Have you or your loved ones been diagnosed with urinary bladder neoplasms?
You may be eligible to participate in a urinary bladder neoplasms clinical trial.
Have you or your loved ones been diagnosed with urinary bladder neoplasms? You may be eligible to participate in a urinary bladder neoplasms clinical trial.
What is a clinical trial? Is participating in a clinical trial right for you? Learn more
Urinary Bladder Neoplasms Clinical Trial
Have you or your loved ones been diagnosed with urinary bladder neoplasms?
You may be eligible to participate in a urinary bladder neoplasms clinical trial.
Have you or your loved ones been diagnosed with urinary bladder neoplasms? You may be eligible to participate in a urinary bladder neoplasms clinical trial.
Recruiting
Male & Female
18 Years +
The purpose of this study is to evaluate recurrence-free survival (RFS) in participants treated with erdafitinib vs Investigator's Choice, for participants with high-risk non-muscle-invasive bladder cancer (NMIBC) who harbor fibroblast growth factor receptor (FGFR) mutations or fusions, and who recurred after bacillus calmette-guerin (BCG) therapy.
Details for the study
Brief Title
A Study of Erdafitinib Versus Investigator Choice of Intravesical Chemotherapy in Participants Who Received Bacillus Calmette-Guérin (BCG) and Recurred With High Risk Non-Muscle-Invasive Bladder Cancer (NMIBC)
Official Title
A Randomized Phase 2 Study of Erdafitinib Versus Investigator Choice of Intravesical Chemotherapy in Subjects Who Received Bacillus Calmette-Guérin (BCG) and Recurred With High Risk Non-Muscle-Invasive Bladder Cancer (NMIBC) and FGFR Mutations or Fusions
Brief Summary
The purpose of this study is to evaluate recurrence-free survival (RFS) in participants <br /> treated with erdafitinib vs Investigator's Choice, for participants with high-risk <br /> non-muscle-invasive bladder cancer (NMIBC) who harbor fibroblast growth factor receptor <br /> (FGFR) mutations or fusions, and who recurred after bacillus calmette-guerin (BCG) therapy.
Detailed Description
This study enrolls participants with high risk NMIBC and FGFR mutations or fusions.
Erdafitinib is an oral pan-fibroblast growth factor receptor (FGFR) 1-4 inhibitor with
demonstrated clinical activity in participants with solid tumors, including urothelial
carcinoma, with alterations in the FGFR pathway. In Cohort 1, participants will be randomized
to erdafitinib or to Investigators Choice (intravesical gemcitabine or intravesical
MMC/hyperthermic MMC). The study consists of Screening period, Treatment Phase and Follow-up
Phase.
Treatments and/or Procedures
Investigator choice gemcitabine
Investigator's Choice treatment will be given once weekly for at least 4 doses of induction followed by monthly maintenance for at least 6 months.
Investigator choice mitomycin C
Investigator's Choice treatment will be given once weekly for at least 4 doses of induction followed by monthly maintenance for at least 6 months.
Erdafitinib
Participants will receive erdafitinib orally beginning on Cycle 1 Day 1 until 2 years of treatment have been completed, disease recurrence, intolerable toxicity, withdrawal of consent, a decision by the investigator to discontinue treatment, or study termination, whichever occurs first. Each cycle is of 28 days.
Outcome Measures
Outcome measures are the tests that investigators perform to prove whether or not a treatment being tested in a clinical trial is having any effect.
Primary
Recurrence-Free Survival (RFS)
RFS is defined as the time from the date of randomization until the date of the reappearance of high-risk disease, or death, whichever is reported first.
Secondary
Change from Baseline in European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire (EORTC QLQ) -C30
EORTC QLQ-C30 is a core 30-item questionnaire for evaluating the health-related quality of life (HRQoL) of participants participating in cancer clinical studies.
Secondary
Change from Baseline in EuroQol European Quality of Life - 5 Dimensions-5 Levels (EQ-5D-5L)
EQ-5D-5L is a standardized measure of health status developed by the EuroQol Group to provide a simple, generic measure of health for clinical and economic appraisal. The EQ-5D-5L descriptive system comprises the following 5 dimensions: mobility, selfcare, usual activities, pain/discomfort, and anxiety/depression.
