Durvalumab+ Gemcitabine/Cisplatin (Neoadjuvant Treatment) and Durvalumab (Adjuvant Treatment) in Patients With MIBC (NIAGARA)
A Phase III, Randomized, Open-Label, Multi-Center, Global Study to Determine the Efficacy and Safety of Durvalumab in Combination With Gemcitabine+Cisplatin for Neoadjuvant Treatment Followed by Durvalumab Alone for Adjuvant Treatment in Patients With Muscle-Invasive Bladder Cancer.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Brisbane, Australia, 4122
- Research Site
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Elizabeth Vale, Australia, 5112
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Macquarie University, Australia, 2109
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Melbourne, Australia, 3004
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Murdoch, Australia, 6150
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South Brisbane, Australia, 4101
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Bruges, Belgium, 8000
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Charleroi, Belgium, 6000
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Kortrijk, Belgium, 8500
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Leuven, Belgium, 3000
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Liège, Belgium, 4000
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Roeselare, Belgium, 8800
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Barretos, Brazil, 14784-400
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Porto Alegre, Brazil, 90610-000
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Porto Alegre, Brazil, 91350-200
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Porto Alegre, Brazil, 90020-090
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Porto Alegre, Brazil, 90470-340
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Rio de Janeiro, Brazil, 20231-050
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Santa Maria, Brazil, 97015-450
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São José do Rio Preto, Brazil, 15090-000
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São Paulo, Brazil, 03102-002
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São Paulo, Brazil, 01246-000
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São Paulo, Brazil, 01509-900
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São Paulo, Brazil, 01323-903
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 4E6
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Ontario
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London, Ontario, Canada, N6A 5W9
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Ottawa, Ontario, Canada, K1H 8L6
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Toronto, Ontario, Canada, M5G IX6
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Quebec
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Montreal, Quebec, Canada, H2X 0C2
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Sherbrooke, Quebec, Canada, J1H 5N4
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Antofagasta, Chile, 1267348
- Research Site
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Port Montt, Chile, 5480000
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Santiago, Chile, 7520349
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Temuco, Chile, 4810218
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Temuco, Chile, 4810469
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Viña del Mar, Chile, 2540488
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Brno, Czechia, 656 53
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Brno, Czechia, 656 91
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Hradec Králové, Czechia, 500 05
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Olomouc, Czechia, 77900
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Prague, Czechia, 128 08
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Prague, Czechia, 140 59
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Prague, Czechia, 180 81
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Angers, France, 49033
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Dijon, France, 21079
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Grenoble, France, 38043
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Montpellier, France, 34070
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Nîmes, France, 30029
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Pierre-Bénite, France, 69495
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Poitiers, France, 86021
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Rouen, France, F-76031 CE
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Bergisch Gladbach, Germany, 51465
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Bonn, Germany, 53127
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Cologne, Germany, 50937
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Erlangen, Germany, 91054
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Göttingen, Germany, 37075
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Herne, Germany, 44625
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Jena, Germany, 07747
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Magdeburg, Germany, 39120
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Mannheim, Germany, 68167
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Münster, Germany, 48149
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Nuremberg, Germany, 90491
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Oldenburg, Germany, 23758
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Regensburg, Germany, 93053
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Ulm, Germany, 89081
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Würzburg, Germany, 97080
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Haifa, Israel, 31096
- Research Site
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Jerusalem, Israel, 91120
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Kfar Saba, Israel, 95847
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Petah Tikva, Israel, 4941492
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Ramat Gan, Israel, 52621
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Bari, Italy, 70124
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Bologna, Italy, 40138
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Florence, Italy, 50134
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Milan, Italy, 20132
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Milan, Italy, 20133
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Naples, Italy, 80131
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Orbassano, Italy, 10043
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Pozzuoli, Italy, 80078
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Verona, Italy, 37126
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Bunkyō City, Japan, 113-8603
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Fukuoka, Japan, 812-8582
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Fukuoka, Japan, 811-1347
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Hirosaki-shi, Japan, 036-8563
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Hiroshima, Japan, 730-8518
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Kanazawa, Japan, 920-8641
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Kumamoto, Japan, 860-0008
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Kōtoku, Japan, 135-8550
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Miyazaki, Japan, 889-1692
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Nagasaki, Japan, 852-8501
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Nagoya, Japan, 466-8560
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Niigata, Japan, 951-8520
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Osaka, Japan, 545-8586
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Osaka, Japan, 541-8567
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Osakasayama-shi, Japan, 589-8511
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Sendai, Japan, 980-0872
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Toyama, Japan, 930-0194
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Tsukuba, Japan, 305-8576
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Yokohama, Japan, 241-8515
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Yokohama, Japan, 232-0024
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Amsterdam, Netherlands, 1066 CX
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Amsterdam, Netherlands, 1081 HV
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Breda, Netherlands, 4818 CK
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Rotterdam, Netherlands, 3015 GD
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Baguio City, Philippines, 2600
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Cebu, Philippines, 6000
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Davao City, Philippines, 8000
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Makati, Philippines, 1229
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Manila, Philippines, 1015
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Quezon City, Philippines, 1104
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Quezon City, Philippines, 1101
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Bialystok, Poland, 15-027
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Gdansk, Poland, 80-952
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Grudziądz, Poland, 86-300
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Koszalin, Poland, 75-581
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Krakow, Poland, 30-510
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Olsztyn, Poland, 10-228
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Ostrołęka, Poland, 07-410
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Poznan, Poland, 60-693
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Warsaw, Poland, 02-781
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Wroclaw, Poland, 53-413
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Krasnoyarsk, Russia, 660133
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Moscow, Russia, 105077
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Nizhny Novgorod, Russia, 603074
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Novosibirsk, Russia, 630007
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Saint Petersburg, Russia, 194354
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Saint Petersburg, Russia, 197022
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Saint Petersburg, Russia, 194017
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Saint Petersburg, Russia, 194044
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Samara, Russia, 443031
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Ufa, Russia, 450000
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Vologda, Russia, 160012
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Daegu, South Korea, 41404
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Goyang-si, South Korea, 10408
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Gyeonggi-do, South Korea, 13620
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Incheon, South Korea, 21565
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Seoul, South Korea, 03080
- Research Site
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Seoul, South Korea, 05505
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Seoul, South Korea, 136-705
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Badalona, Spain, 08916
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Barcelona, Spain, 08035
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Córdoba, Spain, 14004
- Research Site
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Las Palmas de Gran Canaria, Spain, 35016
- Research Site
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Madrid, Spain, 28041
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Madrid, Spain, 28007
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Santander, Spain, 39008
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Seville, Spain, 41013
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Kaohsiung City, Taiwan, 807
- Research Site
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Taichung, Taiwan, 40705
- Research Site
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Taichung, Taiwan, 404
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Tainan, Taiwan, 704
- Research Site
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Tainan, Taiwan, 710
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Taipei, Taiwan, 11217
- Research Site
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Taipei, Taiwan, 10050
- Research Site
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Taoyuan City, Taiwan, 333
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Ankara, Turkey (Türkiye), 06590
- Research Site
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Cordaleo, Turkey (Türkiye), 35575
- Research Site
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Edirne, Turkey (Türkiye), 22030
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Istanbul, Turkey (Türkiye), 34030
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Istanbul, Turkey (Türkiye), 34457
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Izmir, Turkey (Türkiye)
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Edinburgh, United Kingdom, EH4 2XR
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London, United Kingdom, E1 1BB
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Metropolitan Borough of Wirral, United Kingdom, CH63 4JY
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Nottingham, United Kingdom, NG5 1PB
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Sheffield, United Kingdom, S10 2SJ
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Alabama
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Birmingham, Alabama, United States, 35294
- Research Site
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California
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Los Angeles, California, United States, 90095
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Palo Alto, California, United States, 94304
- Research Site
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Connecticut
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New Haven, Connecticut, United States, 06520
- Research Site
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Illinois
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Chicago, Illinois, United States, 60611
- Research Site
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Geneva, Illinois, United States, 60134
- Research Site
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Iowa
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Iowa City, Iowa, United States, 52242
- Research Site
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Kansas
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Westwood, Kansas, United States, 66205
- Research Site
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Kentucky
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Louisville, Kentucky, United States, 40202
- Research Site
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Louisiana
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New Orleans, Louisiana, United States, 70112
- Research Site
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Maryland
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Towson, Maryland, United States, 21204
- Research Site
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Michigan
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Ann Arbor, Michigan, United States, 48109
- Research Site
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Detroit, Michigan, United States, 48201
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New York
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New York, New York, United States, 10029
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Rochester, New York, United States, 14642
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Pennsylvania
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Bethlehem, Pennsylvania, United States, 18015
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Vermont
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Burlington, Vermont, United States, 05401
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
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Hanoi, Vietnam, 100000
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Ho Chi Minh City, Vietnam, 700000
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Hochiminh, Vietnam, 70000
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion:
- Patient resectable muscle-invasive bladder cancer with clinical stage T2-T4aN0/1M0 with transitional and mixed transitional cell histology
- Patients must be planning to undergo a radical cystectomy
- Patients who have not received prior systemic chemotherapy or immunotherapy for treatment of MIBC
- ECOG performance status of 0 or 1
- Must have a life expectancy of at least 12 weeks at randomization
Exclusion:
- Evidence of lymph node (N2-N3) or metastatic (M1) disease at time of screening.
- Prior pelvic radiotherapy treatment within 2 years of randomization to study
- Prior exposure to immune-mediated therapy (with exclusion of Bacillus-Calmette Guerin [BCG]), including but not limited to other anti-CTLA-4, anti-PD-1, anti PD-L1, or anti-PD-L2 antibodies.
- Current or prior use of immunosuppressive medication within 14 days before the first dose of investigational product (IP). The following are exceptions to this criterion: Intranasal, inhaled, topical steroids, or local steroid injections (eg, intra articular injection); Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent; Steroids as premedication for hypersensitivity reactions (eg, CT scan premedication)
- Receipt of live attenuated vaccine within 30 days prior to the first dose of IP.
- Uncontrolled intercurrent illness
- Active infection including Tuberculosis, Hepatitis B, Hepatitis C, and Human Immunodeficiency
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Arm 1
Chemotherapy + Durvalumab
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Anti- PD-L1 Antibody
Chemotherapy Agent
Chemotherapy agent
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Active Comparator: Arm 2
Chemotherapy alone
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Chemotherapy Agent
Chemotherapy agent
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Pathologic Complete Response (pCR) Rates at Time of Cystectomy
Time Frame: Up to 6 months
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pCR rate is defined as the proportion of patients whose pathological staging was T0N0M0 as assessed per central pathology review using specimens obtained via radical cystectomy following the neoadjuvant treatment.
The denominator for pCR will be the number of patients in the FAS.
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Up to 6 months
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Event-free Survival (EFS) Per Central Review Defined as Time From Randomization to Event
Time Frame: Up to 48 months
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EFS is defined as the time from randomization to the first recurrence of disease post radical cystectomy, time of first documented progression in patients who were medically precluded for radical cystectomy, or time of expected surgery in patients who refuse to undergo a radical cystectomy or failure to undergo a radical cystectomy in participants with residual disease, or the time of death due to any cause, whichever occurs first
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Up to 48 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Event-free Survival at 24 Months (EFS24) Per Central Review Defined as Time From Randomization to Event
Time Frame: Up to 24 months
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EFS24 is defined as the Kaplan-Meier estimate of EFS at 24 months after randomization, as assessed per blinded independent central review or by central pathology review if a biopsy is required for a suspected new lesion, and per local investigator or local biopsy review if a biopsy is required for a suspected new lesion
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Up to 24 months
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Proportion of Patients Who Undergo Cystectomy
Time Frame: Up to 6 months
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The proportion of patients who undergo cystectomy is defined as the proportion patients who undergo radical cystectomy after the neoadjuvant treatment.
The denominator will be patients in the FAS.
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Up to 6 months
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Overall Survival
Time Frame: Up to 65 months
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OS is defined as the time from the date of randomization until death due to any cause regardless of whether the patient withdraws from randomized therapy or receives another anti-cancer therapy (i.e., date of death or censoring - date of randomization + 1)
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Up to 65 months
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Metastasis-free Survival Per Investigator Assessment or Local Biopsy Review.
Time Frame: Up to 48 months
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MFS is defined as the time from date of randomization until the first recognition of distant metastases or death, whichever occurs first
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Up to 48 months
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Disease-specific Survival Per Investigator Assessment or Local Biopsy Review.
Time Frame: Up to 48 months
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DSS is defined as the time from the date of randomization until death due to bladder cancer
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Up to 48 months
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Immunogenicity of Durvalumab When Used in Combination With Gemcitabine/Cisplatin as Measured by Presence of Antidrug Antibodies (ADA)
Time Frame: Up to 12 months
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Whole blood samples for assessing ADA for durvalumab in serum were collected from patients undergoing durvalumab treatment, following the specified assessment schedule.
ADA prevalence is the proportion of patients with a positive ADA result at any time, baseline or post-baseline.
Treatment-emergent ADA includes both treatment-induced and treatment-boosted ADA.
Its incidence is the proportion of patients with treatment-emergent ADA positivity.
Treatment-boosted ADA refers to a baseline-positive ADA titer that increased ≥4-fold during the study.
Persistently positive patients have at least two post-baseline ADA-positive readings, with at least 16 weeks between the first and last, or an ADA-positive result at the final assessment.
This includes baseline-positive patients meeting these criteria.
Transiently positive is defined by at least one post-baseline ADA-positive reading without being persistently positive, including baseline-positive patients meeting these terms.
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Up to 12 months
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Male Urogenital Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urologic Neoplasms
- Urinary Bladder Diseases
- Urinary Bladder Neoplasms
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Inorganic Chemicals
- Chlorine Compounds
- Nitrogen Compounds
- Deoxycytidine
- Cytidine
- Pyrimidine Nucleosides
- Pyrimidines
- Platinum Compounds
- Gemcitabine
- Cisplatin
- durvalumab
Other Study ID Numbers
Other Study ID Numbers
- D933RC00001
- 2018-001811-59 (EudraCT Number)
- 2023-510015-19-00 (Registry Identifier: CTIS)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.