Study of Cretostimogene Given in Patients With Non-Muscle Invasive Bladder Cancer ,Unresponsive to Bacillus-Calmette-Guerin

NCT ID: NCT04452591

Last Updated: 2025-07-03

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

190 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-27

Study Completion Date

2029-12-24

Brief Summary

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This is a Phase 3, open-label, single arm trial designed to evaluate Cretostimogene patients with NMIBC who have failed prior BCG therapy. Up to approximately 115 CIS bladder cancer patients with or without HG Ta or HG T1 papillary disease will be enrolled under the original protocol through Amendment 4, which will comprise Cohort C. Cohort C is closed to enrollment.

Under Amendment 5-1, Cohort P was added to enroll up to 70 patients with HG Ta/T1 papillary bladder cancer.

Under Amendment 6, the target number of patients enrolled in Cohort P was increased to 75. Cohort P is open to enrollment

Cohort C and Cohort P will be analyzed and reported separately. Patients will have had to fail prior BCG therapy which is defined as having persistent or recurrent disease within 12 months (Cohort C) or 6 months (Cohort P) following the completion of adequate BCG therapy for HGUC

Detailed Description

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Cohort C(All Countries) :

An open-label trial designed to evaluate Cretostimogene + DDM in patients with NMIBC who have failed prior BCG therapy. Single treatment arm that enrolled 115 patients with carcinoma in situ with or without concomitant high-grade Ta or T1 papillary disease

BCG failure is defined as a persistent or recurrent disease within 12 months of completion of adequate BCG therapy.

Cohort P(Japan and the United States Only):

To determine the all-cause High Grade Event Free Survival (HG-EFS) of cretostimogene in up to 75 patients with BCG-unresponsive HG Ta/T1 papillary disease without CIS.

BCG failure is defined as a persistent or recurrent disease within 6 months of completion of adequate BCG therapy.

Conditions

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Non Muscle Invasive Bladder Cancer High-grade Ta/ T1 Papillary Disease Bladder Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cohort C(All Countries):Enrollment Closed

Patients with CIS with or without HG Ta/T1 papillary disease. Cretostimogene will be administered intravesically following a series of bladder washes with 5% DDM and normal saline. Cretostimogene will be administered weekly x 6 on Weeks 1, 2, 3, 4, 5, and 6. If the patient has disease recurrence at Week 13, they will receive another cycle of 6 weekly treatments. If there is no disease present at Week 13 then the patient will receive 3 weekly treatments. Cohort C(All Countries):Beginning at Week 25, patients will receive weekly x 3 treatments every 12 weeks through week 51 then every 6 months and then a last treatment at Weeks 73, 74, and 75 until the tumor returns or study treatment is completed at Week 97. Cohort C Extension( Japan and the US) At Week 25, patients will receive weekly x 3 treatments every 12 weeks through week 51 then every 6 months starting at Weeks 73, 74, and 75 through Weeks 157, 158, and 159 until the tumor returns or study treatment is completed at Week 159.

Group Type EXPERIMENTAL

Cretostimogene Grenadenorepvec

Intervention Type BIOLOGICAL

Engineered Oncolytic Adenovirus

n-dodecyl-B-D-maltoside

Intervention Type OTHER

Transduction-enhancing agent.

Cohort P(Japan and United States Only) :Open to Enrollment

HG Ta/T1 papillary disease bladder cancer patients.

In Cohort P, cretostimogene will be administered at a dose of 1 × 1012vp IVE following instillation of 5% DDM. Cretostimogene will be administered every week for 6 treatments on Weeks 1, 2, 3, 4, 5, and 6. If the patient has recurrence at Week 13 or any timepoint, the patient will receive a second induction of 6 weekly treatments (Weeks 13, 14, 15, 16, 17, and 18.). If the tumor has not returned they will receive 3 weekly treatments every 12 weeks (approximately 3 months) starting Weeks 13, 14, and 15 through Week 51 (approximately 12 months), and then every 6 months starting at Weeks 73, 74, and 75 (approximately 18 months) through Month 36.

Group Type EXPERIMENTAL

Cretostimogene Grenadenorepvec

Intervention Type BIOLOGICAL

Engineered Oncolytic Adenovirus

n-dodecyl-B-D-maltoside

Intervention Type OTHER

Transduction-enhancing agent.

Interventions

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Cretostimogene Grenadenorepvec

Engineered Oncolytic Adenovirus

Intervention Type BIOLOGICAL

n-dodecyl-B-D-maltoside

Transduction-enhancing agent.

Intervention Type OTHER

Other Intervention Names

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DDM

Eligibility Criteria

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Inclusion Criteria

In order to be eligible for participation in this trial, the patient must:

* Be ≥18 years of age (or legal age of majority in the jurisdiction) on day of signing informed consent.
* Have Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
* Have pathologically confirmed (WHO grading system employed for tumor grading) (Compérat 2019) BCG unresponsive CIS. Patients with BCG unresponsive CIS are those unlikely to benefit from, and who will not be receiving, further intravesical BCG. There is no maximum limit to the amount of prior BCG treatment, but maintenance BCG should be administered on a schedule consistent with standard induction-maintenance protocols (e.g., BCG weekly × 6 then weekly × 3 weeks administered at Months 3, 6, 12, 18, 24, and 36). Specifically, the definition of BCG unresponsive CIS will also require the following:

* Pathologically confirmed relapsed or persistent CIS (with or without HG Ta or HG T1 disease) within 12 months of completion (last dose) of adequate BCG treatment for HGUC (e.g., CIS, HG Ta, HG T1, or a combination of these HGUC pathologies).
* Completion of qualifying BCG treatment (e.g., "5+2" minimum exposure) within 12 months of the initial qualifying dose of BCG (e.g., induction and initial maintenance or re-induction cycle must be completed over no more than a 12-month period of time).
* Pathological confirmation of BCG unresponsive CIS within 8 weeks of study enrollment.
* CIS specimen must be predominantly urothelial (transitional cell) and have less than 50% variant (e.g., sarcomatoid, squamous etc. component) histology.
* No maximum limit to the amount of BCG administered but maintenance BCG should be administered on a schedule consistent with the SWOG 8507 regimen (Lamm 2000).
* Have all Ta and/or T1 disease resected and all CIS resected or fulgurated, as feasible, prior to study treatment (e.g., prior to Day 1 treatment).
* Ineligible to receive radical cystectomy (medically unfit) or refusal of radical cystectomy according to Investigator assessment.
* Demonstrate adequate organ function
* Patients must be willing to comply with study mandated cystoscopies, urine cytology, urograms, biopsies, and other procedures (including TURBT or other resection for all Ta/T1 disease) for the duration of the study. Patients who withdraw consent for these procedures will be withdrawn from the trial


* Be ≥18 years of age (or legal age of majority in the jurisdiction) on day of signing informed consent
* Have ECOG performance status of 0 to 2.
* Have pathologically confirmed (WHO grading system employed for tumor grading) (Compérat 2019) BCG-unresponsive HG Ta/T1 papillary disease without CIS. Patients with BCG-unresponsive HG Ta/T1 papillary disease are those unlikely to benefit from and who will not be receiving further IVE BCG. There is no maximum limit to the amount of prior BCG treatment, but maintenance BCG should be administered on a schedule consistent with standard induction-maintenance protocols. Specifically, the definition of BCG unresponsive HG Ta/T1 papillary disease without CIS will also require the following:

* Pathologically confirmed recurrent HG Ta/T1 papillary disease without CIS within 6 months of completion (last dose) of adequate BCG treatment for HGUC (e.g., CIS, HG Ta, HG T1, or a combination of these HGUC pathologies).
* Patients with HG Ta: Completion of qualifying BCG treatment (e.g., "5+2" minimum exposure) within 12 months of the initial qualifying dose of BCG (e.g., induction and initial maintenance or re-induction cycle must be completed over no more than a 12-month period of time).
* Patients with HG T1: Patients may be eligible after the initial induction alone (5 of 6 doses of an induction course) as the qualifying BCG treatment.
* Completion (last dose) of qualifying BCG treatment within 12 months of study enrollment.
* Pathological confirmation of BCG-unresponsive HG Ta/T1 papillary disease without CIS within 14 days of study enrollment.
* All pathology specimens must be predominantly urothelial (transitional cell) and have less than 50% variant (e.g., sarcomatoid, squamous etc. component) histology.
* No maximum limit to the amount of BCG administered; however, there should be no more than 12 months between cycles of BCG
* Have all Ta and/or T1 disease resected, prior to study treatment (e.g., prior to Day 1 treatment).
* Ineligible to receive radical cystectomy (medically unfit) or refusal of radical cystectomy based on Investigator assessment.
* Demonstrate adequate organ function,
* Patients must be willing to comply with study-mandated cystoscopies, urine cytology, imaging, biopsies, and other procedures for the duration of the trial

Exclusion Criteria

* Has current or past history of muscle invasive (T2 or higher stage) or locally advanced (T3/T4, any N) or metastatic bladder cancer.
* Any HGUC as T1, HG Ta, or CIS in the upper genitourinary tract or prostatic urethra (including CIS of the urethra) within 24 months prior to enrollment OR any history of T2 or higher stage urothelial carcinoma in the upper genitourinary tract (kidneys, renal collecting systems, ureters).
* Has received systemic anti-cancer therapy, including investigational agents, within 4 weeks of Day 1.
* Has had prior systemic treatment (with the exception of checkpoint inhibitor therapy), radiation therapy, or surgery for bladder cancer other than TURBT or bladder biopsies.
* Has any of the following within the 6 months prior to starting study treatment: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident, pulmonary embolus, uncontrolled hypertension, or uncontrolled congestive heart failure.
* Cannot tolerate study-related biopsies, IVE administration, or 1-hour bladder hold of cretostimogene.
* IVE therapy within 8 weeks prior to beginning study treatment with the exception of cytotoxic agents (e.g., Mitomycin C, gemcitabine, doxorubicin and epirubicin) when administered as a single instillation immediately following a TURBT procedure which is permitted 14 or more days prior to beginning study treatment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CG Oncology, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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CG Oncology

