This is a phase III, single-arm, multicenter, international study to assess the efficacy and safety of ONCOFID-P-B following intravesical instillation in adult patients with histologically and cytologically confirmed CIS, with or without concomitant Ta-T1, who are unresponsive to BCG therapy and unwilling or unfit to undergo radical cystectomy. After providing written informed consent (in presence of an Independent Witness, if applicable), patients will receive an induction therapy consisting of 12 weekly intravesical instillations of ONCOFID-P-B (induction phase). Patients with residual CIS at the end of induction treatment are eligible to enter a re-induction course of therapy (reinduction phase). Patients with stable disease by Investigator assessment defined as neither increased or decreased in extent or severity compared to baseline, are not eligible for re-induction therapy. Patients who achieve a complete resonde (CR) at the end of the induction or re-induction phase enter in the maintenance phase and receive monthly intravesical instillations of ONCOFID-P-B for an additional 12 monsthe or untile recurrence of CIS/HG Ta-T1 or progression to MIBC or extravesical disease. Patients who do not achieve a CR at the end of induction or re-induction phase, will discontinue investigational treatement and are followed up until month 48 from induction or re-induction start, or until a new antitumor therapy is initiated, wichever occurs first. Tumor response is evaluated by cystoscopy, cytology and biopsy at the end of the induction and re-induction phases and at Safety Follow Up Visit (SFUV). During the maintenance/follow-up period, tumorresponse is evaluated by cystoscopy and cytology every 3 months for up to 24 months from induction or re-induction start, and then every 6 months for an additional 2 years (long-term follow-up). Tumor biopsies are performed in case of of positive cystoscopy and/or cytology. Random biopsies are to be performed at 6, 12 and 18 months after the end of the induction or re-induction phase in responding patients (i.e. at 9, 15 and 21 months after induction or re-induction start.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
112
Schedule: once a week for 12 consecutive weeks (induction phase). Patients who achieve a complete response at the end of the induction phase will enter the maintenance phase, during which ONCOFID-P-B is administered once a month for 12 months until recurrence or progression of the disease.
Banner Health- MD Anderson Cancer Center
Gilbert, Arizona, United States
RECRUITINGOchsner Clinic Foundation
New Orleans, Louisiana, United States
RECRUITINGJohns Hopkins Kimmel Cancer Center
Baltimore, Maryland, United States
RECRUITINGUniversity of Minnesota
Minneapolis, Minnesota, United States
Centrally assessed Complete Response Rate (CRR) at any time
CRR calculated as the proportion of patients achieving a CR at any time. CRR will be based on central assessment of response
Time frame: CRR will be evaluated at any time
Centrally assessed CRR
CRR calculated as the proportion of patients achieving a CR at 6, 9, 12, 15, 18, 21, 24, 30, 36, 42 and 48 months after induction or re-induction start
Time frame: CRR will be evaluated at 6, 9, 12, 15, 18, 21, 24, 30, 36, 42 and 48 months after induction or re-induction
Duration of Response (DoR)
DoR defined as the time from first documented evidence of CR to time of documented recurrence (CIS or Ta-T1), progression to MIBC, to extravesical disease, or death
Time frame: DoR will be evaluated at 6, 9, 12, 15, 18, 21, 24, 30, 36, 42 and 48 months after induction or re-inductiononths after treatment start
Duration of Response (DoR) rate
DoR rate calculated as the proportion of patients who maintained a CR after 6, 9, 12, 15, 18, 21, 30, 36, 42 and 48 months after induction or re-induction start.
Time frame: DoR rates will be evaluated at 6, 9, 12, 15, 18, 21, 30, 36, 42 and 48 after induction or re-induction start
Progression rate
Progression rate calculated as the proportion of patients with muscle invasion or extravesical expansion of the disease at EOIT/EORIT, 15, 24 and 48 months after induction or re-induction start
Time frame: Progression rate will be evaluated at EOIT/EROIT, 15, 24 and 48 months after induction or re-inductionstart
Time to progression
Time to progression defined as time from treatment start to time of documented tumor progression to MIBC or extravesical disease.
Time frame: Time to progression will be evaluated at 15, 24 and 48 months after induction or re-induction start
Rate of patients undergoing cystectomy
Proportion of patients undergoing cystectomy for disease progression at EOIT/EORIT, 9, 15, 24 and 48 months after induction or re-induction start.
Time frame: Rate of patients undergoing cystectomy will be evaluated at EOIT/EROIT, 9, 15, 24, 24 and 48 months after induction or re-induction start.
Time to cystectomy defined as time from start of treatment to the date of cystectomy
Time to cystectomy is defined as the time (months) form start of treatment to the date of cystectomy, analyzed using the Kaplan-Meier method. The median time to cystectomy will be presented along with 95% CI.
Time frame: from start of treatment to date of cystectomy
event-free survival (EFS)
EFS defined as time from treatment start to the time of documented recurrence after CR, or progression or death due to any cause.
Time frame: Event-free survival (EFS) will be evaluated at any time during the study up to 48 months after treatment start
Overall survival (OS)
OS defined as time from treatment start to death due to any cause.
Time frame: overall survival (OS) will be evaluated at any time during the study up to 48 months after treatment start
Incidence of Treatment-Emergent Adverse Events (Overall Safety)
Overall safety and tolerability evaluated throughout the study on the basis of the incidence, nature, severity and causality of TEAEs, coded to preferred term and system organ class (SOC) using the Medical Dictionary for Regulatory Activities (MedDRA) and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5 and the incidence of serious adverse events (SAEs)
Time frame: Safety data will be evaluated up to study month 16
Treatment time of retention (tolerability)
The tolerability of ONCOFID-P-B expressed as the ability to retain intravesical instillation for the desired dwell time (optimal retention time is 120 minutes) and measured as time of retention.
Time frame: Tolerability will be evaluated up to study month 16
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TriState Urologic Services PSC Inc. dba The Urology Group
Cincinnati, Ohio, United States
RECRUITINGMedical University of South Carolina (MUSC)
Charleston, South Carolina, United States
RECRUITINGCHU Bordeaux -Hopital Pellegrin
Bordeaux, France
RECRUITINGCHU de Clermont-Ferrand - Hopital Gabriel Montpied
Clermont-Ferrand, France
RECRUITINGCHU de Lille - Hopital Claude Huriez
Lille, France
RECRUITINGInstitute Paoli-Calmettes
Marseille, France
RECRUITING...and 37 more locations