- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04637594
Trying to Find the Correct Length of Treatment With Immune Checkpoint Therapy (IMAGINE)
Duration of Immune Checkpoint Therapy in Locally Advanced or Metastatic Urothelial Carcinoma: A Randomized Phase 3 Non-Inferiority Trial (IMAGINE)
Study Overview
Status
Conditions
- Metastatic Bladder Urothelial Carcinoma
- Metastatic Renal Pelvis Urothelial Carcinoma
- Metastatic Ureter Urothelial Carcinoma
- Metastatic Urethral Urothelial Carcinoma
- Metastatic Urothelial Carcinoma
- Locally Advanced Bladder Urothelial Carcinoma
- Locally Advanced Renal Pelvis Urothelial Carcinoma
- Locally Advanced Ureter Urothelial Carcinoma
- Locally Advanced Urethral Urothelial Carcinoma
- Locally Advanced Urothelial Carcinoma
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVE:
I. To compare overall survival (OS).
SECONDARY OBJECTIVES:
I. To compare progression free survival (PFS) by (Response Evaluation Criteria in Solid Tumors) RECIST 1.1 criteria.
II. To compare PFS by immune-related (ir)RECIST criteria. III. To determine treatment-free interval (TFI) after immune checkpoint inhibitor (ICI) discontinuation. (Arm B) IV. To determine the rate of response by RECIST 1.1 criteria after ICI rechallenge. (Arm B) V. To assess adverse events in each study arm by Common Terminology Criteria for Adverse Events (CTCAE) 5.0.
OUTLINE: Patient are randomized to 1 of 2 arms.
ARM A (CONTINUATION OF ICI TREATMENT): Patients receive either pembrolizumab intravenously (IV) over 30 minutes on day 1, nivolumab IV over 30 minutes on days 1 and 15, atezolizumab IV over 30-60 minutes on day 1, durvalumab IV over 60 minutes on days 1 and 15, or avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 21 or 42 days for pembrolizumab, every 21 days for atezolizumab, and 28 days for nivolumab, durvalumab, and avelumab in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, starting new treatment or withdrawn consent, patients are followed up at 4 weeks, and then every 6 months for 5 years following registration.
ARM B (DISCONTINUATION OF ICI TREATMENT): Patients receiving ICI treatment will discontinue ICI treatment within 1 cycle length after randomization. Cycle length is determined by the ICI regimen the patient is receiving at randomization. At disease progression patients may restart the same ICI treatment they were receiving upon randomization at physician discretion.
After completion of study treatment, patients are followed up at 4 weeks, and then every 6 months for 5 years following registration.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Alaska
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Anchorage, Alaska, United States, 98508
- Anchorage Associates in Radiation Medicine
-
Anchorage, Alaska, United States, 99508
- Alaska Breast Care and Surgery LLC
-
Anchorage, Alaska, United States, 99508
- Alaska Oncology and Hematology LLC
-
Anchorage, Alaska, United States, 99508
- Alaska Women's Cancer Care
-
Anchorage, Alaska, United States, 99508
- Anchorage Oncology Centre
-
Anchorage, Alaska, United States, 99508
- Katmai Oncology Group
-
Anchorage, Alaska, United States, 99508
- Providence Alaska Medical Center
-
Anchorage, Alaska, United States, 99504
- Anchorage Radiation Therapy Center
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Fairbanks, Alaska, United States, 99701
- Fairbanks Memorial Hospital
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Arizona
-
Phoenix, Arizona, United States, 85004
- Cancer Center at Saint Joseph's
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Arkansas
-
Fort Smith, Arkansas, United States, 72903
- Mercy Hospital Fort Smith
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Hot Springs, Arkansas, United States, 71913
- CHI Saint Vincent Cancer Center Hot Springs
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Little Rock, Arkansas, United States, 72205
- University of Arkansas for Medical Sciences
-
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California
-
Antioch, California, United States, 94531
- Kaiser Permanente-Deer Valley Medical Center
-
Arroyo Grande, California, United States, 93420
- Mission Hope Medical Oncology - Arroyo Grande
-
Burbank, California, United States, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
-
Dublin, California, United States, 94568
- Kaiser Permanente Dublin
-
Fremont, California, United States, 94538
- Kaiser Permanente-Fremont
-
Fresno, California, United States, 93720
- Kaiser Permanente-Fresno
-
Fresno, California, United States, 93720
- Fresno Cancer Center
-
Modesto, California, United States, 95356
- Kaiser Permanente-Modesto
-
Oakland, California, United States, 94611
- Kaiser Permanente-Oakland
-
Oakland, California, United States, 94611
- Kaiser Permanente Oakland-Broadway
-
Palo Alto, California, United States, 94304
- Stanford Cancer Institute Palo Alto
-
Rancho Cordova, California, United States, 95670
- Kaiser Permanente-Rancho Cordova Cancer Center
-
Redwood City, California, United States, 94063
- Kaiser Permanente- Marshall Medical Offices
-
Richmond, California, United States, 94801
- Kaiser Permanente-Richmond
-
Rohnert Park, California, United States, 94928
