- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00028756
Comparison of Immediate and Delayed Adjuvant Chemotherapy in Treating Patients Who Have Undergone a Radical Cystectomy for Stage III or Stage IV Transitional Cell Carcinoma of the Bladder Urothelium
Randomized Phase III Trial Comparing Immediate Versus Deferred Chemotherapy After Radical Cystectomy in Patients With pT3-pT4, and/or N+M0 Transitional Cell Carcinoma (TCC) of the Bladder
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVES:
I. Compare the overall and progression-free survival of patients with stage III or IV transitional cell carcinoma of the bladder urothelium treated with immediate versus deferred adjuvant chemotherapy after radical cystectomy.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center, tumor status (pT1-2 vs pT3 vs pT4), and node status (node positive vs node negative with 15 or more nodes sampled vs node negative with less than 15 nodes sampled). Patients are randomized to one of two treatment arms.
ARM I: Beginning within 90 days of radical cystectomy, patients receive a total of 4 courses of adjuvant chemotherapy.
ARM II: Beginning at the time of clinical relapse, patients receive a total of 6 courses of adjuvant chemotherapy.
Patients in both arms receive one of the following chemotherapy regimens to be determined by participating center:
REGIMEN A (Classical M-VAC): Patients receive classical M-VAC comprising methotrexate IV on days 1, 15 and 22; vinblastine IV on days 2, 15, and 22; and doxorubicin IV and cisplatin IV on day 2. Courses repeat every 28 days.
REGIMEN B (High-dose M-VAC): Patients receive high-dose M-VAC comprising methotrexate IV on day 1 and vinblastine IV, doxorubicin IV, and cisplatin IV on day 2. Patients also receive filgrastim (G-CSF subcutaneously once daily on days 4-10. Courses repeat every 14 days.
REGIMEN C (Gemcitabine and cisplatin): Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15 followed by cisplatin IV on day 1 or 2. Courses repeat every 28 days.
Patients are followed every 3 months for 1 year, every 6 months for 5 years, and then annually thereafter.
Peer Reviewed and Funded or Endorsed by Cancer Research UK and EORTC.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Histologically confirmed transitional cell carcinoma of the bladder urothelium
- T3-4, N1-3, M0
- No pure squamous cell or adenocarcinoma tumors
- No more than 90 days since prior radical cystectomy and bilateral lymphadenectomy without evidence of microscopic residual disease
- Performance status - WHO 0-1
- WBC at least 3,500/mm^3
- Platelet count at least 120,000/mm^3
- SGOT/SGPT less than 2.5 times upper limit of normal (ULN)
- Alkaline phosphatase less than 2.5 times ULN
- Bilirubin normal
- Glomerular filtration rate greater than 60 mL/min
- No clinically significant cardiac arrhythmia
- No congestive heart failure
- No complete bundle branch block
- No New York Heart Association class III or IV heart disease
- Not pregnant or nursing
- Fertile patients must use effective contraception during and for 6 months after study
- Considered fit for cisplatin-containing combination chemotherapy
- No clinically abnormal auditory function
- No known hypersensitivity to E. coli-derived drug preparations
- No grade 2 or greater peripheral neuropathy
- No other prior or concurrent malignancy except adequately treated carcinoma in situ of the cervix, treated basal cell skin cancer, or treated incidental prostate cancer (pT2, Gleason score no greater than 6, and PSA less than 0.5 ng/mL)
- No psychological, familial, sociological, or geographical condition that would preclude study involvement
- No prior systemic chemotherapy
- No prior radiotherapy to the bladder
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Arm I (immediate chemotherapy)
Beginning within 90 days of radical cystectomy, patients receive a total of 4 courses of adjuvant chemotherapy.
|
Given IV
Other Names:
Given IV
Other Names:
Given IV
Other Names:
Given SC
Other Names:
Given IV
Other Names:
Given IV
Other Names:
|
EXPERIMENTAL: Arm II (deferred chemotherapy)
Beginning at the time of clinical relapse, patients receive a total of 6 courses of adjuvant chemotherapy.
|
Given IV
Other Names:
Given IV
Other Names:
Given IV
Other Names:
Given SC
Other Names:
Given IV
Other Names:
Given IV
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Duration of survival
Time Frame: 5 years
|
Estimated using the Kaplan-Meier technique and compared based on a two sided logrank test with retrospective stratification for the participating cooperative group, the chemotherapy regimen, the T category and the nodal status.
|
5 years
|
Duration of progression-free survival
Time Frame: 5 years
|
Estimated using the Kaplan-Meier technique and compared based on a two sided logrank test with retrospective stratification for the participating cooperative group, the chemotherapy regimen, the T category and the nodal status.
|
5 years
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Cora Sternberg, Dr., San Camillo Forlanini Hospitals
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Urologic Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Urologic Diseases
- Neoplasms, Glandular and Epithelial
- Urinary Bladder Diseases
- Carcinoma
- Urinary Bladder Neoplasms
- Carcinoma, Transitional Cell
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Dermatologic Agents
- Antibiotics, Antineoplastic
- Reproductive Control Agents
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Folic Acid Antagonists
- Gemcitabine
- Cisplatin
- Doxorubicin
- Liposomal doxorubicin
- Methotrexate
- Vinblastine
Other Study ID Numbers
- EORTC 30994
- EORTC-30994
- CDR0000069130
- CAN-NCIC-EORTC-30994
- ACOSOG-EORTC-30994
- NCRI-BLADDER-EORTC-30994
- UKCCCR-EORTC-30994
- FNCLCC-GETUG-EORTC-30994
- N02CM62212 (OTHER_GRANT: US NIH Grant/Contract Award Number)
- 2005-003741-13 (EUDRACT_NUMBER)
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.
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