Bladder Cancer Clinical Trial
Study of Cretostimogene Given in Patients With Non-Muscle Invasive Bladder Cancer ,Unresponsive to Bacillus-Calmette-Guerin
Summary
To evaluate the activity of intravesical (IVE) administration of CG0070 in patients with tissue pathology confirmed non-muscular invasive bladder cancer (NMIBC) who have Bacillus-Calmette-Guerin (BCG) unresponsive disease, with either carcinoma in situ with or without Ta/T1 disease
Full Description
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.
Eligibility Criteria
Cohort C 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
Cohort P Inclusion Criteria
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 8 weeks 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
Cohort C and Cohort P Key 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
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There are 26 Locations for this study
Phoenix Arizona, 85054, United States More Info
Principal Investigator
Tucson Arizona, 85704, United States More Info
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Principal Investigator
Irvine California, 92868, United States More Info
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Principal Investigator
Washington District of Columbia, 20010, United States More Info
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Jacksonville Florida, 32224, United States More Info
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Principal Investigator
Atlanta Georgia, 30322, United States More Info
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Principal Investigator
Kansas City Kansas, 66160, United States More Info
Principal Investigator
Rochester Minnesota, 55905, United States
Durham North Carolina, 27710, United States More Info
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Principal Investigator
Toledo Ohio, 43614, United States More Info
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Principal Investigator
Philadelphia Pennsylvania, 19104, United States More Info
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Principal Investigator
Myrtle Beach South Carolina, 29572, United States More Info
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Principal Investigator
Nashville Tennessee, 37232, United States More Info
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Principal Investigator
San Antonio Texas, 78229, United States More Info
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Principal Investigator
Geelong , , Australia
Melbourne , , Australia
Wollongong , , Australia
Chiba , , Japan
Fujita , , Japan
Hashimoto , , Japan
Hiroshima , , Japan
Ishizuka , , Japan
Kandori , , Japan
Kashihara , , Japan
Kashiwa , , Japan
Kikuchi , , Japan
Kyoto , , Japan
Marugame , , Japan
Matsumoto , , Japan
Okayama , , Japan
Osaka , , Japan
Osaka , , Japan
Sagamihara , , Japan
Saitama , , Japan
Sapporo , , Japan
Shizuoka , , Japan
Tokyo , , Japan
Toon , , Japan
Toyoma , , Japan
Wakayama , , Japan
Yokohama , , Japan
Busan , 49241, Korea, Republic of
Goyang-si , 10408, Korea, Republic of
Gyeongsang , 50612, Korea, Republic of
Jeongnam , 58128, Korea, Republic of
Seoul , 03080, Korea, Republic of
Seoul , , Korea, Republic of
Seoul , , Korea, Republic of
Seoul , , Korea, Republic of
Keelung City , , Taiwan
Keelung , 204, Taiwan
Taichung , 40447, Taiwan
Taipei , , Taiwan
Taipei , , Taiwan
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