Bladder CancerPhase 2NCT00055835
S0121, Neoadjuvant Carboplatin, Paclitaxel, and Gemcitabine Followed by Cisplatin and Radiation Therapy in Treating Patients With Locally Advanced or Recurrent Carcinoma of the Urothelium
A Phase 2 study testing carboplatin, cisplatin and gemcitabine hydrochloride in people with Bladder Cancer and Urethral Cancer, run by SWOG Cancer Research Network at 92 sites in United States.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as carboplatin, paclitaxel, gemcitabine, and cisplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Bladder Cancer, Urethral Cancer
- What is being tested?
- carboplatin, cisplatin and gemcitabine hydrochloride
- Type of treatment
- Injection or infusion, Surgery or procedure
- How many people
- 7 participants
- Where
- 92 sitesUnited States
- Study dates
- Nov 2002to Jun 2006
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically confirmed primary or recurrent invasive carcinoma of the urothelium
- Transitional, squamous, or mixed cell subtypes allowed
- Primary disease site must be the urinary bladder or urethra
- Disease confined to the true pelvis (T2-T4, N0-N3, M0)
- Must meet at least 1 of the following criteria:
- Nodal involvement at or below the level of the bifurcation of the iliac vessels
- Medically or surgically inoperable
- Patient refused cystectomy
- Measurable or nonmeasurable disease
- Evidence of tumor invasion of the muscularis by cystoscopy and biopsy and detailed bladder mapping within the past 56 days
- No extrapelvic metastases
- Eligible to receive radiotherapy
- Planned radiotherapy at a SWOG-approved facility
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Zubrod 0-2
Life expectancy
- Not specified
Hematopoietic
- Granulocyte count at least 1,500/mm^3
- Platelet count at least lower limit of normal
Hepatic
- Bilirubin no greater than upper limit of normal (ULN)
- SGOT or SGPT no greater than 2.5 times ULN
Renal
- Creatinine clearance at least 60 mL/min OR
- Creatinine no greater than ULN
Gastrointestinal
- No chronic diarrhea
- No malabsorption
- No extensive diverticular disease of the colon
- No inflammatory bowel disease
- No other pre-existing gastrointestinal disorders
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No active infections requiring antibiotics
- No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer currently in complete remission
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- No prior chemotherapy for patients with a current diagnosis of advanced bladder cancer that is also the initial diagnosis
- No prior systemic chemotherapy except adjuvant therapy for recurrent disease completed more than 6 months ago
- No prior carboplatin
- No prior paclitaxel
- No prior gemcitabine
Endocrine therapy
- Not specified
Radiotherapy
- See Disease Characteristics
- No prior pelvic radiotherapy
Surgery
- See Disease Characteristics
- Recovered from prior surgery
Trial locations and contacts
92 sites in 1 country.
92 sites in 1 country
United States92 sites
Veterans Affairs Medical Center - Albuquerque
Albuquerque, New Mexico, 87108-5138
MBCCOP - University of New Mexico HSC
Albuquerque, New Mexico, 87131
Harrington Cancer Center
Amarillo, Texas, 79106
Texas Tech University Health Sciences Center School of Medicine
Amarillo, Texas, 79106
Veterans Affairs Medical Center - Amarillo
Amarillo, Texas, 79106
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, 48106
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109-0946
CCOP - Atlanta Regional
Atlanta, Georgia, 30342-1701
University of Colorado Cancer Center at University of Colorado Health Sciences Center
Aurora, Colorado, 80010
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Cancer Research Center at Boston Medical Center
Boston, Massachusetts, 02118
Western New York Urology Associates
Buffalo, New York, 14220
Veterans Affairs Medical Center - Charleston
Charleston, South Carolina, 29401-5799
Hollings Cancer Center at Medical University of South Carolina
Charleston, South Carolina, 29425
MBCCOP - University of Illinois at Chicago
Chicago, Illinois, 60612
Veterans Affairs Medical Center - Chicago Westside Hospital
Chicago, Illinois, 60612
Veterans Affairs Medical Center - Cincinnati
Cincinnati, Ohio, 45220-2288
Charles M. Barrett Cancer Center at University Hospital
Cincinnati, Ohio, 45267-0501
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195-9001
CCOP - Columbus
Columbus, Ohio, 43206
Veterans Affairs Medical Center - Dayton
Dayton, Ohio, 45428-1002
CCOP - Dayton
Dayton, Ohio, 45429
CCOP - Central Illinois
Decatur, Illinois, 62526
Veterans Affairs Medical Center - Denver
Denver, Colorado, 80220
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, 48201-1379
Veterans Affairs Medical Center - Detroit
Detroit, Michigan, 48201-1932
Josephine Ford Cancer Center at Henry Ford Health System
Detroit, Michigan, 48202
City of Hope Comprehensive Cancer Center
Duarte, California, 91010-3000
Brooke Army Medical Center
Fort Sam Houston, Texas, 78234-6200
University of Texas Medical Branch
Galveston, Texas, 77555-0565
CCOP - Southeast Cancer Control Consortium
Goldsboro, North Carolina, 27534-9479
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
CCOP - Greenville
Greenville, South Carolina, 29615
Veterans Affairs Medical Center - Hines
Hines, Illinois, 60141
MBCCOP - Hawaii
Honolulu, Hawaii, 96813
M.D. Anderson Cancer Center at University of Texas
Houston, Texas, 77030-4095
Baylor College of Medicine
Houston, Texas, 77030
University of Mississippi Medical Center
Jackson, Mississippi, 39216-4505
Veterans Affairs Medical Center - Jackson
Jackson, Mississippi, 39216
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
Kansas City, Kansas, 66160-7390
CCOP - Kansas City
Kansas City, Missouri, 64131
Veterans Affairs Medical Center - Lexington
Lexington, Kentucky, 40502-2236
Markey Cancer Center at University of Kentucky Chandler Medical Center
Lexington, Kentucky, 40536-0084
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Veterans Affairs Medical Center - Little Rock
Little Rock, Arkansas, 72205
USC/Norris Comprehensive Cancer Center and Hospital
Los Angeles, California, 90033
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, 90095-1781
UMC Southwest Cancer and Research Center
Lubbock, Texas, 79415-3364
Veterans Affairs Outpatient Clinic - Martinez
Martinez, California, 94553
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, 60153-5500
University of Tennessee Cancer Institute at Methodist Central Hospital
Memphis, Tennessee, 38104
MBCCOP - Gulf Coast
Mobile, Alabama, 36607
MBCCOP - LSU Health Sciences Center
New Orleans, Louisiana, 70112
Tulane Cancer Center at Tulane University Hospital and Clinic
New Orleans, Louisiana, 70112
Veterans Affairs Medical Center - New Orleans
New Orleans, Louisiana, 70112
NYU Cancer Institute at New York University Medical Center
New York, New York, 10016
Herbert Irving Comprehensive Cancer Center at Columbia University
New York, New York, 10032
Sentara Cancer Institute at Sentara Norfolk General Hospital
Norfolk, Virginia, 23510-1115
CCOP - Bay Area Tumor Institute
Oakland, California, 94609-3305
Oklahoma University Medical Center
Oklahoma City, Oklahoma, 73104
Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
Orange, California, 92868
CCOP - Western Regional, Arizona
Phoenix, Arizona, 85006-2726
Veterans Affairs Medical Center - Phoenix (Carl T. Hayden)
Phoenix, Arizona, 85012
Cancer Institute at Oregon Health and Science University
Portland, Oregon, 97201-3098
CCOP - Columbia River Oncology Program
Portland, Oregon, 97225
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
CCOP - Beaumont
Royal Oak, Michigan, 48073-6769
University of California Davis Cancer Center
Sacramento, California, 95817
Huntsman Cancer Institute at University of Utah
Salt Lake City, Utah, 84112-5550
Veterans Affairs Medical Center - Salt Lake City
Salt Lake City, Utah, 84148
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229-3900
Veterans Affairs Medical Center - San Antonio (Murphy)
San Antonio, Texas, 78229
CCOP - Santa Rosa Memorial Hospital
Santa Rosa, California, 95403
CCOP - Virginia Mason Research Center
Seattle, Washington, 98101
Veterans Affairs Medical Center - Seattle
Seattle, Washington, 98108
Puget Sound Oncology Consortium
Seattle, Washington, 98109
Veterans Affairs Medical Center - Shreveport
Shreveport, Louisiana, 71101-4295
Feist-Weiller Cancer Center at Louisiana State University Health Sciences
Shreveport, Louisiana, 71130-3932
Providence Cancer Institute at Providence Hospital - Southfield Campus
Southfield, Michigan, 48075
CCOP - Upstate Carolina
Spartanburg, South Carolina, 29303
CCOP - Cancer Research for the Ozarks
Springfield, Missouri, 65807
Saint Louis University Cancer Center
St Louis, Missouri, 63110
CCOP - St. Louis-Cape Girardeau
St Louis, Missouri, 63141
CCOP - Northwest
Tacoma, Washington, 98405-0986
Veterans Affairs Medical Center - Tampa (Haley)
Tampa, Florida, 33612
Veterans Affairs Medical Center - Temple
Temple, Texas, 76504
CCOP - Scott and White Hospital
Temple, Texas, 76508
Veterans Affairs Medical Center - Tucson
Tucson, Arizona, 85723
Arizona Cancer Center at University of Arizona Health Sciences Center
Tucson, Arizona, 85724
MBCCOP - Howard University Cancer Center
Washington D.C., District of Columbia, 20060
CCOP - Wichita
Wichita, Kansas, 67214-3882
Veterans Affairs Medical Center - Wichita
Wichita, Kansas, 67218
About this study
Official title: Phase II Evaluation of Carboplatin, Paclitaxel and Gemcitabine Followed by Concurrent Cisplatin and Radiation Therapy in Patients With Locally Advanced or Recurrent Urothelial Malignancy
RATIONALE: Drugs used in chemotherapy, such as carboplatin, paclitaxel, gemcitabine, and cisplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving chemotherapy before radiation therapy, and combining chemotherapy with radiation therapy, may kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of neoadjuvant gemcitabine, paclitaxel, and carboplatin followed by cisplatin and radiation therapy in treating patients who have locally advanced or recurrent carcinoma (cancer) of the urothelium.