- Rohnert Park Cancer Center
-
Roseville, California, United States, 95678
- The Permanente Medical Group-Roseville Radiation Oncology
-
Roseville, California, United States, 95661
- Kaiser Permanente-Roseville
-
Sacramento, California, United States, 95814
- Kaiser Permanente Downtown Commons
-
Sacramento, California, United States, 95823
- Kaiser Permanente-South Sacramento
-
Sacramento, California, United States, 95823
- South Sacramento Cancer Center
-
San Francisco, California, United States, 94115
- Kaiser Permanente-San Francisco
-
San Jose, California, United States, 95119
- Kaiser Permanente-Santa Teresa-San Jose
-
San Leandro, California, United States, 94577
- Kaiser Permanente San Leandro
-
San Luis Obispo, California, United States, 93401
- Pacific Central Coast Health Center-San Luis Obispo
-
San Rafael, California, United States, 94903
- Kaiser San Rafael-Gallinas
-
Santa Clara, California, United States, 95051
- Kaiser Permanente Medical Center - Santa Clara
-
Santa Maria, California, United States, 93444
- Mission Hope Medical Oncology - Santa Maria
-
Santa Rosa, California, United States, 95403
- Kaiser Permanente-Santa Rosa
-
South San Francisco, California, United States, 94080
- Kaiser Permanente Cancer Treatment Center
-
South San Francisco, California, United States, 94080
- Kaiser Permanente-South San Francisco
-
Stockton, California, United States, 95210
- Kaiser Permanente-Stockton
-
Vacaville, California, United States, 95688
- Kaiser Permanente Medical Center-Vacaville
-
Vallejo, California, United States, 94589
- Kaiser Permanente-Vallejo
-
Walnut Creek, California, United States, 94596
- Kaiser Permanente-Walnut Creek
-
-
Colorado
-
Aurora, Colorado, United States, 80012
- Rocky Mountain Cancer Centers-Aurora
-
Aurora, Colorado, United States, 80012
- The Medical Center of Aurora
-
Boulder, Colorado, United States, 80303
- Boulder Community Foothills Hospital
-
Boulder, Colorado, United States, 80304
- Rocky Mountain Cancer Centers-Boulder
-
Centennial, Colorado, United States, 80112
- Rocky Mountain Cancer Centers - Centennial
-
Colorado Springs, Colorado, United States, 80907
- Penrose-Saint Francis Healthcare
-
Colorado Springs, Colorado, United States, 80907
- Rocky Mountain Cancer Centers-Penrose
-
Colorado Springs, Colorado, United States, 80923
- Saint Francis Cancer Center
-
Denver, Colorado, United States, 80210
- Porter Adventist Hospital
-
Denver, Colorado, United States, 80218
- Presbyterian - Saint Lukes Medical Center - Health One
-
Denver, Colorado, United States, 80220
- Rose Medical Center
-
Denver, Colorado, United States, 80218
- Rocky Mountain Cancer Centers-Midtown
-
Denver, Colorado, United States, 80220
- Rocky Mountain Cancer Centers-Rose
-
Denver, Colorado, United States, 80218
- Colorado Blood Cancer Institute
-
Denver, Colorado, United States, 80209
- The Women's Imaging Center
-
Denver, Colorado, United States, 80220
- Western Surgical Care
-
Durango, Colorado, United States, 81301
- Mercy Medical Center
-
Durango, Colorado, United States, 81301
- Southwest Oncology PC
-
Englewood, Colorado, United States, 80113
- Mountain Blue Cancer Care Center - Swedish
-
Englewood, Colorado, United States, 80113
- Swedish Medical Center
-
Englewood, Colorado, United States, 80113
- Rocky Mountain Cancer Centers - Swedish
-
Englewood, Colorado, United States, 80113
- The Melanoma and Skin Cancer Institute
-
Lakewood, Colorado, United States, 80228
- Saint Anthony Hospital
-
Lakewood, Colorado, United States, 80228
- Rocky Mountain Cancer Centers-Lakewood
-
Littleton, Colorado, United States, 80120
- Rocky Mountain Cancer Centers-Littleton
-
Littleton, Colorado, United States, 80122
- Littleton Adventist Hospital
-
Lone Tree, Colorado, United States, 80124
- Sky Ridge Medical Center
-
Lone Tree, Colorado, United States, 80124
- Rocky Mountain Cancer Centers-Sky Ridge
-
Longmont, Colorado, United States, 80501
- Longmont United Hospital
-
Longmont, Colorado, United States, 80501
- Rocky Mountain Cancer Centers-Longmont
-
Parker, Colorado, United States, 80138
- Parker Adventist Hospital
-
Pueblo, Colorado, United States, 81004
- Saint Mary Corwin Medical Center
-
Thornton, Colorado, United States, 80260
- Rocky Mountain Cancer Centers-Thornton
-
-
Florida
-
Fort Lauderdale, Florida, United States, 33308
- Holy Cross Hospital
-
-
Hawaii
-
Honolulu, Hawaii, United States, 96819
- Kaiser Permanente Moanalua Medical Center
-
-
Idaho
-
Boise, Idaho, United States, 83712
- Saint Luke's Cancer Institute - Boise
-
Fruitland, Idaho, United States, 83619
- Saint Luke's Cancer Institute - Fruitland
-
Meridian, Idaho, United States, 83642
- Saint Luke's Cancer Institute - Meridian
-
Nampa, Idaho, United States, 83686
- Saint Luke's Cancer Institute - Nampa
-
Twin Falls, Idaho, United States, 83301
- Saint Luke's Cancer Institute - Twin Falls
-
-
Illinois
-
Alton, Illinois, United States, 62002
- Saint Anthony's Health
-
Aurora, Illinois, United States, 60504
- Rush - Copley Medical Center
-
Bloomington, Illinois, United States, 61704
- Illinois CancerCare-Bloomington
-
Canton, Illinois, United States, 61520
- Illinois CancerCare-Canton
-
Carbondale, Illinois, United States, 62902
- Memorial Hospital of Carbondale
-
Carterville, Illinois, United States, 62918
- SIH Cancer Institute
-
Carthage, Illinois, United States, 62321
- Illinois CancerCare-Carthage
-
Centralia, Illinois, United States, 62801
- Centralia Oncology Clinic
-
Chicago, Illinois, United States, 60612
- Rush University Medical Center
-
Danville, Illinois, United States, 61832
- Carle at The Riverfront
-
Decatur, Illinois, United States, 62526
- Decatur Memorial Hospital
-
Decatur, Illinois, United States, 62526
- Cancer Care Specialists of Illinois - Decatur
-
Dixon, Illinois, United States, 61021
- Illinois CancerCare-Dixon
-
Effingham, Illinois, United States, 62401
- Crossroads Cancer Center
-
Effingham, Illinois, United States, 62401
- Carle Physician Group-Effingham
-
Eureka, Illinois, United States, 61530
- Illinois CancerCare-Eureka
-
Galesburg, Illinois, United States, 61401
- Western Illinois Cancer Treatment Center
-
Galesburg, Illinois, United States, 61401
- Illinois CancerCare-Galesburg
-
Kewanee, Illinois, United States, 61443
- Illinois CancerCare-Kewanee Clinic
-
Macomb, Illinois, United States, 61455
- Illinois CancerCare-Macomb
-
Mattoon, Illinois, United States, 61938
- Carle Physician Group-Mattoon/Charleston
-
Mount Vernon, Illinois, United States, 62864
- Good Samaritan Regional Health Center
-
O'Fallon, Illinois, United States, 62269
- Cancer Care Center of O'Fallon
-
Ottawa, Illinois, United States, 61350
- Illinois CancerCare-Ottawa Clinic
-
Pekin, Illinois, United States, 61554
- Illinois CancerCare-Pekin
-
Peoria, Illinois, United States, 61636
- Methodist Medical Center of Illinois
-
Peoria, Illinois, United States, 61615
- Illinois CancerCare-Peoria
-
Peru, Illinois, United States, 61354
- Illinois CancerCare-Peru
-
Peru, Illinois, United States, 61354
- Valley Radiation Oncology
-
Princeton, Illinois, United States, 61356
- Illinois CancerCare-Princeton
-
Springfield, Illinois, United States, 62781
- Memorial Medical Center
-
Springfield, Illinois, United States, 62702
- Southern Illinois University School of Medicine
-
Springfield, Illinois, United States, 62702
- Springfield Clinic
-
Urbana, Illinois, United States, 61801
- Carle Cancer Center
-
Urbana, Illinois, United States, 61801
- The Carle Foundation Hospital
-
Washington, Illinois, United States, 61571
- Illinois CancerCare - Washington
-
Yorkville, Illinois, United States, 60560
- Rush-Copley Healthcare Center
-
-
Indiana
-
New Albany, Indiana, United States, 47150
- Baptist Health Floyd
-
-
Iowa
-
Ames, Iowa, United States, 50010
- Mary Greeley Medical Center
-
Ames, Iowa, United States, 50010
- McFarland Clinic - Ames
-
Boone, Iowa, United States, 50036
- McFarland Clinic - Boone
-
Carroll, Iowa, United States, 51401
- Saint Anthony Regional Hospital
-
Clive, Iowa, United States, 50325
- Mercy Cancer Center-West Lakes
-
Clive, Iowa, United States, 50325
- Medical Oncology and Hematology Associates-West Des Moines
-
Council Bluffs, Iowa, United States, 51503
- Alegent Health Mercy Hospital
-
Creston, Iowa, United States, 50801
- Greater Regional Medical Center
-
Des Moines, Iowa, United States, 50309
- Iowa Methodist Medical Center
-
Des Moines, Iowa, United States, 50314
- Mercy Medical Center - Des Moines
-
Des Moines, Iowa, United States, 50309
- Medical Oncology and Hematology Associates-Des Moines
-
Des Moines, Iowa, United States, 50314
- Broadlawns Medical Center
-
Des Moines, Iowa, United States, 50314
- Mission Cancer and Blood - Laurel
-
Des Moines, Iowa, United States, 50316
- Iowa Lutheran Hospital
-
Fort Dodge, Iowa, United States, 50501
- Trinity Regional Medical Center
-
Fort Dodge, Iowa, United States, 50501
- McFarland Clinic - Trinity Cancer Center
-
Jefferson, Iowa, United States, 50129
- McFarland Clinic - Jefferson
-
Marshalltown, Iowa, United States, 50158
- McFarland Clinic - Marshalltown
-
West Des Moines, Iowa, United States, 50266-7700
- Methodist West Hospital
-
West Des Moines, Iowa, United States, 50266
- Mercy Medical Center-West Lakes
-
-
Kansas
-
Garden City, Kansas, United States, 67846
- Central Care Cancer Center - Garden City
-
Great Bend, Kansas, United States, 67530
- Central Care Cancer Center - Great Bend
-
-
Kentucky
-
Bardstown, Kentucky, United States, 40004
- Flaget Memorial Hospital
-
Corbin, Kentucky, United States, 40701
- Baptist Health Corbin
-
Corbin, Kentucky, United States, 40701
- Commonwealth Cancer Center-Corbin
-
Elizabethtown, Kentucky, United States, 42701
- Baptist Health Hardin
-
Lexington, Kentucky, United States, 40504
- Saint Joseph Radiation Oncology Resource Center
-
Lexington, Kentucky, United States, 40509
- Saint Joseph Hospital East
-
Lexington, Kentucky, United States, 40503
- Baptist Health Lexington
-
London, Kentucky, United States, 40741
- Saint Joseph London
-
Louisville, Kentucky, United States, 40202
- Jewish Hospital
-
Louisville, Kentucky, United States, 40245
- UofL Health Medical Center Northeast
-
Louisville, Kentucky, United States, 40207
- Baptist Health Louisville
-
Louisville, Kentucky, United States, 40215
- Saints Mary and Elizabeth Hospital
-
Madisonville, Kentucky, United States, 42431
- Baptist Health Madisonville/Merle Mahr Cancer Center
-
Paducah, Kentucky, United States, 42003
- Baptist Health Paducah
-
Richmond, Kentucky, United States, 40475
- Baptist Health Richmond
-
Shepherdsville, Kentucky, United States, 40165
- Jewish Hospital Medical Center South
-
-
Louisiana
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Metairie, Louisiana, United States, 70006
- East Jefferson General Hospital
-
Metairie, Louisiana, United States, 70006
- LSU Healthcare Network / Metairie Multi-Specialty Clinic
-
New Orleans, Louisiana, United States, 70112
- Louisiana State University Health Science Center
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Dana-Farber Cancer Institute
-
Milford, Massachusetts, United States, 01757
- Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
-
Newton, Massachusetts, United States, 02467
- Dana-Farber Cancer Institute - Chestnut Hill
-
South Weymouth, Massachusetts, United States, 02190
- Dana-Farber/Brigham and Women's Cancer Center at South Shore
-
-
Michigan
-
Adrian, Michigan, United States, 49221
- Hickman Cancer Center
-
Ann Arbor, Michigan, United States, 48106
- Saint Joseph Mercy Hospital
-
Brighton, Michigan, United States, 48114
- Saint Joseph Mercy Brighton
-
Brighton, Michigan, United States, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
-
Brownstown, Michigan, United States, 48183
- Henry Ford Cancer Institute-Downriver
-
Canton, Michigan, United States, 48188
- Saint Joseph Mercy Canton
-
Canton, Michigan, United States, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
-
Caro, Michigan, United States, 48723
- Caro Cancer Center
-
Chelsea, Michigan, United States, 48118
- Saint Joseph Mercy Chelsea
-
Chelsea, Michigan, United States, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
-
Clarkston, Michigan, United States, 48346
- Hematology Oncology Consultants-Clarkston
-
Clarkston, Michigan, United States, 48346
- Newland Medical Associates-Clarkston
-
Clinton Township, Michigan, United States, 48038
- Henry Ford Macomb Hospital-Clinton Township
-
Clinton Township, Michigan, United States, 48038
- Henry Ford Hematology Oncology - Hayes
-
Dearborn, Michigan, United States, 48126
- Henry Ford Medical Center-Fairlane
-
Detroit, Michigan, United States, 48202
- Henry Ford Hospital
-
Detroit, Michigan, United States, 48236
- Ascension Saint John Hospital
-
East China, Michigan, United States, 48054
- Great Lakes Cancer Management Specialists-Doctors Park
-
Flint, Michigan, United States, 48503
- Hurley Medical Center
-
Flint, Michigan, United States, 48503
- Genesee Cancer and Blood Disease Treatment Center
-
Flint, Michigan, United States, 48503
- Genesee Hematology Oncology PC
-
Flint, Michigan, United States, 48503
- Genesys Hurley Cancer Institute
-
Grosse Pointe Woods, Michigan, United States, 48236
- Academic Hematology Oncology Specialists
-
Grosse Pointe Woods, Michigan, United States, 48236
- Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
-
Grosse Pointe Woods, Michigan, United States, 48236
- Michigan Breast Specialists-Grosse Pointe Woods
-
Jackson, Michigan, United States, 49201
- Allegiance Health
-
Lansing, Michigan, United States, 48912
- Sparrow Hospital
-
Livonia, Michigan, United States, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Livonia, Michigan, United States, 48154
- Hope Cancer Clinic
-
Macomb, Michigan, United States, 48044
- Great Lakes Cancer Management Specialists-Macomb Medical Campus
-
Macomb, Michigan, United States, 48044
- Michigan Breast Specialists-Macomb Township
-
Marlette, Michigan, United States, 48453
- Saint Mary's Oncology/Hematology Associates of Marlette
-
Monroe, Michigan, United States, 48162
- Toledo Clinic Cancer Centers-Monroe
-
Novi, Michigan, United States, 48377
- Henry Ford Medical Center-Columbus
-
Pontiac, Michigan, United States, 48341
- Saint Joseph Mercy Oakland
-
Pontiac, Michigan, United States, 48341
- 21st Century Oncology-Pontiac
-
Pontiac, Michigan, United States, 48341
- Hope Cancer Center
-
Pontiac, Michigan, United States, 48341
- Newland Medical Associates-Pontiac
-
Saginaw, Michigan, United States, 48601
- Ascension Saint Mary's Hospital
-
Saginaw, Michigan, United States, 48604
- Oncology Hematology Associates of Saginaw Valley PC
-
Shelby, Michigan, United States, 48315
- Henry Ford Macomb Health Center - Shelby Township
-
Sterling Heights, Michigan, United States, 48312
- Bhadresh Nayak MD PC-Sterling Heights
-
Tawas City, Michigan, United States, 48764
- Ascension Saint Joseph Hospital
-
Warren, Michigan, United States, 48093
- Saint John Macomb-Oakland Hospital
-
Warren, Michigan, United States, 48088
- Advanced Breast Care Center PLLC
-
Warren, Michigan, United States, 48093
- Great Lakes Cancer Management Specialists-Macomb Professional Building
-
Warren, Michigan, United States, 48093
- Macomb Hematology Oncology PC
-
Warren, Michigan, United States, 48093
- Michigan Breast Specialists-Warren
-
West Bloomfield, Michigan, United States, 48322
- Henry Ford West Bloomfield Hospital
-
West Branch, Michigan, United States, 48661
- Saint Mary's Oncology/Hematology Associates of West Branch
-
Wyandotte, Michigan, United States, 48192
- Henry Ford Wyandotte Hospital
-
Ypsilanti, Michigan, United States, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
-
Ypsilanti, Michigan, United States, 48106
- Huron Gastroenterology PC
-
-
Minnesota
-
Bemidji, Minnesota, United States, 56601
- Sanford Joe Lueken Cancer Center
-
Burnsville, Minnesota, United States, 55337
- Fairview Ridges Hospital
-
Burnsville, Minnesota, United States, 55337
- Minnesota Oncology - Burnsville
-
Cambridge, Minnesota, United States, 55008
- Cambridge Medical Center
-
Coon Rapids, Minnesota, United States, 55433
- Mercy Hospital
-
Duluth, Minnesota, United States, 55805
- Saint Luke's Hospital of Duluth
-
Edina, Minnesota, United States, 55435
- Fairview Southdale Hospital
-
Fridley, Minnesota, United States, 55432
- Unity Hospital
-
Maple Grove, Minnesota, United States, 55369
- Fairview Clinics and Surgery Center Maple Grove
-
Maplewood, Minnesota, United States, 55109
- Saint John's Hospital - Healtheast
-
Maplewood, Minnesota, United States, 55109
- Minnesota Oncology Hematology PA-Maplewood
-
Minneapolis, Minnesota, United States, 55415
- Hennepin County Medical Center
-
Minneapolis, Minnesota, United States, 55407
- Abbott-Northwestern Hospital
-
Minneapolis, Minnesota, United States, 55454
- Health Partners Inc
-
Monticello, Minnesota, United States, 55362
- Monticello Cancer Center
-
New Ulm, Minnesota, United States, 56073
- New Ulm Medical Center
-
Princeton, Minnesota, United States, 55371
- Fairview Northland Medical Center
-
Robbinsdale, Minnesota, United States, 55422
- North Memorial Medical Health Center
-
Saint Cloud, Minnesota, United States, 56303
- Coborn Cancer Center at Saint Cloud Hospital
-
Saint Louis Park, Minnesota, United States, 55416
- Park Nicollet Clinic - Saint Louis Park
-
Saint Paul, Minnesota, United States, 55101
- Regions Hospital
-
Saint Paul, Minnesota, United States, 55102
- United Hospital
-
Shakopee, Minnesota, United States, 55379
- Saint Francis Regional Medical Center
-
Stillwater, Minnesota, United States, 55082
- Lakeview Hospital
-
Thief River Falls, Minnesota, United States, 56701
- Sanford Thief River Falls Medical Center
-
Waconia, Minnesota, United States, 55387
- Ridgeview Medical Center
-
Willmar, Minnesota, United States, 56201
- Rice Memorial Hospital
-
Woodbury, Minnesota, United States, 55125
- Minnesota Oncology Hematology PA-Woodbury
-
Worthington, Minnesota, United States, 56187
- Sanford Cancer Center Worthington
-
Wyoming, Minnesota, United States, 55092
- Fairview Lakes Medical Center
-
-
Mississippi
-
Jackson, Mississippi, United States, 39216
- University of Mississippi Medical Center
-
-
Missouri
-
Ballwin, Missouri, United States, 63011
- Saint Louis Cancer and Breast Institute-Ballwin
-
Bolivar, Missouri, United States, 65613
- Central Care Cancer Center - Bolivar
-
Branson, Missouri, United States, 65616
- Cox Cancer Center Branson
-
Cape Girardeau, Missouri, United States, 63703
- Saint Francis Medical Center
-
Cape Girardeau, Missouri, United States, 63703
- Southeast Cancer Center
-
City of Saint Peters, Missouri, United States, 63376
- Siteman Cancer Center at Saint Peters Hospital
-
Creve Coeur, Missouri, United States, 63141
- Siteman Cancer Center at West County Hospital
-
Farmington, Missouri, United States, 63640
- Parkland Health Center - Farmington
-
Jefferson City, Missouri, United States, 65109
- Capital Region Southwest Campus
-
Joplin, Missouri, United States, 64804
- Freeman Health System
-
Joplin, Missouri, United States, 64804
- Mercy Hospital Joplin
-
Rolla, Missouri, United States, 65401
- Delbert Day Cancer Institute at PCRMC
-
Rolla, Missouri, United States, 65401
- Mercy Clinic-Rolla-Cancer and Hematology
-
Saint Joseph, Missouri, United States, 64506
- Heartland Regional Medical Center
-
Sainte Genevieve, Missouri, United States, 63670
- Sainte Genevieve County Memorial Hospital
-
Springfield, Missouri, United States, 65807
- CoxHealth South Hospital
-
Springfield, Missouri, United States, 65804
- Mercy Hospital Springfield
-
St Louis, Missouri, United States, 63110
- Washington University School of Medicine
-
St Louis, Missouri, United States, 63129
- Siteman Cancer Center-South County
-
St Louis, Missouri, United States, 63136
- Siteman Cancer Center at Christian Hospital
-
St Louis, Missouri, United States, 63131
- Missouri Baptist Medical Center
-
St Louis, Missouri, United States, 63141
- Mercy Hospital Saint Louis
-
St Louis, Missouri, United States, 63128
- Mercy Hospital South
-
St Louis, Missouri, United States, 63109
- Saint Louis Cancer and Breast Institute-South City
-
Sullivan, Missouri, United States, 63080
- Missouri Baptist Sullivan Hospital
-
Sunset Hills, Missouri, United States, 63127
- Missouri Baptist Outpatient Center-Sunset Hills
-
Washington, Missouri, United States, 63090
- Mercy Hospital Washington
-
-
Montana
-
Missoula, Montana, United States, 59802
- Saint Patrick Hospital - Community Hospital
-
-
Nebraska
-
Grand Island, Nebraska, United States, 68803
- CHI Health Saint Francis
-
Kearney, Nebraska, United States, 68847
- CHI Health Good Samaritan
-
Lincoln, Nebraska, United States, 68510
- Saint Elizabeth Regional Medical Center
-
Omaha, Nebraska, United States, 68124
- Alegent Health Bergan Mercy Medical Center
-
Omaha, Nebraska, United States, 68122
- Alegent Health Immanuel Medical Center
-
Omaha, Nebraska, United States, 68130
- Alegent Health Lakeside Hospital
-
Omaha, Nebraska, United States, 68131
- Creighton University Medical Center
-
Papillion, Nebraska, United States, 68046
- Midlands Community Hospital
-
-
New Hampshire
-
Londonderry, New Hampshire, United States, 03053
- The Dana-Farber Cancer Institute at Londonderry
-
-
New Mexico
-
Albuquerque, New Mexico, United States, 87102
- University of New Mexico Cancer Center
-
-
New York
-
Buffalo, New York, United States, 14263
- Roswell Park Cancer Institute
-
Fresh Meadows, New York, United States, 11366
- Queens Medical Associates PC
-
Lake Success, New York, United States, 11042
- Northwell Health/Center for Advanced Medicine
-
Oneida, New York, United States, 13421
- Upstate Cancer Center at Oneida
-
Oswego, New York, United States, 13126
- Upstate Cancer Center at Oswego
-
Stony Brook, New York, United States, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, United States, 13210
- State University of New York Upstate Medical University
-
-
North Carolina
-
Clinton, North Carolina, United States, 28328
- Southeastern Medical Oncology Center-Clinton
-
Goldsboro, North Carolina, United States, 27534
- Southeastern Medical Oncology Center-Goldsboro
-
Jacksonville, North Carolina, United States, 28546
- Southeastern Medical Oncology Center-Jacksonville
-
Winston-Salem, North Carolina, United States, 27157
- Wake Forest University Health Sciences
-
-
North Dakota
-
Bismarck, North Dakota, United States, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, United States, 58122
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, United States, 58122
- Sanford Broadway Medical Center
-
Fargo, North Dakota, United States, 58103
- Sanford South University Medical Center
-
Fargo, North Dakota, United States, 58103
- Southpointe-Sanford Medical Center Fargo
-
Fargo, North Dakota, United States, 58104
- Sanford Medical Center Fargo
-
-
Ohio
-
Cincinnati, Ohio, United States, 45220
- Good Samaritan Hospital - Cincinnati
-
Cincinnati, Ohio, United States, 45242
- Bethesda North Hospital
-
Cincinnati, Ohio, United States, 45247
- TriHealth Cancer Institute-Westside
-
Cincinnati, Ohio, United States, 45255
- TriHealth Cancer Institute-Anderson
-
Toledo, Ohio, United States, 43623
- Mercy Health - Saint Anne Hospital
-
Toledo, Ohio, United States, 43623
- Toledo Clinic Cancer Centers-Toledo
-
-
Oklahoma
-
Oklahoma City, Oklahoma, United States, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, United States, 73120
- Mercy Hospital Oklahoma City
-
Tulsa, Oklahoma, United States, 74146
- Oklahoma Cancer Specialists and Research Institute-Tulsa
-
-
Oregon
-
Bend, Oregon, United States, 97701
- Saint Charles Health System
-
Clackamas, Oregon, United States, 97015
- Clackamas Radiation Oncology Center
-
Clackamas, Oregon, United States, 97015
- Providence Cancer Institute Clackamas Clinic
-
Coos Bay, Oregon, United States, 97420
- Bay Area Hospital
-
Newberg, Oregon, United States, 97132
- Providence Newberg Medical Center
-
Portland, Oregon, United States, 97213
- Providence Portland Medical Center
-
Portland, Oregon, United States, 97225
- Providence Saint Vincent Medical Center
-
Redmond, Oregon, United States, 97756
- Saint Charles Health System-Redmond
-
-
Pennsylvania
-
Allentown, Pennsylvania, United States, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Bethlehem, Pennsylvania, United States, 18017
- Lehigh Valley Hospital - Muhlenberg
-
East Stroudsburg, Pennsylvania, United States, 18301
- Pocono Medical Center
-
Hazleton, Pennsylvania, United States, 18201
- Lehigh Valley Hospital-Hazleton
-
-
South Dakota
-
Sioux Falls, South Dakota, United States, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
Sioux Falls, South Dakota, United States, 57104
- Sanford Cancer Center Oncology Clinic
-
-
Tennessee
-
Germantown, Tennessee, United States, 38138
- The West Clinic - Wolf River
-
-
Texas
-
Bryan, Texas, United States, 77802
- Saint Joseph Regional Cancer Center
-
Dallas, Texas, United States, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Fort Worth, Texas, United States, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Richardson, Texas, United States, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
-
Washington
-
Aberdeen, Washington, United States, 98520
- Providence Regional Cancer System-Aberdeen
-
Bellingham, Washington, United States, 98225
- PeaceHealth Saint Joseph Medical Center
-
Bremerton, Washington, United States, 98310
- Harrison HealthPartners Hematology and Oncology-Bremerton
-
Bremerton, Washington, United States, 98310
- Harrison Medical Center
-
Burien, Washington, United States, 98166
- Highline Medical Center-Main Campus
-
Centralia, Washington, United States, 98531
- Providence Regional Cancer System-Centralia
-
Edmonds, Washington, United States, 98026
- Swedish Cancer Institute-Edmonds
-
Enumclaw, Washington, United States, 98022
- Saint Elizabeth Hospital
-
Everett, Washington, United States, 98201
- Providence Regional Cancer Partnership
-
Federal Way, Washington, United States, 98003
- Saint Francis Hospital
-
Issaquah, Washington, United States, 98029
- Swedish Cancer Institute-Issaquah
-
Kennewick, Washington, United States, 99336
- Kadlec Clinic Hematology and Oncology
-
Lacey, Washington, United States, 98503
- Providence Regional Cancer System-Lacey
-
Lakewood, Washington, United States, 98499
- Saint Clare Hospital
-
Longview, Washington, United States, 98632
- PeaceHealth Saint John Medical Center
-
Port Townsend, Washington, United States, 98368
- Jefferson Healthcare
-
Poulsbo, Washington, United States, 98370
- Harrison HealthPartners Hematology and Oncology-Poulsbo
-
Seattle, Washington, United States, 98107
- Swedish Medical Center-Ballard Campus
-
Seattle, Washington, United States, 98122
- Swedish Medical Center-First Hill
-
Seattle, Washington, United States, 98104
- Pacific Gynecology Specialists
-
Seattle, Washington, United States, 98122-5711
- Swedish Medical Center-Cherry Hill
-
Sedro-Woolley, Washington, United States, 98284
- PeaceHealth United General Medical Center
-
Shelton, Washington, United States, 98584
- Providence Regional Cancer System-Shelton
-
Tacoma, Washington, United States, 98405
- Northwest Medical Specialties PLLC
-
Tacoma, Washington, United States, 98405
- Franciscan Research Center-Northwest Medical Plaza
-
Vancouver, Washington, United States, 98664
- PeaceHealth Southwest Medical Center
-
Walla Walla, Washington, United States, 99362
- Providence Saint Mary Regional Cancer Center
-
Yelm, Washington, United States, 98597
- Providence Regional Cancer System-Yelm
-
-
Wisconsin
-
Eau Claire, Wisconsin, United States, 54701
- Marshfield Medical Center-EC Cancer Center
-
Marshfield, Wisconsin, United States, 54449
- Marshfield Medical Center-Marshfield
-
Minocqua, Wisconsin, United States, 54548
- Marshfield Clinic-Minocqua Center
-
Mukwonago, Wisconsin, United States, 53149
- ProHealth D N Greenwald Center
-
New Richmond, Wisconsin, United States, 54017
- Cancer Center of Western Wisconsin
-
Oconomowoc, Wisconsin, United States, 53066
- ProHealth Oconomowoc Memorial Hospital
-
Rice Lake, Wisconsin, United States, 54868
- Marshfield Medical Center-Rice Lake
-
Stevens Point, Wisconsin, United States, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Waukesha, Wisconsin, United States, 53188
- UW Cancer Center at ProHealth Care
-
Waukesha, Wisconsin, United States, 53188
- ProHealth Waukesha Memorial Hospital
-
Weston, Wisconsin, United States, 54476
- Marshfield Medical Center - Weston
-
-
Wyoming
-
Cheyenne, Wyoming, United States, 82001
- Cheyenne Regional Medical Center-West
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Documentation of disease
- Histologic documentation: Histologically or cytologically confirmed urothelial carcinoma (UC) with predominantly transitional-cell features
- Stage: Locally advanced or metastatic disease prior to starting immune checkpoint blockade
- Tumor Site: Bladder, renal pelvis, ureter, urethra, or prostate
- Patients must have received at least one cycle of current active treatment with standard of care (SOC) Food and Drug Administration (FDA) approved PD-1/L1 immune checkpoint inhibitor (ICI)-containing therapy for locally advance or metastatic UC
- Patients without progressive disease per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1 guidelines (i.e., with an ongoing [complete response] CR, partial response [PR], or stable disease [SD]) following completion of 12-15 months of ICI treatment
No history of tuberculosis, active hepatitis B (HBV) or hepatitis C (HCV), or uncontrolled human immunodeficiency virus (HIV)
- Patients with resolved HBV infection, defined as positive hepatitis B core antibody (anti-Hb) and negative hepatitis B surface antigen (HbsAg), are eligible
- Patients with positive HCV antibody are eligible if HCV ribonucleic acid (RNA) polymerase chain reaction (PCR) is negative
- Patients with HIV who are compliant with highly active antiretroviral therapy (HAART) and have normal CD4 count and undetectable viral load are eligible
- No history of allogeneic organ transplantation
No current immunosuppressive medication exceeding 10 mg/day of prednisone or its equivalent
* Patients with pre-existing or treatment-emergent autoimmune or inflammatory disorders which do not require systemic immunosuppressive treatment exceeding 10 mg/day of prednisone or its equivalent may be included
- No history of another primary malignancy except for malignancy treated with curative intent with no known active disease for >= 2 years, and adequately treated non-melanomatous skin cancer or carcinoma in situ (e.g. cervical carcinoma in situ [CIS]) without evidence of disease
- No female patients who are pregnant or breastfeeding, or male or female patients of reproductive potential who are not willing to employ effective birth control, because this study involves investigational agents whose genotoxic, mutagenic, and teratogenic effects on the developing fetus and newborn are unknown. Therefore, for women of childbearing potential only, a negative urine or serum pregnancy test pregnancy test done =< 14 days prior to registration is required
REGISTRATION ELIGIBILITY CRITERIA:
- Patients without progressive disease per RECIST v 1.1 guidelines (i.e., with an ongoing CR, PR or SD) following completion of 12-15 months of ICI treatment
- No toxicity from ICI therapy that makes continuation of treatment clinically unacceptable
- Adequate bone marrow and organ functions to continue PD-1/L1 ICI as judged by the treating physician
- Age >= 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Central nervous system (CNS) metastasis is allowed if radiographically stable, clinically asymptomatic, and prior local therapy (if received) was completed > 6 months before registration
No history of tuberculosis, active hepatitis B (HBV) or hepatitis C (HCV), or uncontrolled human immunodeficiency virus (HIV)
- Patients with resolved HBV infection, defined as positive hepatitis B core antibody (anti-Hb) and negative hepatitis B surface antigen (HbsAg), are eligible
- Patients with positive HCV antibody are eligible if HCV RNA PCR is negative
- Patients with HIV who are compliant with highly active antiretroviral therapy (HAART) and have normal CD4 count and undetectable viral load are eligible
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Active Comparator: Arm A (immune checkpoint inhibitor)
CONTINUATION OF ICI TREATMENT: Patients receive either pembrolizumab intravenously (IV) over 30 minutes on day 1, nivolumab IV over 30 minutes on days 1 and 15, atezolizumab IV over 30-60 minutes on day 1, durvalumab IV over 60 minutes on days 1 and 15, or avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 21 or 42 days for pembrolizumab, every 21 days for atezolizumab, and 28 days for nivolumab, durvalumab, and avelumab in the absence of disease progression or unacceptable toxicity. |
Given IV
Given IV
Given IV
Given IV
Given IV
|
|
Experimental: Arm B (immune checkpoint inhibitor)
DISCONTINUATION OF ICI TREATMENT: Patients receiving ICI treatment will discontinue ICI treatment within 1 cycle length after randomization. Cycle length is determined by the ICI regimen the patient is receiving at randomization. At disease progression patients may restart the same ICI treatment they were receiving upon randomization at physician discretion. |
Given IV
Given IV
Given IV
Given IV
Given IV
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Survival (OS) Rate at 12 Months
Time Frame: 12 months
|
OS is the length of time patients are alive after registering to receive protocol treatment.
Patients who are lost to follow-up or are not known to be deceased at the time of study analysis will be censored at the time of last patient contact.
Cox models will be used to compare the outcome between the two treatment groups.
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-free Survival (PFS) Rate at 12 Months
Time Frame: 12 months
|
Progression-free survival (PFS) is the length of time patients are alive without disease progression.
Progression will be assessed using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.
Stratified Cox models will be used to compare the outcomes between the two treatment groups.
|
12 months
|
|
Immune-related Progression-free Survival (iPFS) Rate at 12 Months
Time Frame: 12 months
|
Immune-related progression-free survival (iPFS) is the length of time patients are alive without immune-related progression.
Progression will be assessed using immune related (ir)RECIST criteria.
Stratified Cox models will be used to compare the outcomes between the two treatment groups.
|
12 months
|
|
Treatment-free Interval (Arm B)
Time Frame: From last dose of immune checkpoint inhibitor (ICI) to initiation of a subsequent systemic treatment or death, assessed up to 5 years
|
Treatment-free Interval is the length of time patients are off treatment.
A Stratified Cox model will be used to evaluate this outcome.
|
From last dose of immune checkpoint inhibitor (ICI) to initiation of a subsequent systemic treatment or death, assessed up to 5 years
|
|
Rate of Response After Immune Checkpoint Inhibitor (ICI) Rechallenge (Arm B)
Time Frame: Up to 5 years
|
Rate of response is the percentage of patients with response after re-initiation of immune checkpoint inhibitor (ICI) therapy after progression post-registration.
Rate of response will be assessed using RECIST 1.1.
A chi-square test (or Fisher's exact test) will be used to determine whether there is an association between the best tumor response prior to trial enrollment and that achieved upon ICI re-challenge.
|
Up to 5 years
|
|
Number of Patients Experiencing Grade 3 or Greater Adverse Events (AEs)
Time Frame: 2.5 years
|
Adverse events (AEs) are ailments occurring during treatment.
AEs will be assessed using Common Terminology Criteria for Adverse Events version 5.0.
|
2.5 years
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Xiao X. Wei, MD, MAS, Dana-Farber Cancer Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Carcinoma
- Carcinoma, Transitional Cell
- Amino Acids, Peptides, and Proteins
- Proteins
- Antibodies, Monoclonal, Humanized
- Antibodies, Monoclonal
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Nivolumab
- pembrolizumab
- durvalumab
- atezolizumab
- avelumab
Other Study ID Numbers
- A031901
- U10CA180821 (U.S. NIH Grant/Contract)
- NCI-2020-08395 (Registry Identifier: NCI Clinical Trial Reporting Program)
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.
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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