life-threatening within the next 4 years

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* Not specified

Endocrine therapy

* Not specified

Radiotherapy

* Not specified

Surgery

* See Disease Characteristics
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Randall E. Millikan, MD, PhD

Role: STUDY_CHAIR

M.D. Anderson Cancer Center

Colin P. Dinney, MD

Role: STUDY_CHAIR

M.D. Anderson Cancer Center

Locations

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M.D. Anderson Cancer Center at University of Texas

Houston, Texas, United States

Site Status

Countries

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United States

Other Identifiers

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MDA-ID-01317

Identifier Type: -

Identifier Source: secondary_id

ID01-317

Identifier Type: OTHER

Identifier Source: secondary_id

CDR0000355361

Identifier Type: -

Identifier Source: org_study_id