Trial Outcomes & Findings for Pembrolizumab and Combination Chemotherapy Before Surgery for the Treatment of Muscle-Invasive Bladder Cancer (NCT NCT04383743)

NCT ID: NCT04383743

Last Updated: 2025-09-18

Results Overview

Percentage of patients with no histologic evidence of tumor at time of cystectomy (ypT0N0)

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

17 participants

Primary outcome timeframe

At time of radical cystectomy at approximately within 10 weeks of last neoadjuvant infusion

Results posted on

2025-09-18

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Pembrolizumab, aMVAC)
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Overall Study
STARTED
17
Overall Study
COMPLETED
15
Overall Study
NOT COMPLETED
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment (Pembrolizumab, aMVAC)
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Overall Study
Withdrawal by Subject
1
Overall Study
Adverse Event
1

Baseline Characteristics

Pembrolizumab and Combination Chemotherapy Before Surgery for the Treatment of Muscle-Invasive Bladder Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 Participants
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
13 Participants
n=5 Participants
Age, Categorical
>=65 years
4 Participants
n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
Sex: Female, Male
Male
12 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
15 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
17 participants
n=5 Participants

PRIMARY outcome

Timeframe: At time of radical cystectomy at approximately within 10 weeks of last neoadjuvant infusion

Percentage of patients with no histologic evidence of tumor at time of cystectomy (ypT0N0)

Outcome measures

Outcome measures
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 Participants
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Pathologic Complete Response Rate
9 Participants

SECONDARY outcome

Timeframe: Up to 90 days post study therapy completion

The frequency of toxicity of study therapy regimen. Measured as the number of participants that experienced an AE (any grade) related to study therapy while on trial.

Outcome measures

Outcome measures
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 Participants
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Frequency of Any Adverse Event According to Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE v5.0) Related to Study Therapy.
17 Participants

SECONDARY outcome

Timeframe: Up to 90 days post therapy completion

The severity of toxicity of therapy regimen. Measured as the number of participants that experienced an AE of grade 3 or higher related to study therapy while on trial

Outcome measures

Outcome measures
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 Participants
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Frequency of Grade 3 or Greater Adverse Events According to Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE v5.0) Related to Study Therapy.
8 Participants

SECONDARY outcome

Timeframe: At 2 years

Percentage reported represents an estimate using the method of Kaplan-Meier 2-year EFS Estimate (95% CI)

Outcome measures

Outcome measures
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 Participants
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Estimated 2-year Event-free Survival (EFS)
64 percentage of participants
Interval 32.0 to 84.0

SECONDARY outcome

Timeframe: within 10 weeks from completion of study therapy

To evaluate the feasibility of neoadjuvant aMVAC and pembrolizumab as measured by the rate of patients able to receive RC within 10 weeks from completion of study therapy

Outcome measures

Outcome measures
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 Participants
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Number of Participants Able to Undergo Radical Cystectomy Within 10 Weeks From Completion of Study Therapy
14 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: At time of Transurethral Bladder Tumor Resection and radical cystectomy

TIL density will be summarized by means, medians, and quantiles. Changes will be evaluated as both absolute and percentage change. Descriptive statistics will also be used when needed.

Outcome measures

Outcome data not reported

Adverse Events

Treatment (Pembrolizumab, aMVAC)

Serious events: 6 serious events
Other events: 17 other events
Deaths: 3 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 participants at risk
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Renal and urinary disorders
Acute Kidney Injury
11.8%
2/17 • Number of events 2 • Up to 2 years
General disorders
Fatigue
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Vomiting
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Mucositis Oral
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Diarrhea
11.8%
2/17 • Number of events 2 • Up to 2 years
Infections and infestations
Urinary Tract Infection
11.8%
2/17 • Number of events 4 • Up to 2 years
Infections and infestations
Kidney Infection
17.6%
3/17 • Number of events 4 • Up to 2 years
General disorders
Fever
5.9%
1/17 • Number of events 1 • Up to 2 years
Cardiac disorders
Sinus Tachycardia
5.9%
1/17 • Number of events 1 • Up to 2 years
Infections and infestations
Sepsis
5.9%
1/17 • Number of events 1 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Respiratory Failure
5.9%
1/17 • Number of events 1 • Up to 2 years
Nervous system disorders
Encephalopathy
5.9%
1/17 • Number of events 1 • Up to 2 years
Renal and urinary disorders
Urinary Retention
5.9%
1/17 • Number of events 3 • Up to 2 years
Renal and urinary disorders
Hematuria
5.9%
1/17 • Number of events 1 • Up to 2 years
Blood and lymphatic system disorders
Febrile Neutropenia
11.8%
2/17 • Number of events 2 • Up to 2 years
Nervous system disorders
Syncope
5.9%
1/17 • Number of events 1 • Up to 2 years
Injury, poisoning and procedural complications
Hip Fracture
5.9%
1/17 • Number of events 1 • Up to 2 years
Infections and infestations
Enterocolitis Infectious
5.9%
1/17 • Number of events 1 • Up to 2 years
Infections and infestations
Infections and Infestations - Other
5.9%
1/17 • Number of events 1 • Up to 2 years

Other adverse events

Other adverse events
Measure
Treatment (Pembrolizumab, aMVAC)
n=17 participants at risk
Patients receive pembrolizumab IV over 30 minutes on day 1 of weeks 0, 3, and 6 and methotrexate IV, vinblastine IV, doxorubicin IV, and cisplatin IV on day 1 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients also receive pegfilgrastim SC on day 1 or 2 of weeks 0, 2, 4, and 6 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care radical cystectomy. Cisplatin: Given IV Doxorubicin: Given IV Methotrexate: Given IV Pegfilgrastim: Given SC Pembrolizumab: Given IV Radical Cystectomy: Undergo standard of care radical cystectomy Vinblastine Sulfate: Given IV
Gastrointestinal disorders
Abdominal Pain
11.8%
2/17 • Number of events 2 • Up to 2 years
Investigations
Alanine Aminotransferase Increased
5.9%
1/17 • Number of events 1 • Up to 2 years
Investigations
Alkaline Phosphatase Increased
5.9%
1/17 • Up to 2 years
Skin and subcutaneous tissue disorders
Alopecia
52.9%
9/17 • Number of events 9 • Up to 2 years
Blood and lymphatic system disorders
Anemia
52.9%
9/17 • Number of events 30 • Up to 2 years
Metabolism and nutrition disorders
Anorexia
52.9%
9/17 • Number of events 14 • Up to 2 years
Psychiatric disorders
Anxiety
11.8%
2/17 • Number of events 2 • Up to 2 years
Musculoskeletal and connective tissue disorders
Arthralgia
5.9%
1/17 • Number of events 1 • Up to 2 years
Cardiac disorders
Atrial Fibrillation
5.9%
1/17 • Number of events 1 • Up to 2 years
Musculoskeletal and connective tissue disorders
Back Pain
17.6%
3/17 • Number of events 4 • Up to 2 years
Musculoskeletal and connective tissue disorders
Bone Pain
11.8%
2/17 • Number of events 2 • Up to 2 years
General disorders
Chills
11.8%
2/17 • Number of events 2 • Up to 2 years
Nervous system disorders
Concentration Impairment
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Constipation
64.7%
11/17 • Number of events 13 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Cough
17.6%
3/17 • Number of events 3 • Up to 2 years
Investigations
Creatinine Increased
23.5%
4/17 • Number of events 7 • Up to 2 years
Metabolism and nutrition disorders
Dehydration
11.8%
2/17 • Number of events 5 • Up to 2 years
Psychiatric disorders
Depression
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Diarrhea
23.5%
4/17 • Number of events 4 • Up to 2 years
Nervous system disorders
Dizziness
23.5%
4/17 • Number of events 4 • Up to 2 years
Skin and subcutaneous tissue disorders
Dry Skin
5.9%
1/17 • Number of events 1 • Up to 2 years
Nervous system disorders
Dysgeusia
47.1%
8/17 • Number of events 9 • Up to 2 years
Gastrointestinal disorders
Dyspepsia
47.1%
8/17 • Number of events 9 • Up to 2 years
Gastrointestinal disorders
Dysphagia
5.9%
1/17 • Number of events 1 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
11.8%
2/17 • Number of events 2 • Up to 2 years
Renal and urinary disorders
Dysuria
5.9%
1/17 • Number of events 1 • Up to 2 years
General disorders
Edema Limbs
5.9%
1/17 • Number of events 1 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Epistaxis
5.9%
1/17 • Number of events 1 • Up to 2 years
General disorders
Fatigue
64.7%
11/17 • Number of events 11 • Up to 2 years
General disorders
Fever
11.8%
2/17 • Number of events 2 • Up to 2 years
Vascular disorders
Flushing
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Gastroesophageal Reflux Disease
5.9%
1/17 • Number of events 1 • Up to 2 years
Nervous system disorders
Headache
11.8%
2/17 • Number of events 2 • Up to 2 years
Ear and labyrinth disorders
Hearing Impaired
5.9%
1/17 • Number of events 1 • Up to 2 years
Renal and urinary disorders
Hematuria
11.8%
2/17 • Number of events 2 • Up to 2 years
Gastrointestinal disorders
Hemorrhoids
5.9%
1/17 • Number of events 1 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Hiccups
11.8%
2/17 • Number of events 2 • Up to 2 years
Vascular disorders
Hot Flashes
5.9%
1/17 • Number of events 1 • Up to 2 years
Metabolism and nutrition disorders
Hyperglycemia
5.9%
1/17 • Number of events 2 • Up to 2 years
Metabolism and nutrition disorders
Hypocalcemia
11.8%
2/17 • Number of events 4 • Up to 2 years
Metabolism and nutrition disorders
Hypokalemia
29.4%
5/17 • Number of events 5 • Up to 2 years
Metabolism and nutrition disorders
Hypomagnesemia
17.6%
