Comparison of BCG RIVM and Russian Strains for Treating Non-Muscle-Invasive Bladder Cancer (NMIBC)
A Randomized Prospective Trial Comparing Bacillus Calmette-Guerin (BCG) RIVM and Russian Strains in Non-Muscle Invasive Bladder Cancer: Efficacy and Side Effects
The goal of this clinical trial is to compare the efficacy and safety of two Bacillus Calmette-Guérin (BCG) substrains (RIVM and Russian) in the treatment of intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) in adult patients.
The main questions it aims to answer are:
- Is there a significant difference in recurrence-free survival (RFS) between the BCG RIVM and BCG Russian substrains?
- Is there a significant difference in progression-free survival (PFS) between the two substrains?
- Are there notable differences in the incidence of treatment-related adverse events between the strains? Researchers will compare patients treated with BCG RIVM to patients treated with BCG Russian to determine whether one substrain offers superior clinical outcomes in terms of recurrence, progression, and adverse events.
Participants will:
Undergo transurethral resection of bladder tumor (TURBT) prior to initiating therapy.
Be randomly assigned to receive either BCG RIVM or BCG Russian intravesical therapy.
Receive an induction course of six weekly instillations of the assigned BCG substrain.
Receive maintenance therapy at regular intervals (3, 6, 12, 18, 24, 30, and 36 months) based on risk classification.
Undergo regular follow-up with cystoscopy and urine cytology to assess recurrence, progression, and adverse events.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Altindag
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Ankara, Altindag, Turkey
- Ankara University Faculty of Medicine Ibni Sina Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- age ≥18 years,
- histopathologically confirmed NMIBC (stages Ta, T1, or CIS),
- classification as intermediate, high, or very high risk (who either refused or were not suitable candidates for radical cystectomy),
- no prior BCG therapy,
- no evidence of upper urinary tract carcinoma or distant metastases and
- a minimum follow-up period of 12 months.
Exclusion Criteria:
- patients who did not receive adequate BCG therapy (defined as receiving fewer than 5 of the 6 induction doses or fewer than 2 of the 3 maintenance doses),
- patients with a follow-up period of less than 12 months and
- patients who received multiple BCG strains during the follow-up period.
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 |
|---|---|
|
Active Comparator: Group 1 which received BCG RIVM
following transurethral resection of bladder tumor (TURBT), patients in Group 1 received BCG RIVM.
|
In this study we compared the efficacy and side effects of two different strains of BCG (RIVM and RUSSIAN strains) in non muscle invasive bladder cancer patients
|
|
Active Comparator: Group 2 which received BCG RUSSIAN
following transurethral resection of bladder tumor (TURBT), patients in Group 2 received BCG RUSSIAN.
|
In this study we compared the efficacy and side effects of two different strains of BCG (RIVM and RUSSIAN strains) in non muscle invasive bladder cancer patients
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
recurrence free survival
Time Frame: Through study completion, up to 4 years
|
Through study completion, up to 4 years
|
|
progression free survival
Time Frame: Through study completion, up to 4 years
|
Through study completion, up to 4 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
side effects of the treatment
Time Frame: At each BCG instillation and follow-up visit, up to 4 years
|
At each BCG instillation and follow-up visit, up to 4 years
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Unda-Urzaiz M, Cozar-Olmos JM, Minana-Lopez B, Camarero-Jimenez J, Brugarolas-Rossello X, Zubiaur-Libano C, Ribal-Caparros MJ, Suarez-Charneco AJ, Rodriguez-Tesedo V, Chantada-Abal V, Ruiz-de-Leon C, Carrillo-George C, Carballido-Rodriguez J, Villacampa-Auba F; en representacion del Grupo Espanol del Registro de Cepas de BCG. Safety and efficacy of various strains of bacille Calmette-Guerin in the treatment of bladder tumours in standard clinical practice. Actas Urol Esp (Engl Ed). 2018 May;42(4):238-248. doi: 10.1016/j.acuro.2017.10.003. Epub 2017 Dec 30. English, Spanish.
- Niwa N, Kikuchi E, Matsumoto K, Kosaka T, Mizuno R, Oya M. Does switching the bacillus Calmette-Guerin strain affect clinical outcome in patients with recurrent non-muscle-invasive bladder cancer after initial bacillus Calmette-Guerin therapy? Urol Oncol. 2018 Jun;36(6):306.e1-306.e8. doi: 10.1016/j.urolonc.2018.02.005. Epub 2018 Mar 9.
- Krajewski W, Matuszewski M, Poletajew S, Grzegrzolka J, Zdrojowy R, Kolodziej A. Are There Differences in Toxicity and Efficacy between Various Bacillus Calmette-Guerin Strains in Bladder Cancer Patients? Analysis of 844 Patients. Urol Int. 2018;101(3):277-284. doi: 10.1159/000492722. Epub 2018 Sep 18.
- Del Giudice F, Busetto GM, Gross MS, Maggi M, Sciarra A, Salciccia S, Ferro M, Sperduti I, Flammia S, Canale V, Chung BI, Conti SL, Eisenberg ML, Skinner EC, De Berardinis E. Efficacy of three BCG strains (Connaught, TICE and RIVM) with or without secondary resection (re-TUR) for intermediate/high-risk non-muscle-invasive bladder cancers: results from a retrospective single-institution cohort analysis. J Cancer Res Clin Oncol. 2021 Oct;147(10):3073-3080. doi: 10.1007/s00432-021-03571-0. Epub 2021 Mar 6.
- Huang Z, Liu H, Wang Y, Zhang C, Xu T. Determining optimal maintenance schedules for adjuvant intravesical bacillus Calmette-Guerin immunotherapy in non-muscle-invasive bladder cancer: a systematic review and network meta-analysis. Curr Med Res Opin. 2017 Aug;33(8):1379-1387. doi: 10.1080/03007995.2017.1326889. Epub 2017 Jun 6.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
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
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Urologic Neoplasms
- Carcinoma
- Urinary Bladder Diseases
- Non-Muscle Invasive Bladder Neoplasms
- Urinary Bladder Neoplasms
- Immunologic Factors
- Physiological Effects of Drugs
- Adjuvants, Immunologic
- BCG Vaccine
Other Study ID Numbers
Other Study ID Numbers
- İ10-640-21
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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