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Trial of Gemcitabine, Carboplatin, and Sorafenib in Chemotherapy-naive Patients With Advanced/Metastatic Bladder Carcinoma

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ClinicalTrials.gov Identifier: NCT00461851
Recruitment Status : Completed
First Posted : April 18, 2007
Results First Posted : November 1, 2016
Last Update Posted : December 14, 2017
Sponsor:
Collaborator:
Bayer
Information provided by (Responsible Party):
Yale University

Brief Summary:
This is a Phase II, nonrandomized multicenter study designed to evaluate time to progression and response proportion of patients with advanced or metastatic transitional cell carcinoma of bladder receiving 6 cycles of gemcitabine, carboplatin and sorafenib and then maintenance sorafenib.

Condition or disease Intervention/treatment Phase
Bladder Cancer Drug: Gemcitabine Drug: Carboplatin Drug: Sorafenib Phase 2

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 17 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II, Multicenter Trial of Gemcitabine, Carboplatin, and Sorafenib in Chemotherapy-naive Patients With Advanced/Metastatic Bladder Carcinoma
Study Start Date : March 2007
Actual Primary Completion Date : August 2013
Actual Study Completion Date : August 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bladder Cancer
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Chemotherapy plus sorafenib
Gemcitabine 1000 mg/m2 weekly x 2 weeks plus carboplatin AUC (Area under curve) 5 every 3 weeks plus sorafenib x 6 cycles then maintenance sorafenib alone
Drug: Gemcitabine
Gemcitabine will be given at a standard dose schedule of 1000 mg/m² on day 1 and 8.
Other Name: Gemzar
Drug: Carboplatin
Carboplatin will be given on day 1 to an AUC of 5.
Drug: Sorafenib
Sorafenib will be administered orally daily on days 2-19 at 400 mg bid
Other Name: BAY 43-9006



Primary Outcome Measures :
  1. Progression Free Survival (PFS) [ Time Frame: Upon completion of study ]
    The primary outcome was the proportion of patients who achieved progression free survival (PFS) of five months. PFS was defined as time to progression or any-cause mortality, whichever came first.


Secondary Outcome Measures :
  1. Dose Ruction (Toxicity) [ Time Frame: Upon completion of study ]
    To determine the toxicity of combination therapy with sorafenib, gemcitabine and carboplatin, dose reductions by drug are reported. The number of patients that were reduced in dosage are reported here.

  2. Best Reported Response [ Time Frame: Upon completion of study ]
    The best reported response captures the proportion of patients with advanced or metastatic transitional cell carcinoma of the bladder that achieve a complete or partial response to the combination therapy with sorafenib, gemcitabine, and carboplatin.



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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologic documentation of diagnosis of transitional cell carcinoma of the bladder, urethra, ureter, or renal pelvis
  • Unresectable, locally advanced or metastatic disease
  • CrCl ≥ 60 ml/min or serum creatinine < 1.5
  • ≥ 4 weeks since prior RT
  • ECOG Performance Status of 0 or 1 (Appendix I)
  • Age ≥ 18 years of age
  • Women of childbearing potential and men must agree to use adequate contraception (barrier method of birth control) prior to study entry and for the duration of study participation. Men and women should use adequate birth control for at least 2 weeks after the last administration of sorafenib.
  • Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
  • Ability to understand and the willingness to sign a written informed consent. A signed informed consent must be obtained prior to any study specific procedures.
  • Adequate bone marrow, liver and renal function as assessed by the following:

    • Hemoglobin > 9.0 g/dl
    • Absolute neutrophil count (ANC) ≥ 1,500/mm3
    • Platelet count ≥ 100,000/mm3
    • Total bilirubin ≤ 1.5 times ULN
  • ALT and AST ≤ 2.5 times the ULN ( ≤ 5 x ULN for patients with liver involvement)
  • INR < 1.5 or a PT/PTT within normal limits. Patients receiving anti-coagulation treatment with an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly, or as defined by the local standard of care, until INR is stable.

Exclusion Criteria:

  • Prior treatment with systemic chemotherapy (prior intravesical chemotherapy is permitted, and adjuvant therapy is permitted if > 12 months have lapsed)
  • Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study
  • Cardiac disease: Congestive heart failure > class II NYHA. Patients must not have unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months.
  • History of stroke within six months
  • Clinically significant peripheral vascular disease
  • Known brain metastasis. Patients with neurological symptoms must undergo a CT scan/MRI of the brain to exclude brain metastasis.
  • Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy.
  • Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management.
  • Sorafenib is contraindicated in patients with known severe hypersensitivity to sorafenib or any of the excipients.
  • Known human immunodeficiency virus (HIV) infection or chronic Hepatitis B or C.
  • Active clinically serious infection > CTCAE Grade 2.
  • Thrombolytic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months
  • Pulmonary hemorrhage/bleeding event ≥ CTCAE Grade 2 within 4 weeks of first dose of study drug
  • Any other hemorrhage/bleeding event ≥ CTCAE Grade 3 within 4 weeks of first dose of study drug
  • Evidence or history of bleeding diathesis or coagulopathy
  • Major surgery, significant traumatic injury within 4 weeks of first study drug
  • Use of St. John's Wort or rifampin (rifampicin)
  • Known or suspected allergy to sorafenib or any agent given in the course of this trial
  • Any condition that impairs patient's ability to swallow whole pills
  • Any malabsorption problem
  • Anticipation of need for major surgical procedure during the course of the study
  • Pregnant (positive pregnancy test) or lactating
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to Day 0
  • Serious, non-healing wound, ulcer, or bone fracture
  • Inability to comply with study and/or follow-up procedures
  • History of persistent gross hematuria

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00461851


Locations
United States, Connecticut
Yale University, Comprehensive Cancer Center
New Haven, Connecticut, United States, 06520
Sponsors and Collaborators
Yale University
Bayer
Investigators
Principal Investigator: Hari Deshpande, MD Yale University

Responsible Party: Yale University
ClinicalTrials.gov Identifier: NCT00461851     History of Changes
Other Study ID Numbers: 0609001823
First Posted: April 18, 2007    Key Record Dates
Results First Posted: November 1, 2016
Last Update Posted: December 14, 2017
Last Verified: September 2016

Keywords provided by Yale University:
Advanced/Metastatic Bladder Carcinoma

Additional relevant MeSH terms:
Carcinoma
Urinary Bladder Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Urinary Bladder Diseases
Urologic Diseases
Gemcitabine
Sorafenib
Carboplatin
Niacinamide
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Protein Kinase Inhibitors
Vitamin B Complex
Vitamins
Micronutrients
Growth Substances