Locally Advanced Bladder Urothelial CarcinomaPhase 3IMAGINENCT04637594
Trying to Find the Correct Length of Treatment With Immune Checkpoint Therapy
A Phase 3 study testing Pembrolizumab, Nivolumab and Atezolizumab in people with Locally Advanced Bladder Urothelial Carcinoma and Locally Advanced Renal Pelvis Urothelial Carcinoma, run by Alliance for Clinical Trials in Oncology at 377 sites in United States.
Trial summary
This phase III trial compares survival in urothelial cancer patients who stop immune checkpoint inhibitor treatment after being treated for about a year to those patients who continue treatment with immune checkpoint inhibitors. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Locally Advanced Bladder Urothelial Carcinoma, Locally Advanced Renal Pelvis Urothelial Carcinoma, Locally Advanced Ureter Urothelial Carcinoma
- What is being tested?
- Pembrolizumab, Nivolumab and Atezolizumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3 participants
- Where
- 377 sitesUnited States
- Study dates
- 27 May 2022to Sep 2030
- Phase
- Phase 3
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
- Documentation of disease
- Histologic documentation: Histologically or cytologically confirmed urothelial carcinoma (UC) with predominantly transitional-cell features
- Stage: Locally advanced or metastatic disease prior to starting immune checkpoint blockade
- Tumor Site: Bladder, renal pelvis, ureter, urethra, or prostate
- Patients must have received at least one cycle of current active treatment with standard of care (SOC) Food and Drug Administration (FDA) approved PD-1/L1 immune checkpoint inhibitor (ICI)-containing therapy for locally advance or metastatic UC
- Patients without progressive disease per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1 guidelines (i.e., with an ongoing [complete response] CR, partial response [PR], or stable disease [SD]) following completion of 12-15 months of ICI treatment
- No history of tuberculosis, active hepatitis B (HBV) or hepatitis C (HCV), or uncontrolled human immunodeficiency virus (HIV)
- Patients with resolved HBV infection, defined as positive hepatitis B core antibody (anti-Hb) and negative hepatitis B surface antigen (HbsAg), are eligible
- Patients with positive HCV antibody are eligible if HCV ribonucleic acid (RNA) polymerase chain reaction (PCR) is negative
- Patients with HIV who are compliant with highly active antiretroviral therapy (HAART) and have normal CD4 count and undetectable viral load are eligible
- No history of allogeneic organ transplantation
- No current immunosuppressive medication exceeding 10 mg/day of prednisone or its equivalent
- Patients with pre-existing or treatment-emergent autoimmune or inflammatory disorders which do not require systemic immunosuppressive treatment exceeding 10 mg/day of prednisone or its equivalent may be included
- No history of another primary malignancy except for malignancy treated with curative intent with no known active disease for >= 2 years, and adequately treated non-melanomatous skin cancer or carcinoma in situ (e.g. cervical carcinoma in situ [CIS]) without evidence of disease
- No female patients who are pregnant or breastfeeding, or male or female patients of reproductive potential who are not willing to employ effective birth control, because this study involves investigational agents whose genotoxic, mutagenic, and teratogenic effects on the developing fetus and newborn are unknown. Therefore, for women of childbearing potential only, a negative urine or serum pregnancy test pregnancy test done =< 14 days prior to registration is required
REGISTRATION ELIGIBILITY CRITERIA:
- Patients without progressive disease per RECIST v 1.1 guidelines (i.e., with an ongoing CR, PR or SD) following completion of 12-15 months of ICI treatment
- No toxicity from ICI therapy that makes continuation of treatment clinically unacceptable
- Adequate bone marrow and organ functions to continue PD-1/L1 ICI as judged by the treating physician
- Age >= 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Central nervous system (CNS) metastasis is allowed if radiographically stable, clinically asymptomatic, and prior local therapy (if received) was completed > 6 months before registration
- No history of tuberculosis, active hepatitis B (HBV) or hepatitis C (HCV), or uncontrolled human immunodeficiency virus (HIV)
- Patients with resolved HBV infection, defined as positive hepatitis B core antibody (anti-Hb) and negative hepatitis B surface antigen (HbsAg), are eligible
- Patients with positive HCV antibody are eligible if HCV RNA PCR is negative
- Patients with HIV who are compliant with highly active antiretroviral therapy (HAART) and have normal CD4 count and undetectable viral load are eligible
Trial locations and contacts
377 sites in 1 country.
300 sites in 1 country
United States300 sites
Providence Regional Cancer System-Aberdeen
Aberdeen, Washington, 98520
Hickman Cancer Center
Adrian, Michigan, 49221
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87102
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Saint Anthony's Health
Alton, Illinois, 62002
Mary Greeley Medical Center
Ames, Iowa, 50010
McFarland Clinic - Ames
Ames, Iowa, 50010
Anchorage Associates in Radiation Medicine
Anchorage, Alaska, 98508
Anchorage Radiation Therapy Center
Anchorage, Alaska, 99504
Alaska Breast Care and Surgery LLC
Anchorage, Alaska, 99508
Alaska Oncology and Hematology LLC
Anchorage, Alaska, 99508
Alaska Women's Cancer Care
Anchorage, Alaska, 99508
Anchorage Oncology Centre
Anchorage, Alaska, 99508
Katmai Oncology Group
Anchorage, Alaska, 99508
Providence Alaska Medical Center
Anchorage, Alaska, 99508
Saint Joseph Mercy Hospital
Ann Arbor, Michigan, 48106
Kaiser Permanente-Deer Valley Medical Center
Antioch, California, 94531
Mission Hope Medical Oncology - Arroyo Grande
Arroyo Grande, California, 93420
Rocky Mountain Cancer Centers-Aurora
Aurora, Colorado, 80012
The Medical Center of Aurora
Aurora, Colorado, 80012
Rush - Copley Medical Center
Aurora, Illinois, 60504
Saint Louis Cancer and Breast Institute-Ballwin
Ballwin, Missouri, 63011
Flaget Memorial Hospital
Bardstown, Kentucky, 40004
PeaceHealth Saint Joseph Medical Center
Bellingham, Washington, 98225
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
Saint Charles Health System
Bend, Oregon, 97701
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
Central Care Cancer Center - Bolivar
Bolivar, Missouri, 65613
McFarland Clinic - Boone
Boone, Iowa, 50036
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
Boulder Community Foothills Hospital
Boulder, Colorado, 80303
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
Cox Cancer Center Branson
Branson, Missouri, 65616
Harrison HealthPartners Hematology and Oncology-Bremerton
Bremerton, Washington, 98310
Harrison Medical Center
Bremerton, Washington, 98310
Saint Joseph Mercy Brighton
Brighton, Michigan, 48114
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Henry Ford Cancer Institute-Downriver
Brownstown, Michigan, 48183
Saint Joseph Regional Cancer Center
Bryan, Texas, 77802
Roswell Park Cancer Institute
Buffalo, New York, 14263
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
Highline Medical Center-Main Campus
Burien, Washington, 98166
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
Cambridge Medical Center
Cambridge, Minnesota, 55008
Illinois CancerCare-Canton
Canton, Illinois, 61520
Saint Joseph Mercy Canton
Canton, Michigan, 48188
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Southeast Cancer Center
Cape Girardeau, Missouri, 63703
Memorial Hospital of Carbondale
Carbondale, Illinois, 62902
Caro Cancer Center
Caro, Michigan, 48723
Saint Anthony Regional Hospital
Carroll, Iowa, 51401
SIH Cancer Institute
Carterville, Illinois, 62918
Illinois CancerCare-Carthage
Carthage, Illinois, 62321
Rocky Mountain Cancer Centers - Centennial
Centennial, Colorado, 80112
Centralia Oncology Clinic
Centralia, Illinois, 62801
Providence Regional Cancer System-Centralia
Centralia, Washington, 98531
Saint Joseph Mercy Chelsea
Chelsea, Michigan, 48118
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Cheyenne Regional Medical Center-West
Cheyenne, Wyoming, 82001
Rush University Medical Center
Chicago, Illinois, 60612
Good Samaritan Hospital - Cincinnati
Cincinnati, Ohio, 45220
Bethesda North Hospital
Cincinnati, Ohio, 45242
TriHealth Cancer Institute-Westside
Cincinnati, Ohio, 45247
TriHealth Cancer Institute-Anderson
Cincinnati, Ohio, 45255
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri, 63376
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
Providence Cancer Institute Clackamas Clinic
Clackamas, Oregon, 97015
Hematology Oncology Consultants-Clarkston
Clarkston, Michigan, 48346
Newland Medical Associates-Clarkston
Clarkston, Michigan, 48346
Southeastern Medical Oncology Center-Clinton
Clinton, North Carolina, 28328
Henry Ford Hematology Oncology - Hayes
Clinton Township, Michigan, 48038
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
Medical Oncology and Hematology Associates-West Des Moines
Clive, Iowa, 50325
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
Rocky Mountain Cancer Centers-Penrose
Colorado Springs, Colorado, 80907
Saint Francis Cancer Center
Colorado Springs, Colorado, 80923
Mercy Hospital
Coon Rapids, Minnesota, 55433
Bay Area Hospital
Coos Bay, Oregon, 97420
Baptist Health Corbin
Corbin, Kentucky, 40701
Commonwealth Cancer Center-Corbin
Corbin, Kentucky, 40701
Alegent Health Mercy Hospital
Council Bluffs, Iowa, 51503
Greater Regional Medical Center
Creston, Iowa, 50801
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Carle at The Riverfront
Danville, Illinois, 61832
Henry Ford Medical Center-Fairlane
Dearborn, Michigan, 48126
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital
Decatur, Illinois, 62526
The Women's Imaging Center
Denver, Colorado, 80209
Porter Adventist Hospital
Denver, Colorado, 80210
Colorado Blood Cancer Institute
Denver, Colorado, 80218
Presbyterian - Saint Lukes Medical Center - Health One
Denver, Colorado, 80218
Rocky Mountain Cancer Centers-Midtown
Denver, Colorado, 80218
Rocky Mountain Cancer Centers-Rose
Denver, Colorado, 80220
Rose Medical Center
Denver, Colorado, 80220
Western Surgical Care
Denver, Colorado, 80220
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates-Des Moines
Des Moines, Iowa, 50309
Broadlawns Medical Center
Des Moines, Iowa, 50314
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
Mission Cancer and Blood - Laurel
Des Moines, Iowa, 50314
Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Henry Ford Hospital
Detroit, Michigan, 48202
Ascension Saint John Hospital
Detroit, Michigan, 48236
Illinois CancerCare-Dixon
Dixon, Illinois, 61021
Kaiser Permanente Dublin
Dublin, California, 94568
Saint Luke's Hospital of Duluth
Duluth, Minnesota, 55805
Mercy Medical Center
Durango, Colorado, 81301
Southwest Oncology PC
Durango, Colorado, 81301
Great Lakes Cancer Management Specialists-Doctors Park
East China, Michigan, 48054
Pocono Medical Center
East Stroudsburg, Pennsylvania, 18301
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701
Fairview Southdale Hospital
Edina, Minnesota, 55435
Swedish Cancer Institute-Edmonds
Edmonds, Washington, 98026
Carle Physician Group-Effingham
Effingham, Illinois, 62401
Crossroads Cancer Center
Effingham, Illinois, 62401
Baptist Health Hardin
Elizabethtown, Kentucky, 42701
Mountain Blue Cancer Care Center - Swedish
Englewood, Colorado, 80113
Rocky Mountain Cancer Centers - Swedish
Englewood, Colorado, 80113
Swedish Medical Center
Englewood, Colorado, 80113
The Melanoma and Skin Cancer Institute
Englewood, Colorado, 80113
Saint Elizabeth Hospital
Enumclaw, Washington, 98022
Illinois CancerCare-Eureka
Eureka, Illinois, 61530
Providence Regional Cancer Partnership
Everett, Washington, 98201
Fairbanks Memorial Hospital
Fairbanks, Alaska, 99701
Sanford South University Medical Center
Fargo, North Dakota, 58103
Southpointe-Sanford Medical Center Fargo
Fargo, North Dakota, 58103
Sanford Medical Center Fargo
Fargo, North Dakota, 58104
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
Parkland Health Center - Farmington
Farmington, Missouri, 63640
Saint Francis Hospital
Federal Way, Washington, 98003
Genesee Cancer and Blood Disease Treatment Center
Flint, Michigan, 48503
Genesee Hematology Oncology PC
Flint, Michigan, 48503
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa, 50501
Trinity Regional Medical Center
Fort Dodge, Iowa, 50501
Holy Cross Hospital
Fort Lauderdale, Florida, 33308
Mercy Hospital Fort Smith
Fort Smith, Arkansas, 72903
UT Southwestern/Simmons Cancer Center-Fort Worth
Fort Worth, Texas, 76104
Kaiser Permanente-Fremont
Fremont, California, 94538
Queens Medical Associates PC
Fresh Meadows, New York, 11366
Fresno Cancer Center
Fresno, California, 93720
Kaiser Permanente-Fresno
Fresno, California, 93720
Unity Hospital
Fridley, Minnesota, 55432
Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, 83619
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
Western Illinois Cancer Treatment Center
Galesburg, Illinois, 61401
Central Care Cancer Center - Garden City
Garden City, Kansas, 67846
The West Clinic - Wolf River
Germantown, Tennessee, 38138
Southeastern Medical Oncology Center-Goldsboro
Goldsboro, North Carolina, 27534
CHI Health Saint Francis
Grand Island, Nebraska, 68803
Central Care Cancer Center - Great Bend
Great Bend, Kansas, 67530
Academic Hematology Oncology Specialists
Grosse Pointe Woods, Michigan, 48236
Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
Grosse Pointe Woods, Michigan, 48236
Michigan Breast Specialists-Grosse Pointe Woods
Grosse Pointe Woods, Michigan, 48236
Lehigh Valley Hospital-Hazleton
Hazleton, Pennsylvania, 18201
Kaiser Permanente Moanalua Medical Center
Honolulu, Hawaii, 96819
CHI Saint Vincent Cancer Center Hot Springs
Hot Springs, Arkansas, 71913
Swedish Cancer Institute-Issaquah
Issaquah, Washington, 98029
Allegiance Health
Jackson, Michigan, 49201
University of Mississippi Medical Center
Jackson, Mississippi, 39216
Southeastern Medical Oncology Center-Jacksonville
Jacksonville, North Carolina, 28546
McFarland Clinic - Jefferson
Jefferson, Iowa, 50129
Capital Region Southwest Campus
Jefferson City, Missouri, 65109
Freeman Health System
Joplin, Missouri, 64804
Mercy Hospital Joplin
Joplin, Missouri, 64804
CHI Health Good Samaritan
Kearney, Nebraska, 68847
Kadlec Clinic Hematology and Oncology
Kennewick, Washington, 99336
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
Providence Regional Cancer System-Lacey
Lacey, Washington, 98503
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
Rocky Mountain Cancer Centers-Lakewood
Lakewood, Colorado, 80228
Saint Anthony Hospital
Lakewood, Colorado, 80228
Saint Clare Hospital
Lakewood, Washington, 98499
Sparrow Hospital
Lansing, Michigan, 48912
Baptist Health Lexington
Lexington, Kentucky, 40503
Saint Joseph Radiation Oncology Resource Center
Lexington, Kentucky, 40504
Saint Joseph Hospital East
Lexington, Kentucky, 40509
Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Rocky Mountain Cancer Centers-Littleton
Littleton, Colorado, 80120
Littleton Adventist Hospital
Littleton, Colorado, 80122
Hope Cancer Clinic
Livonia, Michigan, 48154
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Saint Joseph London
London, Kentucky, 40741
The Dana-Farber Cancer Institute at Londonderry
Londonderry, New Hampshire, 03053
Rocky Mountain Cancer Centers-Sky Ridge
Lone Tree, Colorado, 80124
Sky Ridge Medical Center
Lone Tree, Colorado, 80124
Longmont United Hospital
Longmont, Colorado, 80501
Rocky Mountain Cancer Centers-Longmont
Longmont, Colorado, 80501
PeaceHealth Saint John Medical Center
Longview, Washington, 98632
Jewish Hospital
Louisville, Kentucky, 40202
Baptist Health Louisville
Louisville, Kentucky, 40207
Saints Mary and Elizabeth Hospital
Louisville, Kentucky, 40215
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
Illinois CancerCare-Macomb
Macomb, Illinois, 61455
Great Lakes Cancer Management Specialists-Macomb Medical Campus
Macomb, Michigan, 48044
Michigan Breast Specialists-Macomb Township
Macomb, Michigan, 48044
Baptist Health Madisonville/Merle Mahr Cancer Center
Madisonville, Kentucky, 42431
Fairview Clinics and Surgery Center Maple Grove
Maple Grove, Minnesota, 55369
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Saint Mary's Oncology/Hematology Associates of Marlette
Marlette, Michigan, 48453
McFarland Clinic - Marshalltown
Marshalltown, Iowa, 50158
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, 83642
East Jefferson General Hospital
Metairie, Louisiana, 70006
LSU Healthcare Network / Metairie Multi-Specialty Clinic
Metairie, Louisiana, 70006
Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
Milford, Massachusetts, 01757
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Health Partners Inc
Minneapolis, Minnesota, 55454
Marshfield Clinic-Minocqua Center
Minocqua, Wisconsin, 54548
Saint Patrick Hospital - Community Hospital
Missoula, Montana, 59802
Kaiser Permanente-Modesto
Modesto, California, 95356
Toledo Clinic Cancer Centers-Monroe
Monroe, Michigan, 48162
Monticello Cancer Center
Monticello, Minnesota, 55362
Good Samaritan Regional Health Center
Mount Vernon, Illinois, 62864
ProHealth D N Greenwald Center
Mukwonago, Wisconsin, 53149
Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, 83686
Baptist Health Floyd
New Albany, Indiana, 47150
Louisiana State University Health Science Center
New Orleans, Louisiana, 70112
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
New Ulm Medical Center
New Ulm, Minnesota, 56073
Providence Newberg Medical Center
Newberg, Oregon, 97132
Dana-Farber Cancer Institute - Chestnut Hill
Newton, Massachusetts, 02467
Henry Ford Medical Center-Columbus
Novi, Michigan, 48377
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
Kaiser Permanente-Oakland
Oakland, California, 94611
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Mercy Hospital Oklahoma City
Oklahoma City, Oklahoma, 73120
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
Alegent Health Lakeside Hospital
Omaha, Nebraska, 68130
Creighton University Medical Center
Omaha, Nebraska, 68131
Upstate Cancer Center at Oneida
Oneida, New York, 13421
Upstate Cancer Center at Oswego
Oswego, New York, 13126
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
Baptist Health Paducah
Paducah, Kentucky, 42003
Stanford Cancer Institute Palo Alto
Palo Alto, California, 94304
Midlands Community Hospital
Papillion, Nebraska, 68046
Parker Adventist Hospital
Parker, Colorado, 80138
Illinois CancerCare-Pekin
Pekin, Illinois, 61554
Illinois CancerCare-Peoria
Peoria, Illinois, 61615
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
Illinois CancerCare-Peru
Peru, Illinois, 61354
Valley Radiation Oncology
Peru, Illinois, 61354
Cancer Center at Saint Joseph's
Phoenix, Arizona, 85004
21st Century Oncology-Pontiac
Pontiac, Michigan, 48341
Hope Cancer Center
Pontiac, Michigan, 48341
Newland Medical Associates-Pontiac
Pontiac, Michigan, 48341
Saint Joseph Mercy Oakland
Pontiac, Michigan, 48341
Jefferson Healthcare
Port Townsend, Washington, 98368
Providence Portland Medical Center
Portland, Oregon, 97213
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Harrison HealthPartners Hematology and Oncology-Poulsbo
Poulsbo, Washington, 98370
Illinois CancerCare-Princeton
Princeton, Illinois, 61356
Fairview Northland Medical Center
Princeton, Minnesota, 55371
Saint Mary Corwin Medical Center
Pueblo, Colorado, 81004
Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, California, 95670
Saint Charles Health System-Redmond
Redmond, Oregon, 97756
Kaiser Permanente- Marshall Medical Offices
Redwood City, California, 94063
Marshfield Medical Center-Rice Lake
Rice Lake, Wisconsin, 54868
UT Southwestern Clinical Center at Richardson/Plano
Richardson, Texas, 75080
Kaiser Permanente-Richmond
Richmond, California, 94801
Baptist Health Richmond
Richmond, Kentucky, 40475
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
Rohnert Park Cancer Center
Rohnert Park, California, 94928
Delbert Day Cancer Institute at PCRMC
Rolla, Missouri, 65401
Mercy Clinic-Rolla-Cancer and Hematology
Rolla, Missouri, 65401
Kaiser Permanente-Roseville
Roseville, California, 95661
The Permanente Medical Group-Roseville Radiation Oncology
Roseville, California, 95678
Kaiser Permanente Downtown Commons
Sacramento, California, 95814
Kaiser Permanente-South Sacramento
Sacramento, California, 95823
South Sacramento Cancer Center
Sacramento, California, 95823
Ascension Saint Mary's Hospital
Saginaw, Michigan, 48601
Oncology Hematology Associates of Saginaw Valley PC
Saginaw, Michigan, 48604
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota, 56303
Heartland Regional Medical Center
Saint Joseph, Missouri, 64506
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
Regions Hospital
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
Kaiser Permanente-San Francisco
San Francisco, California, 94115
Kaiser Permanente-Santa Teresa-San Jose
San Jose, California, 95119
Kaiser Permanente San Leandro
San Leandro, California, 94577
Pacific Central Coast Health Center-San Luis Obispo
San Luis Obispo, California, 93401
Kaiser San Rafael-Gallinas
San Rafael, California, 94903
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
About this study
Official title: Duration of Immune Checkpoint Therapy in Locally Advanced or Metastatic Urothelial Carcinoma: A Randomized Phase 3 Non-Inferiority Trial (IMAGINE)
This phase III trial compares survival in urothelial cancer patients who stop immune checkpoint inhibitor treatment after being treated for about a year to those patients who continue treatment with immune checkpoint inhibitors. Immunotherapy with monoclonal antibodies, such as avelumab, durvalumab, pembrolizumab, atezolizumab, and nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Stopping immune checkpoint inhibitors early may still make the tumor shrink and patients may have similar survival rates as the patients who continue treatment. Stopping treatment early may also lead to fewer treatment-related side effects, an improvement in mental health, and a lower cost burden to patients.
Read the detailed description
PRIMARY OBJECTIVE:
- To compare overall survival (OS).
SECONDARY OBJECTIVES:
- To compare progression free survival (PFS) by (Response Evaluation Criteria in Solid Tumors) RECIST 1.1 criteria.
II. To compare PFS by immune-related (ir)RECIST criteria. III. To determine treatment-free interval (TFI) after immune checkpoint inhibitor (ICI) discontinuation. (Arm B) IV. To determine the rate of response by RECIST 1.1 criteria after ICI rechallenge. (Arm B) V. To assess adverse events in each study arm by Common Terminology Criteria for Adverse Events (CTCAE) 5.0.
OUTLINE: Patient are randomized to 1 of 2 arms.
ARM A (CONTINUATION OF ICI TREATMENT): Patients receive either pembrolizumab intravenously (IV) over 30 minutes on day 1, nivolumab IV over 30 minutes on days 1 and 15, atezolizumab IV over 30-60 minutes on day 1, durvalumab IV over 60 minutes on days 1 and 15, or avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 21 or 42 days for pembrolizumab, every 21 days for atezolizumab, and 28 days for nivolumab, durvalumab, and avelumab in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, starting new treatment or withdrawn consent, patients are followed up at 4 weeks, and then every 6 months for 5 years following registration.
ARM B (DISCONTINUATION OF ICI TREATMENT): Patients receiving ICI treatment will discontinue ICI treatment within 1 cycle length after randomization. Cycle length is determined by the ICI regimen the patient is receiving at randomization. At disease progression patients may restart the same ICI treatment they were receiving upon randomization at physician discretion.
After completion of study treatment, patients are followed up at 4 weeks, and then every 6 months for 5 years following registration.
- Conditions
- