Cabazitaxel in Patients With Urothelial Carcinoma Who Have Disease Progression Following Platinum-Based Chemotherapy

NCT ID: NCT01437488

Last Updated: 2025-05-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 14 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-02-16
• Study Completion Date: 2017-03-30

Brief Summary

There is no accepted standard chemotherapy approved for use in the second line for patients with advanced urothelial carcinoma whose cancer has progressed on combination chemotherapy including either cisplatin or carboplatin. The chemotherapy class called taxanes, either as single agents or in combination, have demonstrated modest efficacy in small studies. Cabazitaxel is an agent in the taxane family designed to be active in the setting of acquired multi-drug resistance that arises in some tumors. The objective of this study is to evaluate the safety and efficacy of this agent in patients with urothelial carcinoma refractory compared to combination platinum based chemotherapy.

Detailed Description

This is a single-arm, open-label study, meaning all patients will be treated in the same fashion with the investigational agent. Scans will be performed every 3 cycles of treatment, and patients will be withdrawn from study in the event of progression or drug intolerance as defined within the protocol.

Treatment will be administered on an outpatient basis. No investigational or commercial agents or therapies other than those described below may be administered with the intent to treat the patient's malignancy.

The length of each cycle is 21 days. For the first cycle of treatment, cabazitaxel will be dosed at 20 mg/m2. During cycle 1, complete blood counts will be performed on days 8 and 15, and dosing on Day 1 cycle 2 will depend upon the nadir counts on those days. If, on toxicity assessment on day 1 of cycle 2, the patient has no residual >grade 2 toxicity, and all other laboratory parameters are within acceptable limits (see below),at the investigator's discretion the dose can be escalated to 25 mg/m2. 25 mg/m2 is the FDA (Food and Drug Administration)-approved dose for prostate cancer. Neulasta will be given with each dose of cabazitaxel to decrease the risk of febrile neutropenic complication.

Conditions

Urothelial Carcinoma

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Cabazitaxel

Cabazitaxel following platinum-based chemotherapy

Group Type: EXPERIMENTAL

Cabazitaxel

Intervention Type: DRUG

• Cycle 1: 20 mg/m2 in 250cc NS via IV on Day 1 every 21 days
• Following cycles: 20 mg/m2 or escalated to 25 mg/m2 or reduced by 5 mg/m2 in 250cc NS via IV on Day 1 every 21 days at investigator's discretion
• Treatment continues until disease progression, intercurrent illness preventing further treatment, unacceptable adverse event(s), patient withdraws from the study, or changes in the patient's condition which render further treatment unacceptable in the judgment of the investigator

Neulasta

Intervention Type: DRUG

6 mg via SQ on Day 2 (24-48 hours post-cabazitaxel) every 21 days

CT Scan

Intervention Type: PROCEDURE

CT scan of chest, abdomen, and pelvis to assess disease following every 3rd cycle of treatment (approximately every 9 weeks)

Blood Draw

Intervention Type: BIOLOGICAL

Approximately 2 tablespoons of blood will be taken to test complete blood count, glucose, hematology, electrolytes, liver function, creatinine clearance, and a chemistry profile. This week be done weekly during the first cycle of treatment

Interventions

Cabazitaxel

• Cycle 1: 20 mg/m2 in 250cc NS via IV on Day 1 every 21 days
• Following cycles: 20 mg/m2 or escalated to 25 mg/m2 or reduced by 5 mg/m2 in 250cc NS via IV on Day 1 every 21 days at investigator's discretion
• Treatment continues until disease progression, intercurrent illness preventing further treatment, unacceptable adverse event(s), patient withdraws from the study, or changes in the patient's condition which render further treatment unacceptable in the judgment of the investigator

Intervention Type: DRUG

Neulasta

6 mg via SQ on Day 2 (24-48 hours post-cabazitaxel) every 21 days

Intervention Type: DRUG

CT Scan

CT scan of chest, abdomen, and pelvis to assess disease following every 3rd cycle of treatment (approximately every 9 weeks)

Intervention Type: PROCEDURE

Blood Draw

Approximately 2 tablespoons of blood will be taken to test complete blood count, glucose, hematology, electrolytes, liver function, creatinine clearance, and a chemistry profile. This week be done weekly during the first cycle of treatment

Intervention Type: BIOLOGICAL

Other Intervention Names

XRP-6258; Jevtana; Pegfilgrastim; X-ray computed tomography; Venipuncture

Eligibility Criteria

Inclusion Criteria

• Patients must have histologically confirmed urothelial carcinoma
• Patients must have measurable disease
• Patients must have been previously treated with a platinum-based regimen, either in the neoadjuvant, adjuvant or first line setting
• Patients can have had disease progression while on platinum chemotherapy, or progression within 12 months of completion of therapy
• At least 4 weeks must have passed since the last dose of previous chemotherapy
• Age > 18 years
• ECOG performance status < 2 (Karnofsky > 60%)
• Life expectancy of greater than 6 months
• Patients must have adequate organ and marrow function as defined below:
• absolute neutrophil count > 1,500/mcL
• hemoglobin > 9.0 g/dl
• platelets > 100,000/mm3
• total bilirubin < normal institutional limits (ULN)
• AST(SGOT)/ALT(SGPT) < 1.5 X institutional upper limit of normal
• creatinine <1.5 x ULN OR creatinine clearance measured > 50 mL/min/1.73 m2for patients with creatinine levels above institutional normal or calculated clearance < 60 by 24 hour urine
• Peripheral neuropathy: must be < grade 1
• Women of childbearing potential must have a negative pregnancy test, and patients must use adequate contraception during study and for 3 months thereafter
• Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

• Patients with any component of small cell carcinoma
• Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
• Patients who are receiving any other investigational agents
• Patients with known brain metastases
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to taxane chemotherapy
• Patients with a history of severe hypersensitivity reaction to Cabazitaxel or other drugs formulated with polysorbate 80
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Pregnant and breastfeeding women
• HIV-positive patients on combination antiretroviral therapy
• Patients who have previously been treated with taxane regimens for bladder cancer or other malignancies
• Patients who have had more than one platinum based chemotherapy regimen
• Patients whose cancer has progressed more than 12 months following abstinence from platinum based chemotherapy can be included on study at the discretion of the investigator, however should first be considered for platinum re-challenge

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Sanofi

INDUSTRY

Sponsor Role: collaborator

Sidney Kimmel Cancer Center at Thomas Jefferson University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jean Hoffman-Censits, MD

Role: PRINCIPAL_INVESTIGATOR

Thomas Jefferson University

Locations

National Cancer Institute

Bethesda, Maryland, United States

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Countries

United States

Related Links

http://www.jeffersonhospital.org/

Thomas Jefferson University Hospital

http://ccr.cancer.gov/

Center for Cancer Research, National Cancer Institute

http://penncancer.org/

Abramson Cancer Center of the University of Pennsylvania

Other Identifiers

2011-52

Identifier Type: OTHER

Identifier Source: secondary_id

JT 2205

Identifier Type: OTHER

Identifier Source: secondary_id

11D.392

Identifier Type: -

Identifier Source: org_study_id