Chemotherapy With or Without Surgery in Treating Patients With Bladder Cancer

September 20, 2012 updated by: European Organisation for Research and Treatment of Cancer - EORTC

Chemoresection With 4 Weekly Intravesical Instillations Of Mitomycin C Versus Transurethral Resection (TUR) Followed By One Single Immediate Instillation Of Mitomycin C In Single, Small, Papillary Stage Ta, T1 Bladder Tumors: A Prospective Randomized Phase III Trial

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Infusing chemotherapy drugs directly into the bladder may kill more cancer cells. It is not yet known if surgery followed by chemotherapy is more effective than chemotherapy alone in treating bladder cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of chemotherapy alone with that of transurethral resection followed by chemotherapy in treating patients who have bladder cancer.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

OBJECTIVES:

  • Compare the efficacy of chemoresection with 4 weekly intravesical instillations of mitomycin vs transurethral resection followed by 1 instillation of mitomycin in patients with low-risk superficial transitional cell carcinoma of the bladder.
  • Compare the disease-free survival of patients treated with these regimens.
  • Determine the response rate at 6 weeks in patients treated with chemoresection.
  • Determine the percent of patients with tumor at 6 weeks treated with transurethral resection.
  • Compare the quality of life of patients treated with these regimens.
  • Compare the side effects of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease status (primary vs recurrent) and participating center. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients undergo chemoresection with intravesical instillation of mitomycin once weekly for 4 weeks.
  • Arm II: Patients undergo transurethral resection followed within 1-6 hours by intravesical instillation of mitomycin.

Quality of life is assessed at baseline, at week 1 (arm II only), at week 5 (arm I only), and then at week 6.

Patients are followed at weeks 6 and 19, every 6 months for 3 years, and then annually for 2 years.

PROJECTED ACCRUAL: A total of 1,000 patients (500 per treatment arm) will be accrued for this study within 5 years.

Study Type

Interventional

Enrollment (Actual)

58

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Belgium
      • Brussels, Belgium, 1090
        • Academisch Ziekenhuis der Vrije Universiteit Brussel
      • Ghent, Belgium, B-9000
        • Universitair Ziekenhuis Gent
      • Hasselt, Belgium, 3500
        • Virga Jesse Hospital
      • Leuven, Belgium, B-3000
        • U.Z. Gasthuisberg
  • Italy
      • Palermo, Italy, 90141
        • Università di Palermo
      • Savigliano, Italy, 12038
        • Ospedale S.S. Annunziata
  • Netherlands
      • Amsterdam, Netherlands, 1105 AZ
        • Academisch Medisch Centrum
      • Amsterdam, Netherlands, 1091 HA
        • Onze Lieve Vrouwe Gasthuis
      • NL'S Hertogenbosch, Netherlands, NL-5211
        • Jeroen Bosch Ziekenhuis
      • Rotterdam, Netherlands, 3008 AE
        • Daniel Den Hoed Cancer Center at Erasmus Medical Center
  • Slovakia
      • Martin, Slovakia, 03659
        • Comenius University School of Medicine
  • Turkey
      • Izmir, Turkey, 35340
        • Dokuz Eylul University School of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 80 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

DISEASE CHARACTERISTICS:

  • Cytologically confirmed solitary primary or recurrent papillary transitional cell carcinoma of the bladder

    • Ta or T1
  • Tumor no greater than 2 cm in diameter
  • Negative urine cytology
  • No suspicious lesions in bladder requiring biopsy
  • No tumors in the prostatic urethra or upper urinary tract
  • No prior history of T1 G3 tumors, muscle invasive tumors (T2 or greater), or carcinoma in situ

PATIENT CHARACTERISTICS:

Age

  • 80 and under

Performance status

  • WHO 0-1

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Not specified

Other

  • HIV negative
  • No active intractable or uncontrollable bladder infection
  • No urethral strictures that would preclude endoscopic procedures or repeated catheterization
  • No prior or concurrent congenital or acquired immune deficiency syndrome
  • No other prior or concurrent malignancy except cured basal cell skin cancer or intraepithelial cancer of the cervix
  • No prior or concurrent leukemia or Hodgkin's disease
  • No concurrent disease for which general anesthesia is contraindicated
  • No psychological, familial, sociological, or geographical condition that would preclude study compliance
  • Not pregnant or nursing

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 12 months since prior BCG vaccine

Chemotherapy

  • At least 1 year since prior mitomycin

Endocrine therapy

  • Not specified

Radiotherapy

  • No prior pelvic radiotherapy

Surgery

  • No prior organ transplant

Other

  • At least 3 months since prior intravesical treatment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

European Organisation for Research and Treatment of Cancer - EORTC

Investigators

  • Study Chair: Willem Oosterlinck, MD, PhD, Universitair Ziekenhuis Gent

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2002

Primary Completion (Actual)

May 1, 2004

Study Registration Dates

First Submitted

August 5, 2002

First Submitted That Met QC Criteria

January 26, 2003

First Posted (Estimate)

January 27, 2003

Study Record Updates

Last Update Posted (Estimate)

September 24, 2012

Last Update Submitted That Met QC Criteria

September 20, 2012

Last Verified

September 1, 2012

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EORTC-30004

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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