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Mycobacterial Cell Wall-DNA Complex in Treatment of BCG-refractory Patients With Non-muscle Invasive Bladder Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT00406068
Recruitment Status : Completed
First Posted : December 4, 2006
Last Update Posted : July 28, 2016
Information provided by (Responsible Party):

Study Description
Brief Summary:
The purpose of this study is to determine the efficacy and safety of intravesical Mycobacterial Cell Wall-DNA Complex (MCC) in patients with non-muscle invasive transitional cell carcinoma (papillary tumors and/or carcinoma in situ) of the urinary bladder at high risk of progression who are refractory to therapy with bacillus Calmette-Guerin (BCG).

Condition or disease Intervention/treatment Phase
Bladder Neoplasms Drug: Mycobacterial cell wall-DNA complex Phase 2 Phase 3

Detailed Description:

The study will be divided into 3 phases: Induction, Maintenance, and Follow-up.

The Induction Phase will cover a period of 6 weeks. During this time, patients will receive 6 weekly intravesical instillations of 8 mg MCC. The patients will be evaluated at month 3, at which time the patients will enter the Maintenance Phase. The Maintenance Phase will last from month 3 to month 24, and during this time, patients will receive weekly MCC instillations for three weeks at months 3, 6, 12, 18, and 24 and evaluations will be performed at months 3, 6, 9, 12, 15, 18, 21 and 24.

At month 3, the patient will be evaluated to assure that the disease is not progressing. Cytology, cystoscopy and biopsies will be performed to obtain adequate staging (if residual tumor persists). If the patient is disease-free, maintenance therapy will be initiated. Patients with non-muscle invasive tumors at month 3 will, at the discretion of the investigator, receive either a second 6-week induction course or a 3-week maintenance course. Patients who show progression to muscle invasive disease will be referred to other treatments.

At month 6 and thereafter at each evaluation visit, patients will be evaluated and managed according to the following results:

  • Patients who are disease-free will continue on maintenance treatment.
  • Patients who are not disease-free (evidence of papillary lesions, CIS or muscle invasive disease) will be withdrawn from further study treatment and will be referred to other therapies at the discretion of the investigator.

The final 36 months of the study is the Follow-up Phase. Evaluations will be performed at months 30, 36, 42, 48, 54 and 60.

Efficacy evaluations will include standard cystoscopy, biopsies and urine cytology. During the Maintenance Phase, standard cystoscopies will be performed at months 3, 6, 9, 12, 15, 18, 21 and 24 for the surveillance of bladder tumors. During the months that instillations will be performed, cystoscopies will be conducted only once at each of these months. During the Follow-up Phase, cystoscopies will be performed at months 30, 36, 42, 48, 54 and 60.

Mandatory bladder biopsies will be done for all patients at month 6.

During the course of the study, biopsies will be taken only if evident or suspicious lesions are seen during cystoscopy or in case of negative cystoscopy but positive cytology.

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 129 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Open-label, Multi-center Study of the Efficacy and Safety of MCC in the Treatment of Patients With Non-muscle Invasive (Superficial) Bladder Cancer at High Risk of Progression and Who Are Refractory to BCG
Study Start Date : November 2006
Primary Completion Date : July 2011
Study Completion Date : July 2011

Resource links provided by the National Library of Medicine

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

Arms and Interventions

Arm Intervention/treatment
Experimental: Mycobacterial cell wall-DNA complex
Mycobacterial cell wall-DNA complex
Drug: Mycobacterial cell wall-DNA complex
8 mg MCC, intravesical - Induction Phase (6 weekly intravesical instillations) and Maintenance Phase (3 weekly instillations at months 3, 6, 12, 18 and 24).
Other Name: MCC - Urocidin

Outcome Measures

Primary Outcome Measures :
  1. One year disease-free survival rate [ Time Frame: Prospective ]

Secondary Outcome Measures :
  1. The 3, 6 and 24 month disease-free survival rate [ Time Frame: Prospective ]
  2. Duration of disease-free survival in all patients [ Time Frame: Prospective ]
  3. Time to progression to muscle invasive disease [ Time Frame: Prospective ]
  4. Overall survival in all patients [ Time Frame: Prospective ]
  5. Rate of overall drug-related adverse events leading to two consecutive treatment delays of one week each or to the discontinuation of treatment. [ Time Frame: Prospective ]

Eligibility Criteria

Information from the National Library of Medicine

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

Inclusion Criteria:

  • Patients refractory to BCG therapy;
  • Patients with histologically confirmed diagnosis of high grade lesions;
  • Diagnosis of high grade lesion must be within 56 days prior to beginning of study treatment;
  • Have had all visible papillary lesion(s) resected by TURBT within 56 days prior to beginning of study treatment;
  • Available for the whole duration of the study including follow-up (60 months);
  • Life expectancy of > 5 years;
  • Patients with an ECOG performance status grade of 2 or less;
  • Absence of urothelial carcinoma involving the upper urinary tract or prostatic urethra within 12 months from beginning of study treatment;
  • Able to understand and give written informed consent;
  • In the investigator's judgment, the patient is able to participate in the study.

Exclusion Criteria:

  • Current or previous history of muscle invasive tumors;
  • Current or previous history of lymph node or distant metastases from bladder cancer;
  • Current systemic cancer therapy;
  • Current or prior pelvic external beam radiotherapy;
  • Pelvic brachytherapy within 2 years of study entry;
  • Prior treatment with MCC;
  • Patients with existing urinary tract infection or recurrent severe bacterial cystitis;
  • Clinically significant and unexplained elevations of liver or renal function tests;
  • White blood cell count below 3 x109/L (3,000/mm3) or platelet count below 100 x 109/L(100,000/mm3);
  • Severe cardiovascular disease;
  • Women who are pregnant or lactating;
  • Congenital or acquired immune deficiency;
  • With history of malignancy of any organ system, treated or untreated, within the past 5 years (with the exception of adequately treated basal cell or squamous cell carcinoma of the skin, stage T1 prostate cancer, carcinoma in situ of the cervix or colon polyps);
  • Previous investigational treatment within 3 months from beginning of study treatment;
  • Patients who cannot hold the instillation for one hour;
  • Patients who cannot tolerate intravesical administration or intravesical surgical manipulation (cystoscopy or biopsy);
  • Clinically significant active infections;
  • Any medical or psychiatric condition which, in the opinion of the investigator, would preclude the participant from adhering to the protocol or completing the trial per protocol.
Contacts and Locations

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): NCT00406068

  Hide Study Locations
United States, Arizona
BCG Oncology
Phoenix, Arizona, United States, 85032
United States, California
San Diego Clinical Trials
San Diego, California, United States, 92120
United States, Connecticut
Connecticut Urological Research at Grove Hill
New Britain, Connecticut, United States, 06052
United States, Florida
University of Miami School of Medicine
Miami, Florida, United States, 33136
Winter Park Urology Associates P.A.
Orlando, Florida, United States, 32803
United States, Illinois
The University of Chicago Hospitals
Chicago, Illinois, United States, 60637
United States, Indiana
Welborn Clinic
Evansville, Indiana, United States, 47713
United States, Maryland
Johns Hopkins University
Baltimore, Maryland, United States, 21231
Chesapeake Urology Research Associates
Towson, Maryland, United States, 21204
United States, Nevada
Sheldon J Freedman, MD, Ltd
Las Vegas, Nevada, United States, 89148
United States, New Jersey
Delaware Valley Urology, LLC-Voorhees
Voorhees, New Jersey, United States, 08043
United States, New York
Memorial Sloan Kettering Cancer Centre
New York, New York, United States, 10021
Hudson Valley Urology
Poughkeepsie, New York, United States, 12601
University of Rochester Medical Center
Rochester, New York, United States, 14642
United States, Pennsylvania
Triangle Urology Group
Pittsburgh, Pennsylvania, United States, 15212
United States, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee, United States, 37232
United States, Texas
Urology Clinics of North Texas, P.A.
Dallas, Texas, United States, 75231
M.D. Anderson Cancer Center
Houston, Texas, United States, 77030
Urology San Antonio Research, PA
San Antonio, Texas, United States, 78229
United States, Virginia
Sentara Medical Group - Urology of Virginia, PC
Norfolk, Virginia, United States, 23502
Canada, British Columbia
Andreou Research
Surrey, British Columbia, Canada, V3V 1N1
Can-Med Clinical Research
Victoria, British Columbia, Canada, V8T 5G1
Dr. Steinhoff Clinical Research
Victoria, British Columbia, Canada, V8V 3N1
Canada, Ontario
Centre for Applied Urological Research
Kingston, Ontario, Canada, K7L 3J7
London Health Sciences Centre
London, Ontario, Canada, N6A 5W9
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada, M4N 3M5
University Health Network / Princess Margaret Hospital
Toronto, Ontario, Canada, M5G 2M9
The Male Health Center
Toronto, Ontario, Canada, M6A 3B5
Canada, Quebec
Centre Hospitalier de l'Universite de Montreal
Montreal, Quebec, Canada, H2X 3J4
Jewish General Hospital
Montreal, Quebec, Canada, H3T 1E2
Centre de Recherche du CHUQ
Quebec City, Quebec, Canada, G1R 2J6
Sponsors and Collaborators
Bioniche Life Sciences Inc.
Principal Investigator: Alvaro Morales, MD Centre for Applied Urological Research, Kingston General Hospital/Queen's University
More Information

Additional Information:
Responsible Party: Bioniche Life Sciences Inc.
ClinicalTrials.gov Identifier: NCT00406068     History of Changes
Other Study ID Numbers: HIS-0611-0602
First Posted: December 4, 2006    Key Record Dates
Last Update Posted: July 28, 2016
Last Verified: July 2016

Keywords provided by Bioniche Life Sciences Inc.:
Bladder neoplasm
Intravesical drug administration
Neoplasm recurrence, local
Transitional cell, carcinoma
Carcinoma in situ

Additional relevant MeSH terms:
Urinary Bladder Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Urinary Bladder Diseases
Urologic Diseases