A single-arm, two-stage, open-label, phase 2 study investigating the safety and efficacy of intravesical gemcitabine/docetaxel for bacillus Calmette-Guerin (BCG)-naïve patients with non-muscle invasive bladder cancer (NMIBC).
All participants will receive an induction course of gemcitabine/docetaxel instillations (administered once a week for six consecutive weeks) followed by monthly maintenance instillations if initial efficacy is seen. In addition to providing initial efficacy data, this study will provide safety and long-term efficacy data on the combination regimen studied. A tolerable safety profile and demonstrated efficacy would support a potential, randomized phase 3 trial comparing the experimental combination therapy and standard of care intravesical BCG therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
27
1g gemcitabine in 50ml sterile water; instilled once weekly for 6 weeks and then once monthly for ≤ 21 months.
37.5mg docetaxel in 50ml normal saline solution (NSS); instilled once weekly for 6 weeks and then once monthly for ≤ 21 months.
Johns Hopkins University: Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland, United States
3-Month Complete Response Rate
Number of patients with no evidence of recurrent high grade urothelial carcinoma of the bladder of any stage as assessed by cystoscopy with biopsy and urine cytology.
Time frame: 3 months
12-Month Relapse-Free Survival Rate
Proportion of patients alive and with no evidence of recurrent high grade urothelial carcinoma of the bladder of any stage.
Time frame: 12 months
24-Month Relapse-Free Survival Rate
Proportion of patients alive and with no evidence of recurrent high grade urothelial carcinoma of the bladder of any stage.
Time frame: 24 months
Safety Profile as Assessed by Proportion of Adverse Events by Type
Proportion of adverse events by type, as defined by Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0).
Time frame: Up to 24 months
Safety Profile as Assessed by Proportion of Adverse Events by Grade
Proportion of adverse events by grade, as defined by Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0).
Time frame: Up to 24 months
Number of Gene Alterations as Measured by RNA-seq
Number of gene alterations as measured by RNA-seq. Compare results to 3-month Complete Response rate using statistical methods.
Time frame: 3 months
Type of Gene Alterations as Measured by RNA-seq
Type of gene alterations as measured by RNA-seq. Compare results to 3-month Complete Response rate using statistical methods.
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Time frame: 3 months
Number of Gene Alterations as Measured by RNA-seq
Number of gene alterations as measured by RNA-seq. Compare results to 12-month Relapse-Free Survival rate using statistical methods.
Time frame: 12 months
Type of Gene Alterations as Measured by RNA-seq
Type of gene alterations as measured by RNA-seq. Compare results to 12-month Relapse-Free Survival rate using statistical methods.
Time frame: 12 months
Number of DNA Mutations as Measured by Whole Transcriptome
Number of DNA mutations as measured by whole transcriptome. Compare results to 3-month Complete Response rate.
Time frame: 3 months
Number of DNA Mutations as Measured by Whole Exome
Number of DNA mutations as measured by whole exome. Compare results to 3-month Complete Response rate.
Time frame: 3 months
Number of DNA Mutations as Measured by Panel DNA Sequencing
Number of DNA mutations as measured by panel DNA sequencing. Compare results to 3-month Complete Response rate.
Time frame: 3 months
Type of DNA Mutations as Measured by Whole Transcriptome
Type of DNA mutations as measured by whole transcriptome. Compare results to 3-month Complete Response rate.
Time frame: 3 months
Type of DNA Mutations as Measured by Whole Exome
Type of DNA mutations as measured by whole exome. Compare results to 3-month Complete Response rate.
Time frame: 3 months
Type of DNA Mutations as Measured by Panel DNA Sequencing
Type of DNA mutations as measured by panel DNA sequencing. Compare results to 3-month Complete Response rate.
Time frame: 3 months
Number of DNA Mutations as Measured by Whole Transcriptome
Number of DNA mutations as measured by whole transcriptome. Compare results to 12-month Relapse Free Survival rate using statistical analysis.
Time frame: 12 months
Number of DNA Mutations as Measured by Whole Exome
Number of DNA mutations as measured by whole exome. Compare results to 12-month Relapse Free Survival rate using statistical analysis.
Time frame: 12 months
Number of DNA Mutations as Measured by Panel DNA Sequencing
Number of DNA mutations as measured by panel DNA sequencing. Compare results to 12-month Relapse Free Survival rate using statistical analysis.
Time frame: 12 months
Type of DNA Mutations as Measured by Whole Transcriptome
Type of DNA mutations as measured by whole transcriptome. Compare results to 12-month Relapse Free Survival rate using statistical analysis.
Time frame: 12 months
Type of DNA Mutations as Measured by Whole Exome
Type of DNA mutations as measured by whole exome. Compare results to 12-month Relapse Free Survival rate using statistical analysis.
Time frame: 12 months
Type of DNA Mutations as Measured by Panel DNA Sequencing
Type of DNA mutations as measured by panel DNA sequencing. Compare results to 12-month Relapse Free Survival rate using statistical analysis.
Time frame: 12 months
Numbers of T-cell Subpopulations
Numbers of t-cell subpopulations utilizing immunohistochemical (IHC) staining and flow cytometry. Compare results to 3-month Complete Response rate using statistical analysis.
Time frame: 3 months
Ratio of T-cell Subpopulations
Ratio of t-cell subpopulations utilizing IHC staining and flow cytometry. Compare results to 3-month Complete Response rate using statistical analysis.
Time frame: 3 months
Numbers of T-cell Subpopulations
Numbers of t-cell subpopulations utilizing IHC staining and flow cytometry. Compare results to 12-month Relapse-Free Survival rate using statistical analysis.
Time frame: 12-months
Ratio of T-cell Subpopulations
Ratio of t-cell subpopulations utilizing IHC staining and flow cytometry. Compare results to 12-month Relapse-Free Survival rate using statistical analysis.
Time frame: 12-months