A Randomised Trial Investigating the Role of ERBT Plus Intravesical BCG in Intermediate-Risk or High-Risk NMBC

July 21, 2026 updated by: Jeremy Yuen Chun TEOH, Chinese University of Hong Kong

A Randomised Trial Investigating the Role of Transurethral En Bloc Resection of Bladder Tumour Plus Intravesical Bacillus Calmette-Guerin Therapy, in Patients With Intermediate-Risk or High-Risk Non-Muscle-Invasive Bladder Cancer

This is a prospective, multi-centre randomised trial comparing between cTURBT plus 1-year BCG therapy, and ERBT plus 1-year BCG therapy, in patients with intermediate-risk or high-risk NMIBC.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

All patients who are diagnosed to have bladder tumour(s) upon flexible cystoscopy will be screened for study eligibility. Imaging will be arranged to rule out any upper urinary tract malignancy. Patients are randomised to receive either transurethral ERBT or cTURBT with an allocation ratio of 1:1. A single dose of intravesical mitomycin C will be instilled according to the EAU guidelines, i.e. in all patients except those with a prior recurrence rate of more than one recurrence per year, or those with an EORTC recurrence score of ≥5. All patients will be followed up at our outpatient clinic and the pathology results will be reviewed. Routine second-look TURBT will be arranged within 2-6 weeks after the first operation should there be any indications as stated in the EAU guidelines. For patients in the intermediate or high-risk groups, 1-year of intravesical BCG therapy will be offered. Surveillance flexible cystoscopy will be performed at a 3-month interval until 2 years after the index surgery, and then every 6 months for another 3 years. Biopsy will be taken and TURBT will be offered if there is any suspicious tumour recurrence noted during surveillance cystoscopy.Primary outcome is recurrence-free survival at 2 years.

Study Type

Interventional

Enrollment (Estimated)

732

Phase

  • Not Applicable

Contacts and Locations

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

Study Contact

Study Contact Backup

  • Name: Yuen Chun Jeremy TEOH

Study Locations

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 18 years or above

  • Fulfil any one of the following three criteria:

    1. Recurrent bladder tumour
    2. Multiple bladder tumours
    3. Any bladder tumour size of >1cm

Exclusion Criteria:

  • EAU low-risk NIMBC as intravesical BCG therapy should not be offered (5)
  • EAU very high-risk NMIBC as upfront radical cystectomy should be offered (5)
  • Any prior use of intravesical BCG therapy
  • Presence or prior history of upper urinary tract malignancy
  • Presence of clinically significant cardiovascular disease (History of acute myocardial infarction, presence of uncontrolled angina within 3 months before screening, New York Heart Association Class III or IV congestive heart failure, presence of ventricular arrhythmias, or presence of second-degree or third-degree heart block) (16)
  • Presence of GOLD Stage III or IV chronic obstructive pulmonary disease
  • ECOG performance status ≥ 2 (Ambulatory and capable of all self-care but unable to carry our any work activities) (18)
  • History of bleeding disorder or use of anti-coagulants
  • Pregnancy
  • Presence of other active malignancy

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
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Conventional Transurethral Resection of Bladder Tumour (cTURBT)
Procedure: Conventional Transurethral Resection of Bladder Tumour
Conventional TURBT is performed by resecting the bladder tumour in a piecemeal manner with a top-down approach. The bladder tumour specimen is fragmented during the procedure and whether a complete resection has been achieved is determined by the operating surgeon's judgment intra-operatively.
Experimental: Transurethral En Bloc Resection of Bladder Tumour (ERBT)
Procedure: Transurethral En Bloc Resection of Bladder Tumour
This surgical technique resects the bladder tumour underneath the submucosal plane, and the bladder tumour can be removed in one piece.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Rate of recurrence-free survival
Time Frame: At Year 2
At Year 2

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of progression-free survival
Time Frame: At Year 2
At Year 2
Cancer-specific survival
Time Frame: At Year 2
At Year 2
Overall survival
Time Frame: At Year 2
At Year 2
Adverse Events
Time Frame: On Day 30 after operation
By CTCAE V5.0
On Day 30 after operation
Detrusor muscle sampling rate
Time Frame: On Day 30 after operation
On Day 30 after operation
Day of hospital stay
Time Frame: On Day 30 after operation
On Day 30 after operation
Total operation time
Time Frame: On Day 30 after operation
On Day 30 after operation

Collaborators and Investigators

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

Sponsor

Chinese University of Hong Kong

Investigators

  • Principal Investigator: Yuen Chun Jeremy TEOH, MD, Chinese University of Hong Kong

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Estimated)

July 1, 2026

Primary Completion (Estimated)

December 31, 2029

Study Completion (Estimated)

March 31, 2030

Study Registration Dates

First Submitted

April 22, 2026

First Submitted That Met QC Criteria

July 21, 2026

First Posted (Actual)

July 24, 2026

Study Record Updates

Last Update Posted (Actual)

July 24, 2026

Last Update Submitted That Met QC Criteria

July 21, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CRE 2025.055

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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