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Trial record 5 of 104 for:    mdv3100 | Recruiting, Not yet recruiting, Available Studies

Enzalutamide for Bladder Cancer Chemoprevention

This study is currently recruiting participants.
Verified July 2017 by Edward Messing, University of Rochester
Sponsor:
ClinicalTrials.gov Identifier:
NCT02605863
First Posted: November 16, 2015
Last Update Posted: July 21, 2017
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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Collaborator:
Astellas Pharma Inc
Information provided by (Responsible Party):
Edward Messing, University of Rochester
  Purpose
The purpose of this study is to examine the effect of androgen deprivation therapy through administration of enzalutamide on preventing bladder cancer recurrences in patients with non-muscle invasive bladder cancer (NMIBC).

Condition Intervention Phase
Bladder Cancer Drug: Enzalutamide Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: The Effect of Androgen Deprivation Therapy With Enzalutamide on Bladder Cancer Chemoprevention

Resource links provided by NLM:


Further study details as provided by Edward Messing, University of Rochester:

Primary Outcome Measures:
  • Evaluate the recurrence rate in NMIBC subjects treated with Enzalutamide (androgen deprivation therapy) [ Time Frame: 1 year ]
    Compare historical rates of bladder cancer recurrence without androgen deprivation therapy


Estimated Enrollment: 50
Study Start Date: January 2016
Estimated Study Completion Date: November 2018
Estimated Primary Completion Date: November 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Intermediate Risk NMIBC
Enzalutamide 160mg by mouth daily for 12 months
Drug: Enzalutamide
160 mg by mouth daily for 12 months
Other Name: Xtandi
Experimental: High Risk NMIBC
Enzalutamide 160mg by mouth daily for 12 months
Drug: Enzalutamide
160 mg by mouth daily for 12 months
Other Name: Xtandi

Detailed Description:
  • A blood draw and an electrocardiogram (EKG). The blood draw will check levels of testosterone, dihydro-testosterone, estradiol, and Vitamin D. Pre-study blood-work will also include a complete blood count (CBC), basic metabolic panel (BMP/CHEM8) and liver function test (LFT) if any of these labs were not drawn within 1 month prior to the transurethral resection of bladder tumor (TURBT).
  • Bladder tumor sample that is stored in the Department of Pathology will have additional tests run on it to confirm study eligibility and to test for certain cell markers.
  • After 1 month following the original TURBT, subjects will begin therapy with enzalutamide. The study drug will be administered orally at a dose of 160mg daily for 12 months.
  • Subjects will be monitored for adverse reactions or side effects from enzalutamide at scheduled office visits.
  • If the bladder tumor is classified as being "intermediate risk", regularly scheduled office visits will occur at 2 months post-operatively (i.e., 1 month after starting enzalutamide), and then again at post-operative months 3, 6, 9 and 12, as is part of the usual standard of care.
  • If the bladder tumor is classified as being "high risk" and the subject receives BCG therapy, then the office visits will occur on a slightly different schedule to conform to the standard of care for this type of disease. Subjects in this group typically start their intravesical BCG instillations 4-6 weeks post-operatively. Therefore, the subjects will be seen approximately 1 month following the initial TURBT, and will begin therapy with enzalutamide at that time, as described above. Subjects will be on study drug at least 7 days prior to the initiation of BCG therapy, which will occur once a week for 6 weeks. Similar to the subjects in the intermediate risk group, the subjects receiving BCG will also be seen 1 month after initiation of enzalutamide therapy to ensure there are no adverse reactions to the study drug. Following this visit, they will be seen again at the time of the post-BCG cystoscopy, which occurs 1 month after your 6th instillation. Subjects will be seen again at the 3, 6, 9 and 12-month post-BCG cystoscopy office visits, as part of routine care.
  • Repeat blood work (CBC, BMP and LFTs) will be checked 1 month after starting enzalutamide (approximately 2 months post-operatively). For subjects with intermediate risk bladder cancer, these labs will be checked again at 3, 6, 9 and 12 months post-operatively (as per the regularly scheduled office visits). For the high risk patients receiving BCG therapy, these labs will be checked again at the 1, 3, 6 and 9-month post-BCG office visits (per the regularly scheduled office visits for these patients).
  • An EKG will be obtained at baseline (before starting the study drug), but will also be re-checked at approximately 6 months (half-way through therapy with enzalutamide) to ensure there are no signs of worsening cardiac disease while on the study drug.
  • A cystoscopy will be done every 3 months as part of the standard of care for bladder cancer follow-up. Lesions suspicious for tumor recurrence will be biopsied as per usual standard of care. If a recurrence is documented, subjects will discontinue use of enzalutamide.
  • For subjects scheduled to undergo therapy with BCG, additional tests will be run on the urine samples that subjects will already be providing in the Urology office as part of the standard of care.
  Eligibility

