The purpose of this study is to evaluate safety, tolerability and pharmacokinetics of intravesical cis-urocanic acid in patients with primary or recurrent non-muscle invasive bladder cancer.
This is a single dose, dose-escalating, Phase I study to evaluate safety, tolerability and pharmacokinetics of intravesical cis-urocanic acid (cis-UCA) in patients with primary or recurrent non-muscle invasive bladder cancer. The primary objectives is to evaluate safety and tolerability of cis-UCA after a single intravesical instillation with escalating doses and to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of cis-UCA after a single intravesical instillation with escalating doses. The secondary objectives are to evaluate pharmacokinetics of cis-UCA after a single intravesical instillation with escalating doses, to obtain preliminary information on possible anti-tumor effects of cis-UCA by cystoscopy and histological evaluation after a single intravesical instillation with escalating doses, and to evaluate the effects of cis-UCA on different surrogate biochemical markers on tumor growth and differentiation after a single intravesical instillation with escalating doses. The key eligibility criteria are the following: Patients with primary or recurrent non-muscle invasive bladder cancer; eligible for intravesical treatment; age 18-80 years; WHO performance status 0-2; acceptable liver, renal and hematological function within 30 days prior to inclusion. At minimum 3 patients and at maximum 24 patients is planned to be included in the study. The fixed dose-escalation levels will be used. Up to three dose cohorts are planned to be included: * Cohort I: 2% cis-UCA solution (50 ml); min 3, max 12 patients * Cohort II: 4% cis-UCA solution (50 ml); min 0, max 12 patients * Cohort III: 6% cis-UCA solution (50 ml); min 0, max 12 patients
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Cohort I: 2% cis-UCA solution (50 ml); min 3, max 12 patients
Cohort II: 4% cis-UCA solution (50 ml); min 0, max 12 patients
Cohort III: 6% cis-UCA solution (50 ml); min 0, max 12 patients
Tampere University Hospital, Department of Urology
Tampere, Finland
Turku University Hospital, Department of Surgery, Division of Urology
Turku, Finland
Bladder-related AEs
Time frame: until resection, max 2 months
Urinalysis
Time frame: participants will be followed until resection, an expected average of 2 months
Evaluation of the appearance of normal bladder epithelium after the cis-UCA dose by cystoscopy during the planned surgical procedure
cystoscopy descriptions
Time frame: participants will be followed until resection, an expected average of 2 months
Area Under Curve (AUC)
Time frame: Predose, 30 min, 45 min, 1 h, 1.5 h, 2 h, 4 h, 6 h, and 24 h post-dose
Efficacy
Change in tumor size from baseline by cystoscopy, change in tumor proliferation marker Ki-67 by immunohistochemistry, change in caspase-3 expression by immunohistochemistry
Time frame: Predose, up to 2 months post-dose
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