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A Phase 2, Randomized, Open Label, Parallel Arm Study to Evaluate the Safety and Efficacy of rAd-IFN/Syn3 Following Intravesical Administration in Subjects With High Grade, BCG Refractory or Relapsed Non-Muscle Invasive Bladder Cancer (NMIBC)

Phase 2
18 Years
Open (Enrolling)
Superficial Bladder Cancer

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Trial Information

A Phase 2, Randomized, Open Label, Parallel Arm Study to Evaluate the Safety and Efficacy of rAd-IFN/Syn3 Following Intravesical Administration in Subjects With High Grade, BCG Refractory or Relapsed Non-Muscle Invasive Bladder Cancer (NMIBC)

Criteria for Evaluation:

Efficacy: A Response is defined as no evidence of recurrence of a high grade tumor by
cystoscopy, cytology or if clinically indicated, biopsy.

Safety: The safety and tolerability of INSTILADRIN will be evaluated based on adverse event
reports, vital signs, ECGs, clinical laboratory values and results of physical examination.

Inclusion Criteria:

1. Aged 18 years or older at the time of consent

2. Able to give informed consent

3. Subjects with high grade BCG-refractory or relapsed NMIBC including

- High grade non-invasive papillary carcinomas (Ta) and subjects with high grade
tumors that invade sub-epithelial connective tissue (T1) or

- Carcinoma in situ (CIS) only or

- CIS and Ta or T1 tumors Refractory is defined as failure to achieve a
disease-free state at six months after adequate induction of BCG therapy with
either maintenance or re-induction at 3 months. Adequate induction is defined
as a minimum of 5 out of 6 induction doses and adequate maintenance is defined
as a minimum of 2 out of 3 doses of treatment.

Relapse is defined as recurrence within 1 year after a complete response to BCG

4. Complete resection of visible papillary lesions or CIS by TURBT or endoscopic
resection between 14 and 60 days prior to beginning study treatment

5. Available for the whole duration of the study

6. Life expectancy >2 years, in the opinion of the investigator

7. ECOG status 2 or less

8. Absence of upper tract urothelial carcinoma

9. Female subjects of childbearing potential must use maximally effective birth control
during the period of therapy, must be willing to use contraception for 1 month
following the last study drug infusion and must have a negative urine or serum
pregnancy test upon entry into this study. Otherwise, female subjects must be
postmenopausal (no menstrual period for a minimum of 12 months) or surgically

10. Male subjects must be surgically sterile or willing to use a double barrier
contraception method upon enrollment, during the course of the study, and for 1 month
following the last study drug infusion.

11. Adequate laboratory values.

- Hemoglobin ≥10 g/dL.

- WBC ≥4000/μL.

- ANC ≥2000/μL.

- Platelet count ≥100,000/μL.

- INR within institutional normal limits.

- aPTT within institutional normal limits.

- AST ≤1.5 x ULN.

- ALT ≤1.5 x ULN.

- Total bilirubin within institutional normal limits.

- Creatinine ≤1.5 x ULN.

Exclusion Criteria:

1. Current or previous evidence of muscle invasive or metastatic disease

2. Current systemic therapy for bladder cancer

3. Current or prior pelvic external beam radiotherapy

4. Prior treatment with adenovirus-based drugs

5. Suspected hypersensitivity to interferon alpha

6. Existing urinary tract infection or bacterial cystitis

7. Clinically significant and unexplained elevated liver or renal function tests

8. Women who are pregnant or lactating

9. Severe cardiovascular disease

10. History of malignancy of other organ system within past 5 years (except treated basal
cell carcinoma or squamous cell carcinoma of the skin)

11. Subjects who cannot hold instillation for 1 hour

12. Subjects who cannot tolerate intravesical dosing or intravesical surgical

13. Intravesical therapy within 6 weeks of enrollment

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

To evaluate the incidence of high grade-recurrence free survival following up to 4 instillations of INSTILADRIN

Outcome Time Frame:

12 months

Safety Issue:


Principal Investigator

Colin Dinney, MD

Investigator Role:

Study Chair

Investigator Affiliation:

M.D. Anderson Cancer Center


United States: Food and Drug Administration

Study ID:




Start Date:

September 2012

Completion Date:

June 2014

Related Keywords:

  • Superficial Bladder Cancer
  • BCG Refractory Superficial Bladder Cancer
  • rAd-IFN
  • Syn3
  • Intravesical
  • transitional cell carcinoma of the bladder
  • superficial non-muscle invasive tumor
  • Interferon alpha2b
  • Urinary Bladder Neoplasms



Baylor College of Medicine Houston, Texas  77030
MD Anderson Cancer Center Houston, Texas  77030-4096
Mayo Clinic Rochester, Minnesota  55905
Emory University Atlanta, Georgia  30322
Thomas Jefferson University Philadelphia, Pennsylvania  19107-6541
Washington University St. Louis, Missouri  63110
University of Texas Southwestern Medical Center Dallas, Texas  
Carolina Urologic Research Center Myrtle Beach, South Carolina  29572
University of North Carolina at Chapel Hill Chapel Hill, North Carolina  27599
Johns Hopkins Hospital Baltimore, Maryland  21287
The Urology Center of Colorado Denver, Colorado  80211
The University Of Texas Health Science Center San Antonio, Texas  78229