The Effectiveness and Safety of Intravesical Docetaxel Instillation for Prevent Bladder Recurrence

NCT ID: NCT03209206

Last Updated: 2017-12-22

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-28

Study Completion Date

2022-04-01

Brief Summary

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The investigators evaluated the efficacy of a single early intravesical instillation of doxetaxel in the prevention of bladder recurrence after nephroureterectomy or distal ureterectomy for upper urinary tract urothelial carcinoma (UUT-UC).

Detailed Description

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Approximately 20% to 50% of patients with upper urinary tract urothelial carcinoma (UUT-UC) experience bladder recurrence after nephroureterectomy. Although many agents have been administered for the prevention of bladder recurrence, the standard prophylactic treatment has yet to be established. A meta-analysis found that a single instillation of chemotherapy immediately after transurethral resection of bladder tumor (TURBT) significantly decreased the risk of recurrence in patients with bladder cancer. Indeed, a single early instillation of Docetaxel was found to reduce the post-TURBT bladder recurrence rate among patients with bladder cancer.

In this prospective, randomized study, the investigators evaluated the efficacy of a single, early, intravesical instillation of Docetaxel in the prevention of bladder recurrence after nephroureterectomy for UUT-UC.

Conditions

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Urothelial Carcinoma

Keywords

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Intravesical Chemotherapy Docetaxel Radical Nephroureterectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective Randomized Phase II Trial
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Docetaxel bladder instillation arm

After Surgery, intravesical chemotherapy with in 48 hrs (Docetaxel 75 mg diluted in 100 cc of normal saline)

Group Type EXPERIMENTAL

Docetaxel

Intervention Type DRUG

Intravesical Instillation of Docetaxel (Docetaxel 75 mg diluted in 100 cc of normal saline) after operation of Upper urinary tract urothelial carcinoma (With in 48 hrs)

Control arm

After Surgery, intravesical chemotherapy with in 48 hrs (Placebo, 100 cc of normal saline)

Group Type PLACEBO_COMPARATOR

Placebo Normal saline

Intervention Type DRUG

Intravesical Instillation of Normal saline (100 cc of normal saline) after operation of Upper urinary tract urothelial carcinoma (With in 48 hrs)

Interventions

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Docetaxel

Intravesical Instillation of Docetaxel (Docetaxel 75 mg diluted in 100 cc of normal saline) after operation of Upper urinary tract urothelial carcinoma (With in 48 hrs)

Intervention Type DRUG

Placebo Normal saline

Intravesical Instillation of Normal saline (100 cc of normal saline) after operation of Upper urinary tract urothelial carcinoma (With in 48 hrs)

Intervention Type DRUG

Other Intervention Names

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Instillation docetaxel after radical nephroureterectomy Instillation Normal saline after radical nephroureterectomy

Eligibility Criteria

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Inclusion Criteria

* Upper urinary tract urothelial cell carcinoma
* Hb\>10g/dL, ANC \>1500mm3, Platelet \> 100K
* Total bilirubin : 1.5 times lower than the normal upper limit
* AST/ALT: 1.8 times lower than the normal upper limit
* Alkaline phosphatase: 1.8 times lower than the normal upper limit

Exclusion Criteria

* Concomitant bladder tumor
* Patients diagnosed with bladder cancer within the last 3 years
* Previous history of hypersensitivity to Docetaxel
* Neurogenic Bladder
* Patients who received chemotherapy for cancer within the last 6 months
* Patients with active disease not fit for this study
* ANC \<1500mm3
* Pregnant or lactating women
* Patients with severe hepatic dysfunction
* patients with severe renal impairment
* patients with hypersensitivity to mannitol, paraplatin, platinum compounds
* Patients with complications of infection
* Patients suspected of having infectious fever
Minimum Eligible Age

19 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ja Hyeon Ku

Professor, MD., PHD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ja Hyeon Ku, M.D.,PH.D

Role: STUDY_DIRECTOR

Seoul National University Hospital

Locations

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Seoul National University Hospital

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Ja Hyeon Ku, M.D.,PH.D

Role: CONTACT

Phone: +82-2-2072-0361

Email: [email protected]

Bum Sik Tae, M.D

Role: CONTACT

Phone: +82-10-9056-6618

Email: [email protected]

Facility Contacts

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Ja Hyeon Ku, M.D, Ph.D

Role: primary

Bum Sik Tae, M.D

Role: backup

References

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Ito A, Shintaku I, Satoh M, Ioritani N, Aizawa M, Tochigi T, Kawamura S, Aoki H, Numata I, Takeda A, Namiki S, Namima T, Ikeda Y, Kambe K, Kyan A, Ueno S, Orikasa K, Katoh S, Adachi H, Tokuyama S, Ishidoya S, Yamaguchi T, Arai Y. Prospective randomized phase II trial of a single early intravesical instillation of pirarubicin (THP) in the prevention of bladder recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma: the THP Monotherapy Study Group Trial. J Clin Oncol. 2013 Apr 10;31(11):1422-7. doi: 10.1200/JCO.2012.45.2128. Epub 2013 Mar 4.

Reference Type RESULT
PMID: 23460707 (View on PubMed)

Delto JC, Kobayashi T, Benson M, McKiernan J, Abate-Shen C. Preclinical analyses of intravesical chemotherapy for prevention of bladder cancer progression. Oncotarget. 2013 Feb;4(2):269-76. doi: 10.18632/oncotarget.852.

Reference Type RESULT
PMID: 23563166 (View on PubMed)

Wu P, Zhu G, Wei D, Liu S, Walsh K, Li D, Harron U, Wang X, Ma H, Wan B, Sun L, Yang Z, Wang J. Prophylactic intravesical chemotherapy decreases bladder tumor recurrence after nephroureterectomy for primary upper tract urothelial carcinoma: A systematic review and meta-analysis. J BUON. 2015 Sep-Oct;20(5):1229-38.

Reference Type RESULT
PMID: 26537069 (View on PubMed)

Laudano MA, Barlow LJ, Murphy AM, Petrylak DP, Desai M, Benson MC, McKiernan JM. Long-term clinical outcomes of a phase I trial of intravesical docetaxel in the management of non-muscle-invasive bladder cancer refractory to standard intravesical therapy. Urology. 2010 Jan;75(1):134-7. doi: 10.1016/j.urology.2009.06.112. Epub 2009 Nov 13.

Reference Type RESULT
PMID: 19913890 (View on PubMed)

Lu S, Neoh KG, Kang ET, Mahendran R, Chiong E. Mucoadhesive polyacrylamide nanogel as a potential hydrophobic drug carrier for intravesical bladder cancer therapy. Eur J Pharm Sci. 2015 May 25;72:57-68. doi: 10.1016/j.ejps.2015.03.006. Epub 2015 Mar 13.

Reference Type RESULT
PMID: 25772330 (View on PubMed)

Barlow L, McKiernan J, Sawczuk I, Benson M. A single-institution experience with induction and maintenance intravesical docetaxel in the management of non-muscle-invasive bladder cancer refractory to bacille Calmette-Guerin therapy. BJU Int. 2009 Oct;104(8):1098-102. doi: 10.1111/j.1464-410X.2009.08543.x. Epub 2009 Apr 15.

Reference Type RESULT
PMID: 19389012 (View on PubMed)

Other Identifiers

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SeoulNUHUro

Identifier Type: -

Identifier Source: org_study_id