E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Muscle invasive transitional cell carcinoma of the urinary bladder |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10066753 |
E.1.2 | Term | Bladder transitional cell carcinoma stage II |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10005084 |
E.1.2 | Term | Bladder transitional cell carcinoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10066754 |
E.1.2 | Term | Bladder transitional cell carcinoma stage III |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 |
To record the proportion of patients whose cancer responds to chemotherapy using the drugs cabazitaxel and cisplatin before surgery in the treatment of transitional cell carcinoma of the urinary bladder. This small study of about 30 patients will help to establish whether this treatment should be studied further in a larger group of patients in future. |
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E.2.2 | Secondary objectives of the trial |
To record side effects and tolerability of chemotherapy by regularly monitoring patients during and after the study, and recording any side effects experienced. To record the average survival of patients treated in the study. To assess quality of life during treatment. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
1. Evaluation of Dynamic Contrast Enhanced Magnetic Resonance Imaging in Early Prediction of Chemotherapy response in Muscle Invasive Transitional Cell Carcinoma of the Urinary Bladder (APPENDIX 1, Protocol version 5 23/11/2011) Objectives: PRIMARY: To determine the sensitivity, specificity and accuracy of DCE MRI in prediction of pathological response to neoadjuvant chemotherapy: 1. After one cycle of chemotherapy; 2. After 3 cycles of chemotherapy. SECONDARY: To determine sensitivity and specificity of DCE MRI com-pared with standard pre-operative response assessment in prediction of pathological response to chemotherapy 2. Evaluation of Circulating Tumour Cell Measurement in the Assessment of Response to Neoadjuvant Chemotherapy for Muscle Invasive Transitional Cell Carcinoma of the Urinary Bladder (APPENDIX 2, protocol version 5 23/11/2011) Objectives: To determine the sensitivity, specificity and accuracy of CTC measurement in prediction of pathological response to neoadjuvant chemotherapy in patients receiving treatment in the Bristol Bladder Trial; To establish whether this approach warrants further investi-gation within a larger cohort. |
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E.3 | Principal inclusion criteria |
Age ≥18 years; Histologically confirmed primary TCC of the urinary bladder; T2 to T4 disease, N0 M0 determined by CT imaging and biopsy or transurethral resection; ECOG Performance status 0 or 1; GFR ≥60ml/min; Written, informed consent |
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E.4 | Principal exclusion criteria |
ECOG Performance Status ≥ 2; Lymph node involvement or metastatic disease; Prior surgery, radiation, chemotherapy, or other anti-cancer therapy within 4 weeks prior to enrolment in the study; Active Grade ≥2 peripheral neuropathy; Active secondary cancers; History of severe hypersensitivity reaction (≥Grade 3) to polysorbate 80 containing drugs; History of severe hypersensitivity reaction (≥Grade 3) or intolerance to prednisone; Other concurrent serious illness or medical conditions; Inadequate organ function as evidenced by the following peripheral blood counts, and serum biochemistry at enrolment: Neutrophils ≤1.5 x 109/L, Haemoglobin ≤10 g/dL, Platelets ≤100 x 109/L, Total bilirubin > upper limit of normal (ULN), Aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT)≥2.5 x ULN, Alanine aminotransferase/serum glutamate pyruvate transaminase (ALT/SGPT)≥2.5 x ULN, Creatinine ≥1.5 x ULN; Uncontrolled cardiac arrhythmias, angina pectoris, and/or hypertension, history of congestive heart failure, or myocardial infarction within last 6 months; Left ventricular ejection fraction ≤50%; Uncontrolled diabetes mellitus; Active uncontrolled gastro-oesophageal reflux disease (GORD); Active infection requiring systemic antibiotic or anti-fungal medication; Participation in another clinical trial with any investigational drug within 30 days prior to study enrolment; Concurrent or planned treatment with strong inhibitors or inducers of cytochrome P450 3A4/5; Contraindications to cisplatin |
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E.5 End points |
E.5.1 | Primary end point(s) |
Response rate (pathological partial response + complete response determined at radical cystectomy) with combination cisplatin and cabazitaxel chemotherapy in muscle invasive transitional cell carcinoma of the urinary bladder. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
This endpoint is evaluated after participants have received 4 cycles of neoadjuvant combination chemotherapy with cabazitaxel and cisplatin, and have undergone subsequent radical cystectomy with histopathological assessment of response to neoadjuvant chemotherapy. |
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E.5.2 | Secondary end point(s) |
Progression free survival, overall survival, Safety, Quality of life |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Safety and Quality of Life data are collected during chemotherapy treatment only and so will be evaluable after the final patient has completed study chemotherapy. Progression free and overall survival data are evaluable after 5 years' follow up (5 years after the final patient has undergone radical cystectomy) |
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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 | No |
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 | No |
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 | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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End of trial will be 5 years after the last patient has undergone radical cystectomy. |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 6 |
E.8.9.2 | In all countries concerned by the trial months | 11 |
E.8.9.2 | In all countries concerned by the trial days | 1 |