Role: STUDY_DIRECTOR

CG Oncology

Locations

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Mayo Clinic Cancer Center

Phoenix, Arizona, United States

Site Status

Arizona Institute of Urology

Tucson, Arizona, United States

Site Status

Arkansas Urology

Little Rock, Arkansas, United States

Site Status

University of California - Irvine

Irvine, California, United States

Site Status

University of Colorado

Aurora, Colorado, United States

Site Status

Colorado Clinical Research

Lakewood, Colorado, United States

Site Status

Urology Associates

Lone Tree, Colorado, United States

Site Status

MedStar Hospital

Washington D.C., District of Columbia, United States

Site Status

Mayo Clinic - Jacksonville

Jacksonville, Florida, United States

Site Status

Moffit Cancer Center

Tampa, Florida, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Urology of Indiana

Greenwood, Indiana, United States

Site Status

University of Kansas

Kansas City, Kansas, United States

Site Status

Wichita Urology

Wichita, Kansas, United States

Site Status

Southern Urology

Lafayette, Louisiana, United States

Site Status

Chesapeake Urology

Severna Park, Maryland, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Mayo Rochester

Rochester, Minnesota, United States

Site Status

Mercy Medical Center

St Louis, Missouri, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

Specialty Clinical Research of St. Louis

St Louis, Missouri, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

University of Toledo

Toledo, Ohio, United States

Site Status

Keystone Urology Specialists

Lancaster, Pennsylvania, United States

Site Status

University of Pennsylvania, Perelman School of Medicine

Philadelphia, Pennsylvania, United States

Site Status

Carolina Urologic Research Center

Myrtle Beach, South Carolina, United States

Site Status

Conrad Pearson Clinic

Germantown, Tennessee, United States

Site Status

Urology Associates- Nashville

Nashville, Tennessee, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Houston Metro Urology

Houston, Texas, United States

Site Status

Urology San Antonio, PA

San Antonio, Texas, United States

Site Status

Spokane Urology

Spokane, Washington, United States

Site Status

Barwon Health, University Hospital Geelong

Geelong, , Australia

Site Status

Royal Melbourne Hospital

Melbourne, , Australia

Site Status

Wollongong Private Hospital

Wollongong, , Australia

Site Status

National Cancer Center Hospital East

Chiba, , Japan

Site Status

Nagoya University Hospital

Fujita, , Japan

Site Status

Hirosaki University Hospital

Hashimoto, , Japan

Site Status

Chugoku Rosai Hospital

Hiroshima, , Japan

Site Status

Shinshu University Hospital

Ishizuka, , Japan

Site Status

University of Tsukuba Hospital

Kandori, , Japan

Site Status

Nara Medical University Hospital

Kashihara, , Japan

Site Status

The Jikei University Kashiwa Hospital

Kashiwa, , Japan

Site Status

St. Marianna University Hospital

Kikuchi, , Japan

Site Status

National Hospital Organization Kyoto Medical Center

Kyoto, , Japan

Site Status

Kagawa Rosai Hospital

Marugame, , Japan

Site Status

Keio University Hospital

Matsumoto, , Japan

Site Status

Okayama University Hospital

Okayama, , Japan

Site Status

Osaka City University Hospital

Osaka, , Japan

Site Status

Osaka Medical and Pharmaceutical University Hospital

Osaka, , Japan

Site Status

Kitsato University Hospital

Sagamihara, , Japan

Site Status

Saitama City Hospital

Saitama, , Japan

Site Status

Sapporo Medical University Hospital

Sapporo, , Japan

Site Status

Shizuoka General Hospital

Shizuoka, , Japan

Site Status

Keio University Hospital

Tokyo, , Japan

Site Status

Toyoma University Hospital

Toyoma, , Japan

Site Status

Ehime University Hospital

Tōon, , Japan

Site Status

Wakayama Medical University Hospital

Wakayama, , Japan

Site Status

National Hospital Organization Yokohama Medical Center

Yokohama, , Japan

Site Status

Pusan National University Hospital

Busan, , South Korea

Site Status

National Cancer Center

Goyang-si, , South Korea

Site Status

Pusan National University Yangsan Hospital

Gyeongsang, , South Korea

Site Status

Chonnam National University Hwasun Hospital

Jeongnam, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Korea University Anam Hospital

Seoul, , South Korea

Site Status

Severance Hospital

Seoul, , South Korea

Site Status

The Catholic University of Korea

Seoul, , South Korea

Site Status

Keelung Chang Gung Memorial Hospital

Keelung, , Taiwan

Site Status

Keelung Chang Gung Memorial Hospital

Keelung, , Taiwan

Site Status

China Medical University Hospital

Taichung, , Taiwan

Site Status

National Taiwan University Hospital

Taipei, , Taiwan

Site Status

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status

Countries

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United States Australia Japan South Korea Taiwan

Other Identifiers

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CG3002S

Identifier Type: -

Identifier Source: org_study_id

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