Read the detailed description
OBJECTIVES:
- Determine the overall survival of patients with locally advanced or recurrent carcinoma of the urothelium treated with neoadjuvant carboplatin, paclitaxel, and gemcitabine followed by concurrent cisplatin and radiotherapy.
- Determine the feasibility of administering this regimen to these patients.
- Determine the progression-free survival of patients treated with this regimen.
- Determine the qualitative and quantitative toxic effects of this regimen in these patients.
- Determine the response rate (confirmed and unconfirmed) of patients treated with the neoadjuvant regimen and those treated with the whole regimen.
- Determine the proportion of patients who qualify for concurrent cisplatin and radiotherapy after receiving the neoadjuvant regimen.
- Determine the potential value of suppressor gene expression analysis (p53 and retinoblastoma gene) and HER2 expression as indicators of prognosis and/or response in patients treated with this regimen.
OUTLINE: This is a multicenter study.
Patients receive neoadjuvant chemotherapy comprising paclitaxel IV over 3 hours and carboplatin IV over 15 minutes on day 1 and gemcitabine IV over 30 minutes on days 1 and 8. Treatment repeats every 21 days for a maximum of 3 courses in the absence of disease progression or unacceptable toxicity.
Within 4-8 weeks after the completion of neoadjuvant chemotherapy, patients receive cisplatin IV over 30-60 minutes on day 1. Treatment repeats every 21 days for a maximum of 2 courses in the absence of disease progression or unacceptable toxicity. Patients also undergo concurrent radiotherapy 5 days a week for 6 weeks.
Patients are followed every 3 months for 2 years and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 80 patients will be accrued for this study within 4 years.
- Conditions
- Bladder Cancer, Urethral Cancer
- Being tested
- carboplatin, cisplatin, gemcitabine hydrochloride, paclitaxel, neoadjuvant therapy
- Keywords
- recurrent bladder cancer, stage III bladder cancer, squamous cell carcinoma of the bladder, stage II bladder cancer, recurrent urethral cancer, urethral cancer associated with invasive bladder cancer, distal urethral cancer, proximal urethral cancer, stage IV bladder cancer, transitional cell carcinoma of the bladder
- Medical subject headings
- Urinary Bladder Neoplasms, Urethral Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
carboplatinDrug
Also called Paraplatin
*AUC=5 (by modified Calvert formula), IV, over 15 minutes; given q 21 days for a maximum of 3 cycles (1 cycle = 21 days)
cisplatinDrug
Also called Platinol; CDDP
75 mg/m2 (maximum dose 150 mg), IV, rapid infusion; given q 21 days for 2 cycles (1 cycle = 21 days)
Also called Gemzar
800 mg/m2, IV, over 30 minutes; given on Days 1 \& 8, q 21 days, for a maximum of 3 cycles (1 cycle = 21 days)
paclitaxelDrug
Also called Taxol
200 mg/m2, IV, over 3 hours; given q 21 days for a maximum of 3 cycles (1 cycle = 21 days)
neoadjuvant therapyProcedure or surgery
Neoadjuvant chemotherapy (paclitaxel, carboplatin, and gemcitabine)
radiation therapyRadiation
Radiation treatments will be delivered once daily. Treatment will be given 5 days per week at a dose of 180 to 200 cGy per day. All fields will be treated everyday.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Mar 2003 (estimated)
- Study startNov 2002
- Primary completionJun 2006
- Study completionJun 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Bladder CancerStudies of the same condition, open and under way.
- More trials run by SWOG Cancer Research NetworkThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 7 participants (actual)
Sponsor and investigators
- Lead sponsor
- SWOG Cancer Research Network
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Ulka N. Vaishampayan, MD, Study chair, Barbara Ann Karmanos Cancer Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00055835
- Sponsor's protocol ID
- CDR0000271309
- Other IDs
- S0121, U10CA032102
- Status last verified
- Jan 2013
- First submitted
- 6 Mar 2003
- Last updated
- 31 Jan 2013
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 31 Jan 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Evaluation of Carboplatin, Paclitaxel and Gemcitabine Followed by Concurrent Cisplatin and Radiation Therapy in Patients With Locally Advanced or Recurrent Urothelial Malignancy
- ClinicalTrials.gov ID
- NCT00055835
- Acronym / sponsor ID
- CDR0000271309
- Conditions
- Bladder Cancer, Urethral Cancer
- Keywords
- recurrent bladder cancer, stage III bladder cancer, squamous cell carcinoma of the bladder, stage II bladder cancer, recurrent urethral cancer, urethral cancer associated with invasive bladder cancer, distal urethral cancer, proximal urethral cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 7 participants (actual)
- Lead sponsor
- SWOG Cancer Research NetworkResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Nov 2002
- Primary completion
- Jun 2006 (actual)
- Study completion
- Jun 2006 (actual)
- First posted
- 7 Mar 2003 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy, such as carboplatin, paclitaxel, gemcitabine, and cisplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving chemotherapy before radiation therapy, and combining chemotherapy with radiation therapy, may kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of neoadjuvant gemcitabine, paclitaxel, and carboplatin followed by cisplatin and radiation therapy in treating patients who have locally advanced or recurrent carcinoma (cancer) of the urothelium.
Detailed description
OBJECTIVES:
- Determine the overall survival of patients with locally advanced or recurrent carcinoma of the urothelium treated with neoadjuvant carboplatin, paclitaxel, and gemcitabine followed by concurrent cisplatin and radiotherapy.
- Determine the feasibility of administering this regimen to these patients.
- Determine the progression-free survival of patients treated with this regimen.
- Determine the qualitative and quantitative toxic effects of this regimen in these patients.
- Determine the response rate (confirmed and unconfirmed) of patients treated with the neoadjuvant regimen and those treated with the whole regimen.
- Determine the proportion of patients who qualify for concurrent cisplatin and radiotherapy after receiving the neoadjuvant regimen.
- Determine the potential value of suppressor gene expression analysis (p53 and retinoblastoma gene) and HER2 expression as indicators of prognosis and/or response in patients treated with this regimen.
OUTLINE: This is a multicenter study.
Patients receive neoadjuvant chemotherapy comprising paclitaxel IV over 3 hours and carboplatin IV over 15 minutes on day 1 and gemcitabine IV over 30 minutes on days 1 and 8. Treatment repeats every 21 days for a maximum of 3 courses in the absence of disease progression or unacceptable toxicity.
Within 4-8 weeks after the completion of neoadjuvant chemotherapy, patients receive cisplatin IV over 30-60 minutes on day 1. Treatment repeats every 21 days for a maximum of 2 courses in the absence of disease progression or unacceptable toxicity. Patients also undergo concurrent radiotherapy 5 days a week for 6 weeks.
Patients are followed every 3 months for 2 years and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 80 patients will be accrued for this study within 4 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| carboplatinAlso: Paraplatin*AUC=5 (by modified Calvert formula), IV, over 15 minutes; given q 21 days for a maximum of 3 cycles (1 cycle = 21 days) | Drug | – |
| cisplatinAlso: Platinol; CDDP75 mg/m2 (maximum dose 150 mg), IV, rapid infusion; given q 21 days for 2 cycles (1 cycle = 21 days) | Drug | – |
| gemcitabine hydrochlorideAlso: Gemzar800 mg/m2, IV, over 30 minutes; given on Days 1 \& 8, q 21 days, for a maximum of 3 cycles (1 cycle = 21 days) | Drug | – |
| paclitaxelAlso: Taxol200 mg/m2, IV, over 3 hours; given q 21 days for a maximum of 3 cycles (1 cycle = 21 days) | Drug | – |
| neoadjuvant therapyNeoadjuvant chemotherapy (paclitaxel, carboplatin, and gemcitabine) | Procedure or surgery | – |
| radiation therapyRadiation treatments will be delivered once daily. Treatment will be given 5 days per week at a dose of 180 to 200 cGy per day. All fields will be treated everyday. | Radiation | – |
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Jan 2013.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ulka N. Vaishampayan, MD study chair
Barbara Ann Karmanos Cancer Institute
92 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing carboplatin, cisplatin and gemcitabine hydrochloride in people with Bladder Cancer and Urethral Cancer, run by SWOG Cancer Research Network at 92 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Jan 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 92 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jan 2013.