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:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subjects with histologically confirmed NMIBC who have undergone their TURBT.
  2. Per the European Association of Urology (EAU) guidelines, only subjects with "Intermediate" or "High risk" bladder cancer will be enrolled21:

    For patients with "high risk" bladder cancer, only those who undergo BCG therapy following their TURBT will be eligible for enrollment.

  3. Subjects who receive BCG instillations post-operatively will be eligible for enrollment.
  4. Subjects whose tumors are AR(+) as well as AR(-) will be included, but we will restrict inclusion of AR(-) subjects so that they represent no more than 1/3 of the total study population, or any single cohort (ie. the intermediate or high-risk groups).
  5. Subjects of child-bearing potential must agree to 2 acceptable forms of birth control.

Exclusion Criteria:

  1. Subjects with "low risk" bladder cancer, as defined by the EAU guidelines21, will be ineligible for enrollment.
  2. Subjects with "high risk" bladder cancer who do not undergo BCG therapy following their TURBT will be ineligible for enrollment.
  3. Subjects who have "failed" BCG therapy in the past (had a recurrence of bladder cancer despite prior use of BCG) will be ineligible for enrollment.
  4. Subjects who receive an immediate post-TURBT single instillation of intravesical chemotherapy will be ineligible for enrollment.
  5. Subjects who receive a post-operative induction course of intravesical chemotherapy (ie. more than just a single immediate post-operative dose of intravesical chemotherapy) will be ineligible for enrollment.
  6. Subjects who undergo blue-light/fluorescence cystoscopy will be ineligible for enrollment.
  7. Subjects with a history of heart attack within the previous 12 months or who have unstable cardiovascular status will be ineligible for enrollment.
  8. Subjects who have uncontrolled hypertension (for our purposes, defined as those having a systolic blood pressure > 160 documented on 2 occasions despite appropriate medical therapy) will similarly be ineligible.
  9. Subjects with a history of venous thrombo-embolism (DVT/PE) within the past 3 years.
  10. Subjects with a history of seizure disorders, or those with a history of stroke or transient ischemic attacks (TIA) within the previous 12 months will be ineligible.
  11. Subjects with a history of liver disease whose hepatic enzymes, alkaline phosphatase or bilirubin are greater than twice the upper limit of normal will be ineligible.
  12. Subjects with kidney disease with an estimated glomerular filtration rate (eGFR) < 30 will be ineligible.
  13. Subjects with neutropenia will be ineligible.
  14. Subjects with clinical hypogonadism, those on androgen replacement therapy, or those with prostate cancer or other diseases treated with various forms of hormonal therapy (not including 5-alpha reductase inhibitors) will also be ineligible for study enrollment.
  15. Subjects who have undergone therapy for any malignancy within the past 5 years except for basal and squamous cell carcinomas of the skin will also be ineligible.
  16. Subjects with prior histories of prostate cancer treated by definitive local therapy > 5 years ago will only be eligible if they have had no clinical or biochemical evidence of recurrent prostate cancer.
  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): NCT02605863


Contacts
Contact: Edward E. Messing, MD 585-275-0998 edward_messing@urmc.rochester.edu

Locations
United States, New York
University of Rochester Recruiting
Rochester, New York, United States, 14642
Contact: Edward E. Messing, MD    585-275-0998    edward_messing@urmc.rochester.edu   
Sponsors and Collaborators
University of Rochester
Astellas Pharma Inc
Investigators
Principal Investigator: Edward E. Messing, MD University of Rochester
  More Information

Responsible Party: Edward Messing, Principal Investigator, University of Rochester
ClinicalTrials.gov Identifier: NCT02605863     History of Changes
Other Study ID Numbers: 52539
First Submitted: November 12, 2015
First Posted: November 16, 2015
Last Update Posted: July 21, 2017
Last Verified: July 2017

Keywords provided by Edward Messing, University of Rochester:
Enzalutamide
Non-Muscle Invasive Bladder Cancer
Androgen Deprivation Therapy

Additional relevant MeSH terms:
Urinary Bladder Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Urinary Bladder Diseases
Urologic Diseases
Androgens
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs