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A Study to Investigate the Efficacy and Safety of Alpha1H as a Neoadjuvant Therapy in Participants With Low- to Intermediate-Risk/Low-Grade Papillary Non-Muscle Invasive Bladder Cancer

31 agosto 2026 aggiornato da: Hamlet Pharma AB

A Randomized Phase III Study to Investigate the Efficacy and Safety of Alpha1H as a Neoadjuvant Therapy in Participants With Low- to Intermediate-Risk/Low-Grade Papillary Non-Muscle Invasive Bladder Cancer

The goal of this clinical trial is to learn if the drug Alpha1H works to treat low-to-intermediate risk non-muscle-invasive bladder cancer in adults. It will also learn about the safety of drug Alpha1H.

The main questions it aims to answer are:

  • Does giving drug Alpha1H before surgery lower the risk of cancer returning or worsening compared to standard care alone?
  • Is drug Alpha1H safe and well-tolerated by participants? Researchers will compare participants receiving drug Alpha1H before standard surgery to participants receiving standard care alone to see if drug Alpha1H lowers the risk of cancer returning or progressing.

Participants will:

  • Be randomly assigned to receive either drug Alpha1H before surgery or standard care alone.
  • Receive drug Alpha1H directly into the bladder 6 times over about 1 month if assigned to the Alpha1H group.
  • Hold the liquid in the bladder for up to 2 hours during each visit.
  • Undergo standard surgery through the urethra (TURBT) to remove remaining tumor tissue.
  • Visit the clinic regularly for follow-up checkups (including bladder examinations and urine tests) to check if the cancer returns.
  • Fill out questionnaires about their quality of life.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

194

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

      • Prague, Cechia, 15000
        • Fakultní nemocnice Motol a Homolka

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Signed and dated informed consent.
  • Low- or intermediate-risk non-muscle-invasive bladder cancer (NMIBC) meeting one of the following definitions:
  • Low-risk NMIBC: Primary, solitary, Ta, low-grade, 0.5 cm to 3 cm.
  • Intermediate-risk NMIBC (low-to-intermediate risk subgroup per IBCG classification):
  • Primary multifocal (<10 lesions), Ta, low-grade, 0.5 cm to 3 cm;
  • Recurrent solitary, Ta, low-grade, 0.5 cm to 3 cm; or
  • Recurrent multifocal (<10 lesions), Ta, low-grade, >1 year after previous recurrence.
  • Men and women aged 18 years or older.
  • Negative pregnancy test at screening for women of childbearing potential.
  • Women of childbearing potential must agree to use highly effective contraception methods throughout study participation; men of childbearing potential must refrain from donating sperm during the study.
  • Ability to retain bladder contents for 2 hours.

Exclusion Criteria:

