Preoperative Intravesical Electromotive Mitomycin-c for Primary Non-muscle Invasive Bladder Cancer

NCT ID: NCT01149174

Last Updated: 2011-10-04

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

PHASE3

Total Enrollment

352 participants

Study Classification

INTERVENTIONAL

Study Start Date

1994-01-31

Study Completion Date

2009-06-30

Brief Summary

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Early single instillation of chemotherapy after TUR is recommended in the European Association of Urology Guidelines. Nevertheless, the procedure is suboptimal for patients with multiple tumors, sometimes is not tolerated and it can results in severe complications. In both laboratory and clinical studies, intravesical electromotive drug administration (EMDA) increases mitomycin-C (MMC) bladder uptake, resulting in an improved clinical efficacy in non-muscle invasive bladder cancer (NMIBC). The investigators will compare the effects of one immediate pre-TUR intravesical EMDA/MMC instillation with one immediate post-TUR intravesical passive diffusion MMC (PD/MMC) instillation and TUR alone in patients with NMIBC.

All eligible patients with primary NMIBC will be randomized into 3 groups who will undergo transurethral resection alone (TUR/alone); TUR plus single immediate postoperative instillation (immediately after TUR) of 40 mg PD/MMC with a dwell time of 60 minutes; or single immediate preoperative instillation (immediately before TUR) of 40 mg EMDA/MMC with 20 mA electric current for 30 minutes. Patients with intermediate and high risk NMIBC will undergo adjuvant intravesical therapy. The primary end points will be the recurrence rate and disease-free interval. All clinical analyses will be performed on an intent to treat basis.

Detailed Description

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Conditions

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Superficial Bladder Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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transurethral resection alone

Patients with non-muscle invasive bladder cancer who underwent transurethral resection alone;

Group Type NO_INTERVENTION

No interventions assigned to this group

intravesical mitomycin-C

Patients with non-muscle invasive bladder cancer who underwent one intravesical instillation of mitomycin-C immediately after transurethral resection

Group Type ACTIVE_COMPARATOR

Mitomycin-C 40 mg

Intervention Type DRUG

Intravesical instillation of Mitomycin-C

electromotive mitomycin-C

Patients with non-muscle invasive bladder cancer who underwent single immediate intravesical instillation of electromotive mitomycin-C immediately before transurethral resection

Group Type EXPERIMENTAL

Mitomycin-C 40 mg

Intervention Type DRUG

Intravesical instillation of Mitomycin-C

Interventions

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Mitomycin-C 40 mg

Intravesical instillation of Mitomycin-C

Intervention Type DRUG

Other Intervention Names

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Mytomicin-C Kyowa Italiana Farmaceutici Milano

Eligibility Criteria

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Inclusion Criteria

* All patients with primary histologically proven stage pTa-pT1 transitional-cell carcinoma of the bladder

Exclusion Criteria

* Previous treatments with bacillus Calmette-Guerin, mitomycin-C, or with any other intravesical cytostatic agent
* Concomitant urothelial tumours of the upper urinary tract
* Previous or concomitant muscle-invasive (ie, stage T2 or higher) transitional-cell carcinoma of the bladder
* Bladder capacity less than 200 ml
* Untreated urinary-tract infection
* Disease of upper urinary tract
* Previous radiotherapy to the pelvis
* Other concurrent chemotherapy
* Treatment with radiotherapy-response or biological-response modifiers
* Other malignant diseases within 5 years of trial registration (except for basal-cell carcinoma)
* Pregnancy or nursing
* And psychological, familial or sociological factors that would preclude study participation
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Rome Tor Vergata

OTHER

Sponsor Role lead

Responsible Party

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Savino M. Di Stasi

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Savino M Di Stasi, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

"Tor Vergata" University, Rome, Italy

Locations

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Dept. of Surgery, Tor Vergata University

Rome, , Italy

Site Status

Countries

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Italy

References

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Di Stasi SM, Verri C, Capelli G, Brausi M , Leprini G, Casilio M, Zampa G. Single preoperative intravesical instillation of electromotive mitomycin-C for primary non- muscle-invasive bladder cancer: A prospective randomized trial. Journal of Clinical Oncology, 2010 ASCO Annual Meeting Proceedings. Vol 28, No 15 Suppl (May 20 Supplement), 2010: Abs # 4543.

Reference Type RESULT

Di Stasi SM, Verri C, Capelli G, Brausi M, Leprini G, G Zampa, Stephen RL. Single preoperative intravesical instillation of electromotive mitomycin-C for primary non-muscle invasive bladder cancer: A randomized trial. The Journal of Urology, 2010 AUA Annual Meeting Proceedings. Vol 183, No. 4 Suppl (April Supplement), 2010: Abs #1346.

Reference Type RESULT

Di Stasi SM, Valenti M, Verri C, Liberati E, Giurioli A, Leprini G, Masedu F, Ricci AR, Micali F, Vespasiani G. Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial. Lancet Oncol. 2011 Sep;12(9):871-9. doi: 10.1016/S1470-2045(11)70190-5. Epub 2011 Aug 8.

Reference Type RESULT
PMID: 21831711 (View on PubMed)

Other Identifiers

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EMDA/PRE-TUR/691836

Identifier Type: -

Identifier Source: org_study_id