3/17 • Number of events 4 • Up to 2 years
Metabolism and nutrition disorders
Hyponatremia
23.5%
4/17 • Number of events 7 • Up to 2 years
Vascular disorders
Hypotension
5.9%
1/17 • Number of events 1 • Up to 2 years
Injury, poisoning and procedural complications
Infusion Related Reaction
5.9%
1/17 • Number of events 1 • Up to 2 years
Psychiatric disorders
Insomnia
5.9%
1/17 • Number of events 1 • Up to 2 years
Blood and lymphatic system disorders
Leukocytosis
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Mucositis Oral
41.2%
7/17 • Number of events 9 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Nasal Congestion
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Nausea
88.2%
15/17 • Number of events 17 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Oropharyngeal Pain
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Periodontal Disease
5.9%
1/17 • Number of events 1 • Up to 2 years
Nervous system disorders
Peripheral Sensory Neuropathy
17.6%
3/17 • Number of events 4 • Up to 2 years
Infections and infestations
Pharyngitis
5.9%
1/17 • Number of events 1 • Up to 2 years
Investigations
Platelet Count Decreased
17.6%
3/17 • Number of events 4 • Up to 2 years
Nervous system disorders
Presyncope
5.9%
1/17 • Number of events 2 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Respiratory, Thoracic and Mediastinal Disorders - Other
5.9%
1/17 • Number of events 1 • Up to 2 years
Cardiac disorders
Sinus Tachycardia
5.9%
1/17 • Number of events 1 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Sore Throat
5.9%
1/17 • Number of events 1 • Up to 2 years
Vascular disorders
Superficial Thrombophlebitis
5.9%
1/17 • Number of events 1 • Up to 2 years
Nervous system disorders
Syncope
5.9%
1/17 • Number of events 1 • Up to 2 years
Vascular disorders
Thromboembolic Event
5.9%
1/17 • Number of events 1 • Up to 2 years
Ear and labyrinth disorders
Tinnitus
35.3%
6/17 • Number of events 6 • Up to 2 years
Gastrointestinal disorders
Toothache
5.9%
1/17 • Number of events 1 • Up to 2 years
Renal and urinary disorders
Urinary Frequency
5.9%
1/17 • Number of events 1 • Up to 2 years
Renal and urinary disorders
Urinary Incontinence
5.9%
1/17 • Number of events 1 • Up to 2 years
Infections and infestations
Urinary Tract Infection
5.9%
1/17 • Number of events 1 • Up to 2 years
Vascular disorders
Vasculitis
5.9%
1/17 • Number of events 1 • Up to 2 years
Eye disorders
Vision Decreased
5.9%
1/17 • Number of events 1 • Up to 2 years
Gastrointestinal disorders
Vomiting
29.4%
5/17 • Number of events 6 • Up to 2 years
Gastrointestinal disorders
Stomach Pain
5.9%
1/17 • Number of events 1 • Up to 2 years
Investigations
Neutrophil Count Decreased
11.8%
2/17 • Number of events 6 • Up to 2 years
Skin and subcutaneous tissue disorders
Skin and Subcutaneous Tissue Disorders - Other
11.8%
2/17 • Number of events 3 • Up to 2 years
Skin and subcutaneous tissue disorders
Rash Maculo-Papular
17.6%
3/17 • Number of events 4 • Up to 2 years
Immune system disorders
Allergic Reaction
5.9%
1/17 • Number of events 2 • Up to 2 years
Gastrointestinal disorders
Gastrointestinal Disorders - Other
17.6%
3/17 • Number of events 3 • Up to 2 years
Gastrointestinal disorders
Abdominal Distension
5.9%
1/17 • Number of events 1 • Up to 2 years
Infections and infestations
Bladder Infection
5.9%
1/17 • Number of events 4 • Up to 2 years
Nervous system disorders
Cognitive Disturbance
5.9%
1/17 • Number of events 1 • Up to 2 years
Infections and infestations
Enterocolitis Infectious
5.9%
1/17 • Number of events 1 • Up to 2 years
Respiratory, thoracic and mediastinal disorders
Laryngeal Edema
5.9%
1/17 • Number of events 2 • Up to 2 years
Metabolism and nutrition disorders
Metabolism and Nutrition Disorders - Other
5.9%
1/17 • Number of events 1 • Up to 2 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms Benign, Malignant and Unspecified (Incl Cysts and Polyps) - Other
5.9%
1/17 • Number of events 1 • Up to 2 years
General disorders
Non-Cardiac Chest Pain
5.9%
1/17 • Number of events 1 • Up to 2 years
Musculoskeletal and connective tissue disorders
Pain in Extremity
5.9%
1/17 • Number of events 1 • Up to 2 years

Additional Information

Dr. Petros Grivas

University of Washington

Phone: 2066061943

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place