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A Phase II Single-Arm Trial to Evaluate Cisplatin and Gemcitabine Chemotherapy in Combination With Sunitinib for First-Line Treatment of Patients With Advanced Transitional Carcinoma of the Urothelium


Phase 2
16 Years
N/A
Open (Enrolling)
Both
Bladder Cancer, Transitional Cell Cancer of the Renal Pelvis and Ureter, Urethral Cancer

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Trial Information

A Phase II Single-Arm Trial to Evaluate Cisplatin and Gemcitabine Chemotherapy in Combination With Sunitinib for First-Line Treatment of Patients With Advanced Transitional Carcinoma of the Urothelium


OBJECTIVES:

- To determine the activity, safety, and feasibility of gemcitabine hydrochloride and
cisplatin in combination with sunitinib malate as first-line therapy in patients with
locally advanced and/or metastatic transitional carcinoma of the urothelium.

OUTLINE: This is a multicenter study.

Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8, cisplatin IV
over 3-4 hours on day 1, and oral sunitinib malate once daily on days 2-15. Treatment
repeats every 21 days for 6 courses in the absence of disease progression or unacceptable
toxicity.

After completion of study treatment, patients are followed at 6 months and 1 year.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed transitional cell carcinoma of the urothelium

- Pure or mixed histology

- Upper or lower urinary tract

- Radiologically measurable, locally advanced and/or metastatic disease not amenable to
curative treatment with surgery or radiotherapy meeting 1 of the following criteria:

- T4b (bladder) or T4 (renal pelvis/ureter), any N, any M

- Any T, N2-3, any M

- Any T, any N, M1

- No urothelial cancer for which subsequent radical treatment is being considered with
a view to possibly cure the disease

- No history of CNS metastases

PATIENT CHARACTERISTICS:

- WHO performance status 0-2

- Life expectancy > 3 months

- Absolute neutrophil count ≥ 1.5 x 10^9/L

- Platelet count ≥ 100 x 10^9/L

- Bilirubin ≤ 1.5 times upper limit of normal (ULN)

- ALT and ALP ≤ 2.5 times ULN

- GFR ≥ 60 mL/min (uncorrected for surface area and measured by isotopic means)

- PT or INR ≤ 1.5 times ULN

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Fit to receive cisplatin-containing combination chemotherapy

- No previous malignancy other than nonmelanoma skin cancer, carcinoma in situ of the
cervix, or incidental localized prostate cancer

- No known HIV positivity or chronic hepatitis B or C infection

- No uncontrolled hypertension

- No symptomatic coronary artery disease, myocardial infarction within the past 6
months, congestive cardiac failure (NYHA class III-IV disease), or uncontrolled or
symptomatic cardiac arrhythmia

- No clinically significant bacterial or fungal infection

- No concurrent grapefruit juice

PRIOR CONCURRENT THERAPY:

- At least 1 month since prior radiotherapy or radiotherapy involving more than 30% of
total bone marrow volume

- At least 1 month since prior investigational drug

- No prior systemic therapy for locally advanced or metastatic disease

- Patients who have received prior neoadjuvant or adjuvant chemotherapy for
urothelial cancer (up to 4 courses), completed at least 6 months prior to first
documented disease progression, are eligible

- No concurrent anticoagulant therapy with warfarin or unfractionated heparin

- Patients requiring anticoagulation may be entered on study after successful
conversion to low molecular weight heparin

- No concurrent medications that have known adverse interactions with sunitinib malate
(i.e., strong CYP3A4 inhibitors or inducers)

- No prior or concurrent live vaccines (e.g., measles, mumps, rubella, oral polio,
bacille Calmette-Guérin [BCG], yellow fever, varicella, and TY21a typhoid vaccines)

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-free survival

Outcome Description:

Proportion of patients progression free at 6 months

Outcome Time Frame:

6 months

Safety Issue:

No

Principal Investigator

Tom Geldart

Investigator Role:

Principal Investigator

Investigator Affiliation:

Royal Bournemouth Hospital

Authority:

United Kingdom: Medicines and Healthcare Products Regulatory Agency

Study ID:

CDR0000667764

NCT ID:

NCT01089088

Start Date:

April 2009

Completion Date:

February 2014

Related Keywords:

  • Bladder Cancer
  • Transitional Cell Cancer of the Renal Pelvis and Ureter
  • Urethral Cancer
  • recurrent urethral cancer
  • recurrent transitional cell cancer of the renal pelvis and ureter
  • metastatic transitional cell cancer of the renal pelvis and ureter
  • regional transitional cell cancer of the renal pelvis and ureter
  • posterior urethral cancer
  • urethral cancer associated with invasive bladder cancer
  • transitional cell carcinoma of the bladder
  • stage IV bladder cancer
  • recurrent bladder cancer
  • anterior urethral cancer
  • Urinary Bladder Neoplasms
  • Carcinoma
  • Carcinoma, Transitional Cell
  • Urethral Neoplasms
  • Kidney Neoplasms
  • Ureteral Neoplasms

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