Mycobacterial Cell Wall-DNA Complex in Treatment of BCG-refractory Patients With Non-muscle Invasive Bladder Cancer

NCT ID: NCT00406068

Last Updated: 2016-07-28

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/PHASE3

Total Enrollment

129 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-11-30

Study Completion Date

2011-07-31

Brief Summary

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The purpose of this study is to determine the efficacy and safety of intravesical Mycobacterial Cell Wall-DNA Complex (MCC) in patients with non-muscle invasive transitional cell carcinoma (papillary tumors and/or carcinoma in situ) of the urinary bladder at high risk of progression who are refractory to therapy with bacillus Calmette-Guerin (BCG).

Detailed Description

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The study will be divided into 3 phases: Induction, Maintenance, and Follow-up.

The Induction Phase will cover a period of 6 weeks. During this time, patients will receive 6 weekly intravesical instillations of 8 mg MCC. The patients will be evaluated at month 3, at which time the patients will enter the Maintenance Phase. The Maintenance Phase will last from month 3 to month 24, and during this time, patients will receive weekly MCC instillations for three weeks at months 3, 6, 12, 18, and 24 and evaluations will be performed at months 3, 6, 9, 12, 15, 18, 21 and 24.

At month 3, the patient will be evaluated to assure that the disease is not progressing. Cytology, cystoscopy and biopsies will be performed to obtain adequate staging (if residual tumor persists). If the patient is disease-free, maintenance therapy will be initiated. Patients with non-muscle invasive tumors at month 3 will, at the discretion of the investigator, receive either a second 6-week induction course or a 3-week maintenance course. Patients who show progression to muscle invasive disease will be referred to other treatments.

At month 6 and thereafter at each evaluation visit, patients will be evaluated and managed according to the following results:

* Patients who are disease-free will continue on maintenance treatment.
* Patients who are not disease-free (evidence of papillary lesions, CIS or muscle invasive disease) will be withdrawn from further study treatment and will be referred to other therapies at the discretion of the investigator.

The final 36 months of the study is the Follow-up Phase. Evaluations will be performed at months 30, 36, 42, 48, 54 and 60.

Efficacy evaluations will include standard cystoscopy, biopsies and urine cytology. During the Maintenance Phase, standard cystoscopies will be performed at months 3, 6, 9, 12, 15, 18, 21 and 24 for the surveillance of bladder tumors. During the months that instillations will be performed, cystoscopies will be conducted only once at each of these months. During the Follow-up Phase, cystoscopies will be performed at months 30, 36, 42, 48, 54 and 60.

Mandatory bladder biopsies will be done for all patients at month 6.

During the course of the study, biopsies will be taken only if evident or suspicious lesions are seen during cystoscopy or in case of negative cystoscopy but positive cytology.

Conditions

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Bladder Neoplasms

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Mycobacterial cell wall-DNA complex

Mycobacterial cell wall-DNA complex

Group Type EXPERIMENTAL

Mycobacterial cell wall-DNA complex

Intervention Type DRUG

8 mg MCC, intravesical - Induction Phase (6 weekly intravesical instillations) and Maintenance Phase (3 weekly instillations at months 3, 6, 12, 18 and 24).

Interventions

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Mycobacterial cell wall-DNA complex

8 mg MCC, intravesical - Induction Phase (6 weekly intravesical instillations) and Maintenance Phase (3 weekly instillations at months 3, 6, 12, 18 and 24).

Intervention Type DRUG

Other Intervention Names

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MCC - Urocidin

Eligibility Criteria

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Inclusion Criteria

* Patients refractory to BCG therapy;
* Patients with histologically confirmed diagnosis of high grade lesions;
* Diagnosis of high grade lesion must be within 56 days prior to beginning of study treatment;
* Have had all visible papillary lesion(s) resected by TURBT within 56 days prior to beginning of study treatment;
* Available for the whole duration of the study including follow-up (60 months);
* Life expectancy of \> 5 years;
* Patients with an ECOG performance status grade of 2 or less;
* Absence of urothelial carcinoma involving the upper urinary tract or prostatic urethra within 12 months from beginning of study treatment;
* Able to understand and give written informed consent;
* In the investigator's judgment, the patient is able to participate in the study.

