E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Radical or total cystectomy on patients with bladder cancer |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.1 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10057191 |
E.1.2 | Term | Transfusion related complications |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Main objective: The objective of this study is to evaluate the safety and efficacy of aprotinin as compared to placebo, in reducing the need for subsequent blood transfusion in subjects with bladder cancer undergoing to radical or total cystectomy. The undermentioned procedures are allowed and belong to radical and total cystectomy: 1. total cystectomy 2. radical cystectomy procedures = cystectomy plus removal of adjacent tissues: cystoprostatectomy, removal of bladder and anterior vaginal wall, cystectomy plus ovariectomy and or hysterectomy 3. urinary tract reconstructive procedures: incontinent cutaneous diversion (eg ileal conduit, etc), continent cutaneous diversion (eg Indiana pouch, etc), orthotopic diversion (eg neobladder) |
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E.2.2 | Secondary objectives of the trial | |
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects (men or non-pregnant women) 18 years of age and older. Subjects requiring elective radical or total cystectomy for bladder cancer. Documented, signed, dated informed consent obtained prior to any study specific procedures being performed.
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E.4 | Principal exclusion criteria |
• Subjects with previous exposure to aprotinin in the last 6 months (if the subject has undergone cardiac surgery in the last 6 months, all attempts should be made to ascertain if aprotinin was administered during surgery; if no records are available, or if the subject received aprotinin, the subject should be excluded) • Subjects with known or suspected allergy to aprotinin • Subjects undergoing laparoscopic resection. • Patients with symptoms indicative for sepsis or local urinary tract infections that make the patient inelegible for total or radical cystectomy • Subjects with a creatinine clearance less than 30 mL/min as calculated by the Cockcroft-Gault formula. • Subjects with a history of bleeding diathesis or known coagulation factor deficiency • Subjects with failure of a major organ system or any active significant medical illness that in the opinion of the Investigator is likely to affect the subject’s ability to complete the study or precludes the subject’s participation in the study • Subjects who refuse to receive allogenic blood products for religious or other reasons • Subjects whose preoperative RBC volume is so low that blood will have to be given peri-operatively (Hct or Hgb values <24% or <8 g/dL, respectively) • Subjects with a history of Deep Vein Thrombosis or Pulmonary Embolism • Women who are pregnant, breastfeeding or women of childbearing potential in whom the possibility of pregnancy cannot be excluded by a negative serum pregnancy test at screening. • Women of childbearing potential who are not using a reliable method of contraception. Methods of contraception that are considered reliable are intrauterine devices (IUDs), birth control pills, hormonal implants/patches, and barrier contraception when used with spermicidal products. The "Rythm" method is not considered a reliable method of contraception. • Planned use of other antifibrinolytic agents (e.g., aminocaproic acid (Amicar®) or tranexamic acid (Cyklokapron®) • Subjects on chronic anticoagulant treatment with Vitamin K antagonists where it cannot be discontinued for the surgical procedure • Subjects on an investigational drug (i.e. not marketed) in the 30 days prior to screening or during the trial before the 6 week follow-up visit. Subjects involved in trials of marketed cancer therapy medications (including those approved for another indication) or combination with radiotherapy are allowed.
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E.5 End points |
E.5.1 | Primary end point(s) |
The objective of this study is to evaluate the safety and efficacy of aprotinin as compared to placebo, in reducing the need for subsequent blood transfusion in subjects with bladder cancer undergoing to radical or total cystectomy. The primary criterion for efficacy is the percent of patients requiring a blood transfusion anytime in the intra-operative or post-operative period (up to the earlier of Day 7 or discharge). The primary analysis will be based on all patients undergoing protocol defined surgery that are valid for analysis of intent to treat.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 17 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The expected duration of the study is approximately 36 months from the first subject being screened, including a two-year long term follow up. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |