Study to Improve Detection and Early Recurrence Rate in Bladder Cancer Patients Using Hexvix Fluorescence Cystoscopy

NCT ID: NCT00233402

Last Updated: 2013-10-11

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

789 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-01-31

Study Completion Date

2008-08-31

Brief Summary

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The purpose of this study is to document the additional detection of papillary bladder cancer and the reduced early recurrence due to the improved detection and resection of these tumors after Hexvix cystoscopy compared to standard cystoscopy in patients with papillary bladder cancer.

Detailed Description

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In superficial bladder cancer macroscopic tumors including non-invasive papillary tumors (Ta) in the bladder are relatively easy to visualize by cystoscopic examination under white light. However, dysplasia, carcinoma in situ (CIS) or small exophytic tumors are easily overlooked. These lesions are predictive of recurrence and progression of disease, and the identification of these lesions is a crucial factor for the prognosis of the patient. The present situation with 50-75% recurrence rate show the inadequacy of white light cystoscopy for detection and resection of the lesions.

A better detection of papillary bladder cancer and early detection of CIS lesions will provide the patient with a more complete TURB, a more optimal pharmacological treatment when needed, may reduce the need for follow up cystoscopies and hopefully result in a better prognosis for the patient.

The aim of the present study is to compare Hexvix cystoscopy with white light cystoscopy in the detection of histology confirmed papillary bladder cancer in patients with papillary bladder cancer and to compare early recurrence rate after Hexvix and white light transurethral resection (TURB) with white light TURB in patients with superficial bladder cancer.

Conditions

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Bladder Cancer

Keywords

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Bladder Cancer Hexvix Fluorescence Cystoscopy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

NONE

Study Groups

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Standard White Light Cystoscopy

Group Type ACTIVE_COMPARATOR

Standard white light cystoscopy

Intervention Type PROCEDURE

Standard White Light and Hexvix Fluorescence Cystoscopy

Group Type EXPERIMENTAL

Hexvix

Intervention Type DRUG

Single Instillation, Transurethral Resection of the Bladder

Standard white light cystoscopy

Intervention Type PROCEDURE

Interventions

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Hexvix

Single Instillation, Transurethral Resection of the Bladder

Intervention Type DRUG

Standard white light cystoscopy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

The patients should be indicated for a cystoscopic examination for suspected or verified papillary bladder cancer and fulfill one or more of the following criteria:

* Patients with more than one initial bladder tumor confirmed on an outpatient cystoscopy.
* Patients having recurrence within 12 months confirmed on an outpatient cystoscopy
* Patients with more than one papillary lesion at recurrence independently of the time of the recurrence confirmed on an outpatient cystoscopy

Exclusion Criteria

* Patients with known tumors in the prostatic urethra or distal urethra
* Gross hematuria. (Note: Gross hematuria is defined as a heavy bladder bleed resulting in marked amounts of blood in the urine, which may interfere with fluorescence cystoscopy. Where the bleed is light, the patient should not be excluded if in the investigator's opinion, rinsing during cystoscopy will alleviate the possible interference with fluorescence cystoscopy).
* Patient with porphyria.
* Known allergy to hexyl aminolevulinate hydrochloride or a similar compound.
* Participation in other clinical studies with investigational drugs either concurrently or within the last 30 days.
* Pregnant or breast-feeding (all women of child-bearing potential must document a negative serum or urine pregnancy test at screening and use the contraceptive pill or intrauterine device (IUD) during the treatments and for at least one month thereafter).
* Patients who have received BCG or chemotherapy within three months prior to the initial cystoscopy/TURB, except for a single dose of chemotherapy for prevention of seeding after resection.
* Conditions associated with a risk of poor protocol compliance.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Photocure

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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H Barton Grossman

Role: PRINCIPAL_INVESTIGATOR

The University of Texas, MD Anderson Cancer Center, Department of Urology

Locations

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Stanford Cancer Center, Department of Urology

Stanford, California, United States

Site Status

V.A. Medical Center

Gainesville, Florida, United States

Site Status

University of Miami School of Medicine

Miami, Florida, United States

Site Status

South Florida Clinical Research Center, Inc.

Pembroke Pines, Florida, United States

Site Status

The Emory Clinic, Dept of Urology

Atlanta, Georgia, United States

Site Status

Boston University School of Medicine

Boston, Massachusetts, United States

Site Status

St. Joseph Mercy Hospital- Ann Arbor

Ann Arbor, Michigan, United States

Site Status

Urologic Clinical Research Unit, Gonda 7102, Mayo Clinic Rochester

Rochester, Minnesota, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Mount Sinai Medical Center, Department of Urology

New York, New York, United States

Site Status

URMC

Rochester, New York, United States

Site Status

Urological Institute at Beachwood Cleveland Clinic

Beachwood, Ohio, United States

Site Status

Thomas Jefferson Medical College, Department of Neurology

Philadelphia, Pennsylvania, United States

Site Status

Vanderbilt University Medical Center, Department of Urologic Surgery

Nashville, Tennessee, United States

Site Status

Baylor College of Medicine, Scott Department of Urology

Houston, Texas, United States

Site Status

AKH, Klinik für Urologie der Universität Wien

Vienna, , Austria

Site Status

Kingston General Hospital

Kingston, Ontario, Canada

Site Status

CHUQ Hotel-Dieu de Quebec

Québec, , Canada

Site Status

University Clinic of Giessen, Department of Urology

Giessen, , Germany

Site Status

Klinikum der Universität München-Großhardern, Urologische Klinik und Poliklinik

München, , Germany

Site Status

Urologische Klinik München-Planegg

Planegg, , Germany

Site Status

Akadem. Lehrkrankenhaus der Uni Regensburg, Klinik für Urologie

Regensburg, , Germany

Site Status

Universitätsklinik Tuebingen, Universitätsklinik für Urologie

Tübingen, , Germany

Site Status

Department of Urology, Academic Medical Center, University of Amsterdam

Amsterdam, , Netherlands

Site Status

Department of Urology, UMC St. Radboud

Nijmegen, , Netherlands

Site Status

Countries

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United States Austria Canada Germany Netherlands

References

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Stenzl A, Burger M, Fradet Y, Mynderse LA, Soloway MS, Witjes JA, Kriegmair M, Karl A, Shen Y, Grossman HB. Hexaminolevulinate guided fluorescence cystoscopy reduces recurrence in patients with nonmuscle invasive bladder cancer. J Urol. 2010 Nov;184(5):1907-13. doi: 10.1016/j.juro.2010.06.148. Epub 2010 Sep 17.

Reference Type DERIVED
PMID: 20850152 (View on PubMed)

Other Identifiers

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PC B305/02

Identifier Type: -

Identifier Source: org_study_id

NCT00209157

Identifier Type: -

Identifier Source: nct_alias