Exclusion Criteria

* Current or previous history of muscle invasive tumors;
* Current or previous history of lymph node or distant metastases from bladder cancer;
* Current systemic cancer therapy;
* Current or prior pelvic external beam radiotherapy;
* Pelvic brachytherapy within 2 years of study entry;
* Prior treatment with MCC;
* Patients with existing urinary tract infection or recurrent severe bacterial cystitis;
* Clinically significant and unexplained elevations of liver or renal function tests;
* White blood cell count below 3 x109/L (3,000/mm3) or platelet count below 100 x 109/L(100,000/mm3);
* Severe cardiovascular disease;
* Women who are pregnant or lactating;
* Congenital or acquired immune deficiency;
* With history of malignancy of any organ system, treated or untreated, within the past 5 years (with the exception of adequately treated basal cell or squamous cell carcinoma of the skin, stage T1 prostate cancer, carcinoma in situ of the cervix or colon polyps);
* Previous investigational treatment within 3 months from beginning of study treatment;
* Patients who cannot hold the instillation for one hour;
* Patients who cannot tolerate intravesical administration or intravesical surgical manipulation (cystoscopy or biopsy);
* Clinically significant active infections;
* Any medical or psychiatric condition which, in the opinion of the investigator, would preclude the participant from adhering to the protocol or completing the trial per protocol.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bioniche Life Sciences Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alvaro Morales, MD

Role: PRINCIPAL_INVESTIGATOR

Centre for Applied Urological Research, Kingston General Hospital/Queen's University

Locations

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BCG Oncology

Phoenix, Arizona, United States

Site Status

San Diego Clinical Trials

San Diego, California, United States

Site Status

Connecticut Urological Research at Grove Hill

New Britain, Connecticut, United States

Site Status

University of Miami School of Medicine

Miami, Florida, United States

Site Status

Winter Park Urology Associates P.A.

Orlando, Florida, United States

Site Status

The University of Chicago Hospitals

Chicago, Illinois, United States

Site Status

Welborn Clinic

Evansville, Indiana, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Chesapeake Urology Research Associates

Towson, Maryland, United States

Site Status

Sheldon J Freedman, MD, Ltd

Las Vegas, Nevada, United States

Site Status

Delaware Valley Urology, LLC-Voorhees

Voorhees Township, New Jersey, United States

Site Status

Memorial Sloan Kettering Cancer Centre

New York, New York, United States

Site Status

Hudson Valley Urology

Poughkeepsie, New York, United States

Site Status

University of Rochester Medical Center

Rochester, New York, United States

Site Status

Triangle Urology Group

Pittsburgh, Pennsylvania, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Urology Clinics of North Texas, P.A.

Dallas, Texas, United States

Site Status

M.D. Anderson Cancer Center

Houston, Texas, United States

Site Status

Urology San Antonio Research, PA

San Antonio, Texas, United States

Site Status

Sentara Medical Group - Urology of Virginia, PC

Norfolk, Virginia, United States

Site Status

Andreou Research

Surrey, British Columbia, Canada

Site Status

Can-Med Clinical Research

Victoria, British Columbia, Canada

Site Status

Dr. Steinhoff Clinical Research

Victoria, British Columbia, Canada

Site Status

Centre for Applied Urological Research

Kingston, Ontario, Canada

Site Status

London Health Sciences Centre

London, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

University Health Network / Princess Margaret Hospital

Toronto, Ontario, Canada

Site Status

The Male Health Center

Toronto, Ontario, Canada

Site Status

Centre Hospitalier de l'Universite de Montreal

Montreal, Quebec, Canada

Site Status

Jewish General Hospital

Montreal, Quebec, Canada

Site Status

Centre de Recherche du CHUQ

Québec, Quebec, Canada

Site Status

Countries

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United States Canada

References

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Morales A, Herr H, Steinberg G, Given R, Cohen Z, Amrhein J, Kamat AM. Efficacy and safety of MCNA in patients with nonmuscle invasive bladder cancer at high risk for recurrence and progression after failed treatment with bacillus Calmette-Guerin. J Urol. 2015 Apr;193(4):1135-43. doi: 10.1016/j.juro.2014.09.109. Epub 2014 Oct 5.

Reference Type RESULT
PMID: 25286009 (View on PubMed)

Other Identifiers

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HIS-0611-0602

Identifier Type: -

Identifier Source: org_study_id

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