  • Patient with non-papillary tumor appearance at the time of initial cystoscopy.
  • Previous history of T1 or high-grade disease in recurrent tumors.
  • Patients with T1 or high-grade non-muscle invasive papillary bladder cancer (NMIBC).
  • Previous intravesical BCG immunotherapy.
  • Patients with any other cancer diagnosis within the last 5 years (except for skin basalioma).
  • Acute urinary tract infection requiring antibiotic treatment.
  • Prior radiotherapy or systemic chemotherapy.
  • WHO performance status of 3 or 4.
  • Any other investigational agent or non-marketed product within one month prior to Visit 1 and during the trial.
  • Known active HIV infection, defined as detectable HIV viral load at screening.
  • Active hepatitis B virus (HBV) infection, defined as hepatitis B surface antigen (HBsAg) positivity with detectable HBV DNA at screening.
  • Active hepatitis C virus (HCV) infection, defined as anti-HCV antibody positivity with detectable HCV RNA at screening in a patient not on stable antiviral treatment.
  • Any concurrent illness that may render a participant ineligible or limit compliance with study requirements.
  • Previously enrolled in this trial.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Alpha1H
Participants receive 6 intravesical instillations of Alpha1H over approximately 1 month prior to transurethral resection of bladder tumor (TURBT).
Administered via intravesical instillation directly into the urinary bladder. Participants in the experimental group receive a total of 6 instillations on Days 1, 3, 5, 8, 15, and 22 over approximately 1 month prior to TURBT. During each treatment, participants are asked to retain the solution in the bladder for up to 2 hours.
Standard endoscopic surgical procedure performed through the urethra to resect and remove papillary bladder tumor tissue. Performed approximately 30 days after study entry (on Visit 8). Resected tumor tissue is collected for histopathology and central analysis.
A single early intravesical instillation of standard-of-care chemotherapy (epirubicin, mitomycin, or gemcitabine) administered into the urinary bladder shortly following TURBT surgery in accordance with local institutional guidelines.
Comparatore attivo: Standard of Care
Participants receive standard of care consisting of transurethral resection of bladder tumor (TURBT) followed by a single early intravesical instillation of standard chemotherapy.
Standard endoscopic surgical procedure performed through the urethra to resect and remove papillary bladder tumor tissue. Performed approximately 30 days after study entry (on Visit 8). Resected tumor tissue is collected for histopathology and central analysis.
A single early intravesical instillation of standard-of-care chemotherapy (epirubicin, mitomycin, or gemcitabine) administered into the urinary bladder shortly following TURBT surgery in accordance with local institutional guidelines.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
Event-Free Survival (EFS)
Lasso di tempo: From randomization until the occurrence of an EFS event or study completion, assessed at 3, 6, 9 (optional), and 12 months post-randomization, and every 6 months thereafter for up to 3 years.
From randomization until the occurrence of an EFS event or study completion, assessed at 3, 6, 9 (optional), and 12 months post-randomization, and every 6 months thereafter for up to 3 years.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Complete Response (CR) Rate
Lasso di tempo: Day 30 (±5 days), prior to TURBT
Day 30 (±5 days), prior to TURBT
Overall Survival (OS)
Lasso di tempo: From randomization through study completion (assessed at 3, 6, 9 [optional], and 12 months, and every 6 months thereafter for up to 3 years).
From randomization through study completion (assessed at 3, 6, 9 [optional], and 12 months, and every 6 months thereafter for up to 3 years).
Tumor Response (Morphological and Cellular)
Lasso di tempo: Baseline (Day 1) to Day 30 (±5 days)
Assessed as: (1) change in papillary tumor size (% reduction from baseline); (2) tumor cell shedding in urine (cells/mL); (3) apoptosis in shed cells (% TUNEL-positive cells); (4) Alpha1H uptake in shed cells (% Alpha1H-positive cells). Each parameter reported separately.
Baseline (Day 1) to Day 30 (±5 days)
Tumor Gene Expression
Lasso di tempo: Baseline (Day 1) to Day 30 (±5 days)
Assessed by RNA sequencing (whole transcriptome) in tumor tissue and urine RNA. Reported as number of differentially expressed cancer-related genes and pathways between the Alpha1H and SOC arms.
Baseline (Day 1) to Day 30 (±5 days)
Urinary Biomarkers and Immune Response
Lasso di tempo: Day 1, 3, 5, 8, 15, and 22 (pre- and post-instillation), and Day 30 (±5 days)
Assessed by proteomic profiling of urine samples. Reported as change in concentration (pg/mL) of cytokines, chemokines, and interferons between pre- and post-instillation samples, compared between the Alpha1H and SOC arms.
Day 1, 3, 5, 8, 15, and 22 (pre- and post-instillation), and Day 30 (±5 days)
Incidence and Severity of Adverse Events (AEs)
Lasso di tempo: From Visit 1 (Screening) through Visit 9 (Day 40/50) and follow-up period (up to 3 years)
From Visit 1 (Screening) through Visit 9 (Day 40/50) and follow-up period (up to 3 years)
Change in Quality of Life (QoL) as Assessed by the QLQ-NMIBC24 Questionnaire
Lasso di tempo: From Visit 1 (Screening) through follow-up visits (up to 3 years)
Quality of life will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Non-Muscle-Invasive Bladder Cancer Module (EORTC QLQ-NMIBC24), a 24-item, disease-specific patient-reported outcome instrument. Each domain score is linearly transformed to range from 0 to 100. On functional scales (e.g., sexual function), higher scores indicate better functioning; on symptom-related scales (e.g., urinary symptoms, future perspective), higher scores indicate greater symptom burden. Scores are calculated per the EORTC scoring manual.
From Visit 1 (Screening) through follow-up visits (up to 3 years)

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 settembre 2026

Completamento primario (Stimato)

1 luglio 2029

Completamento dello studio (Stimato)

1 luglio 2029

Date di iscrizione allo studio

Primo inviato

26 agosto 2026

Primo inviato che soddisfa i criteri di controllo qualità

31 agosto 2026

Primo Inserito (Effettivo)

4 settembre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

4 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

31 agosto 2026

Ultimo verificato

1 agosto 2026

Maggiori informazioni

Termini relativi a questo studio

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

INDECISO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .