- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06290687
Partial Cystectomy & Extended Pelvic Lymph Node Dissection With SOC Perioperative Systemic Therapy
Phase II Trial on the Safety and Efficacy of Partial Cystectomy and Extended Pelvic Lymph Node Dissection With Standard of Care Perioperative Systemic Therapy in the Management of Muscle-Invasive Bladder Cancer (PRESERVE Trial)
Study Overview
Status
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Nima Almassi, MD
- Phone Number: (216) 444-1825
- Email: almassn2@ccf.org
Study Locations
-
-
Ohio
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Cleveland, Ohio, United States, 44195
- Glickman Urological and Kidney Institute, Cleveland Clinic, Case Comprehensive Cancer Center
-
Contact:
- Nima Almassi, MD
- Phone Number: 216-444-1825
- Email: almassn2@ccf.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subjects must have histologically confirmed urothelial carcinoma of the bladder, clinical stage T2-3N0M0. Micropapillary, glandular, squamous, and sarcomatoid histologic variants of urothelial carcinoma are allowed.
- Subjects must have unifocal or limited multifocal disease amenable to complete surgical resection with partial cystectomy, as judged by the treating urologic oncologist.
- Age >18 years. Because of the rarity of this disease and limited data on treatment efficacy in subjects 18 years of age, children are excluded from this study.
- Performance status - Karnofsky Performance Status ≥70 or Eastern Cooperative Oncology Group (ECOG) performance status Grade 0 or 1.
Subjects must have normal organ and marrow function as defined below:
- Total bilirubin within normal limits
- AST (SGOT) ≤ 2.5 X institutional upper limit of normal
- ALT (SGPT) ≤ 2.5 X institutional upper limit of normal
Bone marrow:
- Absolute neutrophil count (ANC) ≥ 1,500/mm3
- Platelet count ≥ 80,000/mm3, Hemoglobin ≥ 9.0 g/dL
- Subjects must have the ability to understand and the willingness to sign a written informed consent document.
- Subjects must have tumor less than or equal to 5 cm in largest dimension as assessed radiographically.
- Treatment naive for MIBC.
Exclusion Criteria:
- Presence of hydronephrosis.
- Presence of multifocal disease that is not amenable to complete resection with partial cystectomy.
- Presence of distant carcinoma in situ.
- Presence of clinical N+ or M+ disease.
- Presence of cT4+ disease.
- Non-urothelial histology.
- Concurrent upper tract (ureter or renal pelvis) or urethral urothelial carcinoma.
- Subjects who are not surgical candidates due to competing medical comorbidities or who refuse surgical treatment.
- Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg, compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cisplatin Eligible Participants
Participants who are deemed eligible for cisplatin-based NAC will undergo:
|
Standard of care neoadjuvant systemic therapy is currently cisplatin-based chemotherapy in cisplatin-eligible participants. Participants will start treatment within 60 days of Transurethral Resection of Bladder Tumor. Regimens may include:
Partial cystectomy will then be performed using the surgical technique at the discretion of the treating Urologic Oncologist.
Extended pelvic lymphadenectomy will then be performed at the discretion of the treating Urologic Oncologist.
Surgery will be performed within 60 days of Transurethral Resection of Bladder Tumor for Cisplatin-ineligible participants.
Surgery will be performed within 60 days of completing neoadjuvant chemotherapy for Cisplatin-eligible participants.
Standard of care adjuvant systemic therapy in eligible participants.
The choice of adjuvant systemic therapy will be left to the discretion of the treating Medical Oncologist but must fall within the SOC as outlined in NCCN guidelines.
|
Experimental: Cisplatin Ineligible Participants
Participants who are deemed ineligible for cisplatin-based NAC will undergo:
|
Partial cystectomy will then be performed using the surgical technique at the discretion of the treating Urologic Oncologist.
Extended pelvic lymphadenectomy will then be performed at the discretion of the treating Urologic Oncologist.
Surgery will be performed within 60 days of Transurethral Resection of Bladder Tumor for Cisplatin-ineligible participants.
Surgery will be performed within 60 days of completing neoadjuvant chemotherapy for Cisplatin-eligible participants.
Standard of care adjuvant systemic therapy in eligible participants.
The choice of adjuvant systemic therapy will be left to the discretion of the treating Medical Oncologist but must fall within the SOC as outlined in NCCN guidelines.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Recurrence-Free Survival (RFS)
Time Frame: Up to 24 months from date of post-surgery baseline scan
|
Recurrence-Free Survival (RFS) is defined as the time from post-surgery baseline scan (revealing no recurrent/metastatic disease) until the first occurrence of either local or distant recurrence as assessed by CT or MRI and/or biopsy.
The primary outcome of distant RFS will be assessed via Kaplan-Meier analysis
|
Up to 24 months from date of post-surgery baseline scan
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Presence of Post-operative Complications
Time Frame: At 90 days after surgery
|
The Clavien-Dindo classification will measure post-operative complications.
The Clavien-Dindo Classification of Post-operative Complications is a tool to assess complications following surgical treatment.
This tool ranks complications on a scale of seven levels, with level 1 being the least complicated and 7 being the worst complication resulting in death.
The average classification at 90 days will be assessed and reported.
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At 90 days after surgery
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Median Bladder RFS
Time Frame: Up to 24 months from date of post-surgery baseline scan
|
The median duration of bladder recurrence-free survival at 2 years.
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Up to 24 months from date of post-surgery baseline scan
|
Median Muscle-Invasive Bladder RFS
Time Frame: Up to 24 months from date of post-surgery baseline scan
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The median duration of muscle-invasive bladder recurrence-free survival at 2 years.
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Up to 24 months from date of post-surgery baseline scan
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Median Bladder-Intact Survival
Time Frame: Up to 24 months from date of post-surgery baseline scan
|
The median duration of bladder-intact survival at 2 years.
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Up to 24 months from date of post-surgery baseline scan
|
Median Cancer-Specific Survival
Time Frame: Up to 24 months from date of post-surgery baseline scan
|
The median duration of cancer-specific survival at 2 years.
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Up to 24 months from date of post-surgery baseline scan
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Changes in Genitourinary-specific HRQoL
Time Frame: Up to 24 months from date of post-surgery baseline scan
|
The mean changes in Genitourinary-specific HRQoL will be reported.
The HRQoL survey is composed of five functional scales (physical, role, emotional, cognitive, and social functioning), three symptom scales (fatigue, nausea and vomiting, pain), a global health status/QoL, and six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties).
The scales and single-item measures range from 0 - 100, with higher values representing a higher response level.
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Up to 24 months from date of post-surgery baseline scan
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Nima Almassi, MD, Cleveland Clinic, Case Comprehensive Cancer Center
Study record dates
Study Major Dates
Study Start (Estimated)
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 (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CASE5824
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
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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