Secondary
Change from Baseline in EORTC QLQ- Non-Muscle-Invasive Bladder Cancer (NMIBC) 24
EORTC QLQ-NMIBC24 is a 24-item questionnaire for evaluating the HRQoL of participants with superficial (non-muscle-invasive) bladder cancer. The questionnaire is designed to supplement the QLQ-C30.
Secondary
Change from Baseline in Patient's Global Impression of Change (of cancer) (PGIC)
PGIC is single-item questionnaires to evaluate a patient's global impression of change of cancer.
Secondary
Recurrence-Free Survival
RFS is defined as the time from the date of randomization until the date of the reappearance of high-risk disease, or death, whichever is reported first. Participants who are recurrence-free and alive or have unknown status will be censored at the last tumor assessment.
Secondary
Number of Participants with Adverse events
An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product
Secondary
Plasma Concentration of Erdafitinib
Plasma concentration of erdafitinib will be reported.
Secondary
RFS by Central Histopathologic Review
RFS will be assessed by central histopathologic review. RFS is defined as the time from the date of randomization until the date of the reappearance of high-risk disease, or death, whichever is reported first.
Secondary
Recurrence-Free Survival 2 (RFS2)
RFS2 is defined as the time from the date of randomization until the date of the reappearance of high-risk disease on the first subsequent non-surgical anticancer treatment, or death, whichever is reported first.
Secondary
Overall Survival
The time from the date of randomization to the date of the participant's death resulting from any cause. Participants who are alive or have unknown vital status will be censored at the date the participant was last known to be alive.
Secondary
Disease-Specific Survival
The time from the date of randomization to the date of the participant's death resulting from bladder cancer. Participants who are alive or have unknown vital status will be censored at the date the participant was last known to be alive. Participants whose death result from causes other than bladder cancer will be censored at their death dates.
Secondary
Time to Progression
Time from the date of randomization until the date of first documented evidence of any of progression or death. Participants who are progression -free and alive or have unknown status will be censored at the date of the last tumor assessment.
Secondary
Time to Disease Worsening
Time from the date of randomization to the date of first documented evidence of cystectomy, change in therapy indicative of more advanced disease (including systemic chemotherapy or radiotherapy). Participants who are free of disease worsening and alive or have unknown status will be censored at the last tumor assessment.
Secondary
Change from Baseline in Patient's Global Impression of Severity (of cancer) (PGIS)
PGIS is single-item questionnaires to evaluate patient's global impression of severity.
Study Criteria
Inclusion Criteria: - Histologically confirmed, recurrent, non-muscle-invasive urothelial carcinoma of the bladder. Variant pathology are allowed - Tumor with specified fibroblast growth factor receptor (FGFR) mutations or fusions - Bacillus Calmette- Guerin (BCG)-unresponsive after adequate BCG therapy or BCG experienced participants - Refuses or is not eligible for cystectomy (Cohort 1 and Cohort 2 only) - Eastern Cooperative Oncology Group (ECOG) performance status Grade 0-1 - Must sign an informed consent form (ICF) (or their legally acceptable representative must sign) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study - A woman of childbearing potential must have a negative pregnancy test (beta-hCG [beta-human chorionic gonadotropin]) (urine or serum) within 7 days before randomization (Cohort 1) or the first dose of study drug (Cohort 2 and Cohort 3) - Adequate bone marrow, liver, and renal function as specified in the protocol Exclusion Criteria: - Histologically confirmed, muscle-invasive (T2 or higher stage) urothelial carcinoma of the bladder - Histopathology demonstrating any small cell component, pure adenocarcinoma, pure squamous cell carcinoma, or pure squamous CIS of the bladder - Prior treatment with an FGFR inhibitor - Active malignancies other than the disease being treated under study. The only allowed exceptions are: (a) skin cancer treated within the last 24 months that is considered completely cured (b) adequately treated lobular carcinoma in situ (LCIS) and ductal CIS (c) history of localized breast cancer and receiving antihormonal agents, or history of localized prostate cancer (N0M0) and receiving androgen deprivation therapy - Current central serous retinopathy or retinal pigment epithelial detachment of any grade