- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05519241
A Phase I Intravesical PPM Therapy for NMIBC
A Phase I Trial of Cancer-targeting Micelles for Non-myoinvasive Bladder Cancer
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Chong-Xian Pan, MD PhD
- Phone Number: (857) 203-6189
- Email: chong-xian.pan@va.gov
Study Contact Backup
- Name: Juan Garisto Risco, MD
- Phone Number: (617) 323-7700
- Email: juan.garistorisco@va.gov
Study Locations
-
-
Massachusetts
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Boston, Massachusetts, United States, 02130-4817
- Recruiting
- VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
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Contact:
- Chong-Xian Pan, MD PhD
- Phone Number: 857-203-6189
- Email: chong-xian.pan@va.gov
-
Principal Investigator:
- Chong-Xian Pan, MD PhD
-
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Patients must meet all of the following criteria to be eligible for study entry.
- Histologically confirmed bladder carcinoma in situ (CIS) urothelial or urothelial carcinoma, with or without T1 cancer. Patients are eligible if the biopsy was done within 3 months of enrollment and a cystoscopy demonstrates no gross disease invasion into muscularis propria within 4 weeks of enrollment.
Patient must have BCG-unresponsive non-muscle-invasive bladder cancer (NMIBC) or intolerance of treatment with BCG. Treatment of pembrolizumab is not an inclusion or exclusion criteria as intravesical taxane probably has comparable efficacy as intravenous pembrolizumab. BCG-unresponsive disease is defined as being at least one of the following:
- Persistent or recurrent CIS alone or with recurrent Ta/T1 (noninvasive papillary disease/tumor invades the subepithelial connective tissue) disease within 12 months of completion of adequate BCG therapy
- Recurrent high-grade Ta/T1 disease within 6 months of completion of adequate BCG therapy
- T1 high-grade disease at the first evaluation following an induction BCG course
In this context, adequate BCG therapy is defined as at least one of the following:
- At least five of six doses of an initial induction course plus at least two of three doses of maintenance therapy
At least five of six doses of an initial induction course plus at least two of six doses of a second induction course
- Refuse or intolerant of a radical cystectomy recommended by the treating urologist as the standard next therapy per urologic guidelines.
- Age 18 years.
- Performance status: ECOG performance status of 0, 1, or 2 (Appendix A) or Karnofsky performance status of 50 or higher (Appendix B).
- Patient with life expectancy greater than 24 months.
- No concurrent radiotherapy, chemotherapy, or other immunotherapy
- No scheduled radiotherapy, chemotherapy, other immunotherapy, or surgery before the scheduled response evaluation.
- Recovery from prior treatment side effects that might interfere with the study treatment, in the judgment of the participating urologist.
- Laboratory tests performed within 14 days of study enrollment:
- Absolute neutrophil count (AGC/ANC) 1,500/uL
- Platelets 100,000/uL [Patients may be transfused to meet this requirement]
- Hemoglobin 8 g/dL [Patients may be transfused to meet this requirement]
- Calculated glomerular filtration rate (GFR) 50 mL/min/1.73m2
- Total bilirubin 2.0 X ULN (< 3 x ULN for patients with Gilbert's syndrome)
AST, ALT, ALP 3.0 X ULN
- Adequate pulmonary function with no clinical signs of severe pulmonary dysfunction.
- Negative serum pregnancy test if the study participant is a female and of childbearing potential (non-childbearing is defined as greater than one year postmenopausal or surgically sterilized).
- Female participants of childbearing potential must adhere to using a medically accepted method of birth control, i.e. a tubal ligation, an approved hormonal contraceptive or an intrauterine device, prior to screening and agree to continue its use during the study and up to 3 months after finishing this study or be surgically sterilized (e.g., hysterectomy or tubal ligation). Males must agree to use barrier methods of birth control while on study.
- Provide signed informed consent and HIPAA authorization and agree to comply with all protocol-specified procedures and follow-up evaluations.
Exclusion Criteria:
Patients who meet any of the following criteria will be excluded from study entry.
- Existence of cancer at the upper urinary tract
- Concurrent use of other investigational agents.
- Evidence of regional and/or distant metastasis.
- NYHA (New York Heart Association) Class III or IV heart failure (Appendix C), uncontrollable supraventricular arrhythmias, any history of a ventricular arrhythmia, or other clinical signs of severe cardiac dysfunction.
- Symptomatic congestive heart failure (CHF), severe/unstable angina pectoris, or myocardial infarction within 6 months prior to study entry.
- Patient has an intractable bleeding disorder (e.g., coagulation factors deficiencies, Von Willebrand Disease).
- Patient taking medications that affect coagulation, such as aspirin (aspirin 81 mg oral once daily is allowed), Coumadin/Warfarin, heparin, low molecular weight heparin, direct thrombin inhibitors, and direct factor Xa inhibitors. Other nonsteroidal anti-inflammatory drugs (NSAIDs) are allowed as long as they are discontinued the day before therapy.
- History or evidence of uncontrollable central nervous system (CNS) disease.
- Active systemic infection requiring parenteral antibiotic therapy.
- Women who are pregnant or nursing.
- Psychiatric illness/social situations that would limit compliance with study requirements
- Other illness that in the opinion of the investigator would exclude the patient from participating in this study.
Any other malignancy diagnosed within 3 years of trial entry with the exception of:
- Basal or squamous cell skin cancers, or
- Noninvasive cancer of the cervix, or
- Any other cancer deemed to be of low-risk for progression or patient morbidity during trial period, such as localized prostate cancer after definitive treatment and prostate-specific antigen (PSA) less than 0.2 ng/ml.
- Patients unwilling to or unable to comply with the protocol.
- Patients with impaired decision-making capacity.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Phase I dose-escalation and expansion cohort
There are three doses at the dose escalation stage: Dose level I: paclitaxel (PTX) 25 mg or 0.5 mg/ml; Dose Level II: PTX 50 mg or 1.0 mg/ml; Dose Level III: PTX 75 mg or 1.5 mg/ml.
At the expansion cohort, up to 12 patients will be recruited and treated with PPM at the PTX dose of 50 mg or 1.0 mg/ml to determine the efficacy.
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PPM will be administrated weekly for 6 times through intravesical instillation into the bladder cavity
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
adverse events
Time Frame: up to 3 months after the last dose
|
CTCAE v5.0 will be used to determine any adverse events and assess the grade.
All toxicity as well as Grade 3 or higher adverse events will be analyzed.
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up to 3 months after the last dose
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
complete response rate
Time Frame: 6 weeks after finishing the last dose of PPM
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urine cytology, cystoscopy.
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6 weeks after finishing the last dose of PPM
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
blood paclitaxel concentration
Time Frame: within 6 hours after administration
|
Blood will be drawn up to a few hours after the first dose of PPM at the expansion cohort to determine the systemic paclitaxel absorption.
|
within 6 hours after administration
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Chong-Xian Pan, MD PhD, VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
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 by Histologic Type
- Neoplasms
- Urologic Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Urologic Diseases
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Urinary Bladder Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Male Urogenital Diseases
- Urinary Bladder Neoplasms
- Non-Muscle Invasive Bladder Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Paclitaxel
Other Study ID Numbers
- ONCA-021-20S
- VA Merit (Other Grant/Funding Number: 1I01CX002247)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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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