Um ensaio aberto de fase 2 para avaliar Nadofaragene Firadenovec intravesical sozinho ou em combinação com quimioterapia ou imunoterapia em participantes com câncer de bexiga invasivo não muscular e sem resposta ao BCG de alto grau (ABLE-22)
Um ensaio de fase 2, randomizado, multicêntrico e aberto para avaliar a segurança e eficácia do Nadofaragene Firadenovec intravesical sozinho ou em combinação com quimioterapia ou imunoterapia em participantes com terapia com Bacillus Calmette-Guerin de alto grau (BCG) sem resposta, não muscular invasivo Câncer de bexiga (NMIBC)
The pivotal phase 3 trial (rAd-IFN-CS 003) evaluating the efficacy of nadofaragene firadenovec showed that 55 (53.4%) of 103 subjects with CIS ± high-grade Ta/T1 achieved a complete response (CR) at 3 months. In this trial, the safety and efficacy of intravesical instillation of nadofaragene firadenovec alone or in combination with chemotherapy or immunotherapy will be evaluated in participants with NMIBC CIS (± high-grade Ta/T1).
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Fase 3
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Ferring Pharmaceuticals
- Número de telefone: 833-548-1402 (US/Canada)
- E-mail: disclosure@ferring.com
Estude backup de contato
- Nome: Ferring Pharmaceuticals
- Número de telefone: +1862-286-5200 (not US/Canada)
- E-mail: disclosure@ferring.com
Locais de estudo
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Alberta
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Calgary, Alberta, Canadá, T2V 1P9
- Recrutamento
- Prostate Cancer Centre
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Ontario
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Hamilton, Ontario, Canadá, L8N 4A6
- Recrutamento
- Research St. Joseph's- Hamilton/St. Joseph's Healthcare Hamilton
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Toronto, Ontario, Canadá, M5G 1Z5
- Recrutamento
- University Health Network UHN - Princess Margaret Cancer Centre
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Quebec
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Montreal, Quebec, Canadá, H2X 0A9
- Recrutamento
- Centre Hospitalier de L'Universite de Montreal
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Gyeongsangnam-do
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Yangsan, Gyeongsangnam-do, Coréia do Sul, 50612
- Recrutamento
- Pusan National University Yangsan Hospital
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Jeollanam-do
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Hwasun, Jeollanam-do, Coréia do Sul, 58128
- Recrutamento
- Chonnam National University Hwasun Hospital (CNUHH) Organisa
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Seoul
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Seoul, Seoul, Coréia do Sul, 02841
- Recrutamento
- Korea University Anam Hospital
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Seoul, Seoul, Coréia do Sul, 06351
- Recrutamento
- Samsung Medical Center
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Seoul, Seoul, Coréia do Sul, 03722
- Recrutamento
- Severance Hospital, Yonsei University Health System
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Songpa-gu
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Seoul, Songpa-gu, Coréia do Sul, 03080
- Recrutamento
- Seoul National University Hospital
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Central Jutland
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Aarhus, Central Jutland, Dinamarca, 8200
- Recrutamento
- Aarhus University Hospital
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Madrid, Espanha, 28033
- Recrutamento
- MD Anderson Cancer Center
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Málaga, Espanha, 29010
- Recrutamento
- Servicio Andaluz de Salud (SAS) - Hospital Universitario Virgen de la Victoria (HUVV)
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Cantabria
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Santander, Cantabria, Espanha, 39008
- Recrutamento
- Instituto de Investigacion Valdecilla (IDIVAL) / Hospital universitario Marques de Valdecilla
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Catalonia
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Barcelona, Catalonia, Espanha, 08036
- Recrutamento
- Hospital Clinic De Barcelona - University of Barcelona
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Barcelona, Catalonia, Espanha, 08003
- Recrutamento
- Hospital del Mar
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Cordoba
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Córdoba, Cordoba, Espanha, 14004
- Recrutamento
- Hospital Universitario Reina Sofia
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Galicia
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A Coruña, Galicia, Espanha, 15006
- Recrutamento
- Hospital Universitario de A Coruna
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Madrid
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Alcorcón, Madrid, Espanha, 28922
- Recrutamento
- Hospital Universitario Fundacion Alcorcon
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Madrid, Madrid, Espanha, 28027
- Recrutamento
- Clinica Universidad de Navarra - Madrid
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Madrid, Madrid, Espanha, 28041
- Recrutamento
- Hospital Universitario 12 De Octubre (Madrid)
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Madrid, Madrid, Espanha, 28046
- Recrutamento
- Universidad Autonoma de Madrid. Hospital Universitario La Paz
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Navarre
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Pamplona, Navarre, Espanha, 31008
- Recrutamento
- Clinica Universidad de Navarra - Pamplona
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Vizcaya
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Bilbao, Vizcaya, Espanha
- Recrutamento
- Hospital Universitario Basurto
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Arizona
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Tucson, Arizona, Estados Unidos, 85718
- Recrutamento
- Center for Neurosciences
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Arkansas
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Little Rock, Arkansas, Estados Unidos, 72211
- Recrutamento
- Arkansas Urology, North Little Rock
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California
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Los Angeles, California, Estados Unidos, 90017
- Recrutamento
- American Institute of Research
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Los Angeles, California, Estados Unidos, 90080
- Recrutamento
- USC Kenneth Norris Jr Cancer Hospital
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Orange, California, Estados Unidos, 92868
- Ativo, não recrutando
- University of California, Irvine
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San Diego, California, Estados Unidos, 92123
- Recrutamento
- Genesis Research, LLC - San Diego
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Colorado
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Denver, Colorado, Estados Unidos, 80210
- Recrutamento
- Advent Health
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Lakewood, Colorado, Estados Unidos, 80228
- Recrutamento
- Colorado Urology - St. Anthony Hospital Campus
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Connecticut
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New Haven, Connecticut, Estados Unidos, 06519
- Recrutamento
- Yale School of Medicine
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District of Columbia
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Washington D.C., District of Columbia, Estados Unidos, 20007
- Recrutamento
- Medstar Georgetown University Hospital
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Florida
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Sarasota, Florida, Estados Unidos, 34239
- Recrutamento
- Sarasota Memorial Healthcare System
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Georgia
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Atlanta, Georgia, Estados Unidos, 30322
- Recrutamento
- Emory University
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Atlanta, Georgia, Estados Unidos, 30328
- Ativo, não recrutando
- Georgia Urology
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Idaho
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Boise, Idaho, Estados Unidos, 83702
- Recrutamento
- Boise VA Medical Center
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Illinois
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Lisle, Illinois, Estados Unidos, 60532
- Recrutamento
- NextStage Clinical Research
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Indiana
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Indianapolis, Indiana, Estados Unidos, 46202
- Recrutamento
- Indiana University
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Kansas
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Wichita, Kansas, Estados Unidos, 67226
- Recrutamento
- Wichita Urology Group
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Maryland
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Annapolis, Maryland, Estados Unidos, 21401
- Recrutamento
- Anne Arundel Urology, PA
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Hanover, Maryland, Estados Unidos, 21076
- Recrutamento
- Chesapeake Urology Research Associates
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Mississippi
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Southhaven, Mississippi, Estados Unidos, 38654
- Recrutamento
- The Urology Group P.C.
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New Jersey
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Morristown, New Jersey, Estados Unidos, 07960
- Recrutamento
- Atlantic Health
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New York
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Buffalo, New York, Estados Unidos, 14263
- Recrutamento
- Roswell Park Cancer Institute
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Cheektowaga, New York, Estados Unidos, 14225
- Recrutamento
- Great Lakes Physician PC d/b/a Western new York Urology Associates
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Lake Success, New York, Estados Unidos, 11042
- Recrutamento
- Northwell Health -The Arthur Smith Institute for Urology
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New York, New York, Estados Unidos, 10010
- Recrutamento
- Veterans Affairs New York Harbor Healthcare System - Manhattan VA Medical Center
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The Bronx, New York, Estados Unidos, 10468
- Recrutamento
- James J. Peters VA Medical Center
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Ohio
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Cincinnati, Ohio, Estados Unidos, 45267
- Recrutamento
- University of Cincinnati
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Columbus, Ohio, Estados Unidos, 43201
- Recrutamento
- OSU Arthur James Cancer Hospital
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Pennsylvania
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Bala-Cynwyd, Pennsylvania, Estados Unidos, 19004
- Recrutamento
- MidLantic Urology
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Lancaster, Pennsylvania, Estados Unidos, 17601
- Recrutamento
- Keystone Urology Specialists
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Philadelphia, Pennsylvania, Estados Unidos, 19104
- Recrutamento
- University of Pennsylvania - Perelman Center for Advanced Medicine - Penn Urology
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Pittsburgh, Pennsylvania, Estados Unidos, 15232
- Recrutamento
- University of Pittsburgh Medical Center - Shadyside Medical Building
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South Carolina
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Myrtle Beach, South Carolina, Estados Unidos, 29572
- Recrutamento
- Carolina Urologic Research Center
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Tennessee
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Germantown, Tennessee, Estados Unidos, 38138
- Recrutamento
- The Conrad Pearson Clinic - Wolf River Office (Urology Center of the South)
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Nashville, Tennessee, Estados Unidos, 37209
- Recrutamento
- Urology Associates, P.C.
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Texas
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Austin, Texas, Estados Unidos, 78759
- Recrutamento
- Urology Austin
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Dallas, Texas, Estados Unidos, 75231
- Recrutamento
- Urology Clinics of North Texas PLLC (Dallas)
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Dallas, Texas, Estados Unidos, 75390
- Recrutamento
- University of Texas Southwestern Medical Center - Urology Clinic
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Houston, Texas, Estados Unidos, 77030
- Recrutamento
- Houston Methodist Hospital (Houston)
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Washington
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Seattle, Washington, Estados Unidos, 98101
- Recrutamento
- Virginia Mason Medical Center
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Paris, França, 75013
- Recrutamento
- Hopital La Pitie Salpetriere
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Auvergne-Rhône-Alpes
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Clermont-Ferrand, Auvergne-Rhône-Alpes, França, 63000
- Recrutamento
- CHU Clermont Ferrand - Hopital Gabriel Montpied
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Lyon, Auvergne-Rhône-Alpes, França, 69003
- Recrutamento
- Hospices Civils de Lyon - Edouard Herriot Hosp.
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Huate-Garonne
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Toulouse, Huate-Garonne, França, 31059
- Recrutamento
- CHU Toulouse - Hopital Rangueil
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Nantes
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Nantes, Nantes, França, 44093
- Recrutamento
- CHU Nantes - Hotel Dieu
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New Aquitaine
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Bordeaux, New Aquitaine, França, 33076
- Recrutamento
- CHU de Bordeaux - Hôpital Pellegrin
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Occitanie
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Nîmes, Occitanie, França, 30900
- Recrutamento
- Centre Hospitalier Universitaire De Nimes (Nîmes)
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Rhone.Alpe
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Lyon, Rhone.Alpe, França, 69310
- Recrutamento
- Centre Hospitaliser Universitaire de Lyon Sud
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Île-de-France Region
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Paris, Île-de-France Region, França, 75018
- Recrutamento
- APHP - Hopital Bichat
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Kuyavian-Pomeranian Voivodeship
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Bydgoszcz, Kuyavian-Pomeranian Voivodeship, Polônia, 85-048
- Recrutamento
- IN-VIVO Bydgoszcz
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Wielkopolska
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Poznan, Wielkopolska, Polônia, 61731
- Recrutamento
- Clinical Research Center Spółka z ograniczoną odpowiedzialnością Medic-R Sp.k.
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Woj. Mazowieckie
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Warsaw, Woj. Mazowieckie, Polônia, 02798
- Recrutamento
- Medical Concierge Centrum Medyczne
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Liberec Region
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Liberec, Liberec Region, Tcheca, 46300
- Recrutamento
- Krajska Nemocnice Liberec
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Prague
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Prague, Prague, Tcheca, 15006
- Recrutamento
- Fakultni nemocnice v Motole
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Prague, Prague, Tcheca, 16000
- Recrutamento
- Androgeos, spol. s r.o.
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Prague, Prague, Tcheca, 14059
- Recrutamento
- Fakultní Thomayerova Nemocnice
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Zlín
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Kroměříž, Zlín, Tcheca, 76701
- Recrutamento
- Kromerizska Nemocnice A S
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
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Diagnosed, as documented, with carcinoma in situ (CIS) ±Ta/T1 high-grade disease.
- For T1 disease biopsies should contain muscle fibres.
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Unresponsive to ≥2 courses of Bacillus Calmette-Guerin (BCG) therapy within the last 12 months. BCG-unresponsive refers to participants with high-grade non-muscle invasive bladder cancer (NMIBC) who are unlikely to benefit from and who will not be receiving further intravesical BCG. The term "BCG-Unresponsive" includes participants who did not respond to BCG treatment and have a persistent high-grade recurrence within 12 months after BCG was initiated, and those who despite an initial complete response to BCG, relapse with CIS within 12 months of their last intravesical treatment with BCG or relapse with high-grade Ta/T1 NMIBC within 6 months of their last intravesical treatment with BCG. The following criteria define the participants who may be included in the trial:
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Have received at least 2 courses of BCG within a 12 month period - defined as at least 5 of 6 induction BCG instillations and at least 2 of 3 instillations of maintenance BCG, or at least 2 of 6 instillations of a second induction course, where maintenance BCG is not given.
o Exception: those who have T1 high-grade disease at 1st evaluation after induction BCG alone (at least 5 of 6 doses) may qualify in the absence of disease progression
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At the time of tumour recurrence, participants with CIS alone or high-grade Ta/T1 with CIS should be within 12 months of last exposure to BCG
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No maximum limit to the amount of BCG administered
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All visible papillary tumours must be resected and those with persistent T1 disease on transurethral resection of bladder tumour (TURBT) should undergo an additional re-TURBT within 14 to 70 days prior to beginning trial treatment. Obvious areas of CIS should also be fulgurated
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Eastern Cooperative Oncology Group (ECOG) status ≤2
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Aged ≥18 years at the time of consent
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Available for the whole duration of the trial
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Life expectancy >2 years, in the opinion of the investigator
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Absence of concomitant upper tract urothelial carcinoma or urothelial carcinoma within the prostatic urethra. Freedom from upper tract disease (if clinically indicated) as indicated by no evidence of upper tract tumour by either intravenous pyelogram, retrograde pyelogram, computed tomography (CT) scan with or without urogram, or magnetic resonance imaging (MRI) with or without urogram performed within 6 months of enrolment. Absence of locally advanced disease as assessed by CT scan or MRI
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Participants who elect not to undergo cystectomy
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Participants with prostate cancer on active surveillance at low risk for progression are permitted to be included into the trial at the discretion of the investigator
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Females of reproductive potential must have a negative highly sensitive urine or serum pregnancy test upon entry into this trial and be willing to use highly effective contraception during treatment with the investigational medicinal product and for 6 months following the last dose. Otherwise, female participants must be post-menopausal (no menstrual period for a minimum of 12 months, as confirmed by follicle-stimulating hormone levels) or surgically sterile
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Male subjects must be willing to use a male condom and effective contraception during sex throughout the treatment period and for 3 months following the last dose.
Exclusion Criteria:
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Current or previous evidence of muscle-invasive (muscularis propria) or metastatic disease presented at the screening visit. Examples of increased risk of muscle-invasive disease include but are not limited to:
- Presence of lymphovascular invasion and / or micropapillary, sarcomatoid, plasmacytoid and / or neuroendocrine disease as shown in the histology of the biopsy sample
- Participants with CIS+T1 disease accompanied by the presence of hydronephrosis secondary to the primary tumour
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Current systemic therapy for bladder cancer other than investigational medicinal products used in randomisation arm
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Current or prior investigational treatment for BCG-unresponsive NMIBC or any other investigational drug (drug used in a clinical trial, i.e drug used in a Ferring sponsored non interventional study does not apply) within 1 month prior to screening
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Current or prior pelvic external beam radiotherapy within 2 years of screening
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Prior treatment with nadofaragene firadenovec at any time
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Prior systemic therapy for bladder cancer at any time
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Prior intravesical chemotherapy for the treatment of BCG-unresponsive NMIBC
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
|
Experimental: Nadofaragene firadenovec
Nadofaragene firadenovec (intravesical) |
vector-based gene therapy for NMIBC treatment to potentiate durable therapeutic responses by interferon (IFN) alfa-2b (IFN-α2b) amplification. It is a non-replicating recombinant adenovirus serotype 5 vector containing a transgene encoding the human IFN-α2b gene.
Outros nomes:
|
|
Experimental: Nadofaragene firadenovec + gemcitabine & docetaxel
Nadofaragene firadenovec (intravesical), and sequential gemcitabine and docetaxel (intravesical) |
vector-based gene therapy for NMIBC treatment to potentiate durable therapeutic responses by interferon (IFN) alfa-2b (IFN-α2b) amplification. It is a non-replicating recombinant adenovirus serotype 5 vector containing a transgene encoding the human IFN-α2b gene.
Outros nomes:
Intravesical Gemcitabine chemotherapy, used in combination with Docetaxel. Intravesical Docetaxel chemotherapy, used in combination with Gemcitabine. |
|
Experimental: Nadofaragene firadenovec + Pembrolizumab
Nadofaragene firadenovec (intravesical), and pembrolizumab (IV infusion). This arm will be closed and patients will no longer be randomised to this arm. This modification will convert ABLE-22 into a two-arm study with 1:1 randomisation between nadofaragene alone and nadofaragene + gemcitabine/docetaxel, to now N=100 in each of the 2 remaining arms. Participants already enrolled in this arm will not be impacted. |
vector-based gene therapy for NMIBC treatment to potentiate durable therapeutic responses by interferon (IFN) alfa-2b (IFN-α2b) amplification. It is a non-replicating recombinant adenovirus serotype 5 vector containing a transgene encoding the human IFN-α2b gene.
Outros nomes:
Pembrolizumab is an FDA approved immune checkpoint inhibitor which restores the anti-tumour immune response by blocking the programmed cell death protein 1 (PD-1). Pembrolizumab is administered via intravenous (IV) infusion. |
O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Complete response
Prazo: up to 6 months
|
Complete response (CR) at any time from first treatment (defined as absence of high-grade (HG) recurrence). |
up to 6 months
|
Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Complete response at month 3
Prazo: 3 months
|
Complete response 3 months from first treatment |
3 months
|
|
Complete response at month 6
Prazo: 6 months
|
Complete response 6 months from first treatment |
6 months
|
|
Durability of complete response
Prazo: Up to 24 months
|
Durability of complete response (defined as time from achieved CR to HG recurrence, progression or death due to any cause). |
Up to 24 months
|
|
Muscle-invasive progression of disease
Prazo: up to 36 months
|
Muscle-invasive progression of disease (defined as time from first treatment to first evidence of muscle-invasive disease or death) |
up to 36 months
|
|
Cystectomy-free survival
Prazo: up to 36 months
|
Cystectomy-free survival (defined as time from first treatment to either cystectomy or death due to any cause) |
up to 36 months
|
|
Pathological staging
Prazo: up to 36 months
|
Pathological staging (tumor, node, metastasis staging system) in participants at time of cystectomy |
up to 36 months
|
|
Overall survival
Prazo: up to 36 months
|
Overall survival (defined as time from first treatment to death due to any cause) |
up to 36 months
|
|
Evidence of malignant lesions of the upper tract and/or prostatic urethra
Prazo: up to 24 months
|
Evidence of malignant lesions of the upper tract and/or prostatic urethra (defined as time from first treatment to first evidence of malignant lesions). |
up to 24 months
|
|
Adverse events
Prazo: up to 36 months
|
Adverse events collected for nadofaragene firadenovec in combination with chemotherapy (gemcitabine and docetaxel) or immunotherapy (pembrolizumab) |
up to 36 months
|
Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Diretor de estudo: Global Clinical Compliance, Ferring Pharmaceuticals
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Produtos químicos orgânicos
- Compostos heterocíclicos, 1 anel
- Compostos heterocíclicos
- Hidrocarbonetos
- Cicloparaffinas
- Hidrocarbonetos, aliciclicos
- Hidrocarbonetos, cíclicos
- Terpenos
- Taxóides
- Ciclodecanos
- Diterpenos
- Desoxicitidina
- Citidina
- Nucleosídeos de pirimidina
- Pirimidinas
- Docetaxel
- Gemcitabina
- Pembrolizumab
Outros números de identificação do estudo
Outros números de identificação do estudo
- 000434
- U1111-1299-0176 (Outro identificador: World Health Organization)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
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