A Multicenter, Non-randomized, Uncontrolled, Open-label Phase I/II study to Observe the Safety and Preliminary Efficacy of Catumaxomab in Patients with Non-Muscle-Invasive Bladder Cancer who have Failed or are Intolerant to Bacillus Calmette-Guerin (BCG) Vaccine
This is a multicenter, non-randomized, uncontrolled, open-label phase I/II study to observe the safety and preliminary efficiency of catumaxomab in patients (hereinafter referred to as participants) with non-muscle-invasive bladder cancer (NMIBC) who have failed or are intolerant to Bacillus Calmette-Guerin (BCG) vaccine. This study is conducted in 3 phases sequentially: dose escalation phase, dose expansion phase and dose extension phase. In the dose escalation phase, the preliminary safety and pharmacokinetic profile of catumaxomab for 4 cycles of instillation in 20ug group participants and 2cycles of instillation in 100ug group participants are explored. Data will be collected after completing DLT observation in all cohorts, but it is not required to lock database. DSMB will review the data of each dose cohort and decide whether to open the enrollment for the next cohort. DSMB will recommend the dose at dose expansion phase according to the relevant data after the completion of DLT observation and the first efficiency assessment. In the dose expansion phase, 24 participants will receive the catumaxomab treatment at dosing scheme recommended by the DSMB. DLT events occurred within 28 days after the initial instillation will be investigated. After th DLT observation period, DSMB will evaluate the data from both dose escalation and dose expansion phase and decide whether to initiate the dose extension phase; protocol amendment might be developed. In the dose extension phase, the elgible participants are enrolled and allocated into three arms according to the type of BCG treatment failure: refractory, relapse, and intolerance. A maximum 125 participants are enrolled in the 3 arms, with at least 30 participants allocated to each. The participants will have chest and abdominal CT and pelvic MRI scan at baseline to determine the area of lesion and to rule out possible extra-bladder lesions. From the initial instillation, cystoscopy, bladder biopsy, urinary cytology, and pelvic MRI scan are performed every 12 weeks (±7 days); chest and abdominal CT scans are performed every 24 weeks (±7 days)1 until recurrence, progression, consent withdrawal, or 96 weeks (±7 days) from the initial instillation, whichever occurs firstly. Participants who discontinue study treatment early due to any reasons other than disease progression will continue to have the tumor response assessment as planned until the participant has disease progression, withdrawal of consent, loss of follow-up, death, 96 weeks (± 7 days) after the initial instillation or until the end of the study, whichever occurs firstly.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
161
This study is conducted in 3 phases sequentially: dose escalation phase, dose expansion phase and dose extension phase. In the dose escalation phase, the preliminary safety and pharmacokinetic profile of catumaxomab by instillation, at 2 dose levels(20ug group and 100ug group), in NMIBC patients are investigated.
The First Affiliated Hospital,Sun Yat-sen University
Guangzhou, Guangdong, China
RECRUITINGSun Yat-sen Memorial Hospital, Sun Yat-sen University
Guangzhou, Guangdong, China
RECRUITINGPeking University Third Hospital
Beijing, China
Dose escalation phase and dose expansion phase only: DLT incidence.
Dose Limited Toxicity
Time frame: 28 days
1-year recurrence rate since the initial instillation
1-year recurrence rate since the initial instillation
Time frame: 1 year
Recurrence rate at 3 months / 6 months / 2 years.
Recurrence rate at 3 months / 6 months / 2 year
Time frame: Up to 2 years
PFS
Relapse-free survival
Time frame: 2 years
2-year progression rate to MIBC.
2-year progression rate to MIBC.
Time frame: 2 years
The incidence and severity of treatment-emergent adverse events (TEAEs) and Serious adverse event(SAE)
The incidence and severity of treatment-emergent adverse events (TEAEs) and Serious adverse event(SAE) during intravesical instillation with catumaxomab are observed according to the National Cancer Institute Common Terminology Standard for Adverse Events (NCI-CTCAE) v5.0.
Time frame: 2 years
ADA
the incidence of anti-drug antibodies (ADA) to catumaxomab by intravesical instillation in serum.
Time frame: 2 years
Pharmacokinetic parameters-Cmax
Pharmacokinetic parameters Cmax of bladder perfusion of Catumaxomab in plasma and urine
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Sun Yat-sen University Cancer Center
Guangzhou, China
RECRUITINGThe Second Hospital of Tianjin Medical University
Tianjin, China
RECRUITINGTime frame: 2 years
Pharmacokinetic parameters-Cmin
Pharmacokinetic parameters Cmin of bladder perfusion of Catumaxomab in plasma and urine
Time frame: 2 years
Pharmacokinetic parameters-AUC
Pharmacokinetic parameters-AUC of bladder perfusion of Catumaxomab in plasma and urine
Time frame: 2 years
Pharmacokinetic parameters-t1/2
Pharmacokinetic parameters-t1/2 of bladder perfusion of Catumaxomab in plasma and urine
Time frame: 2 years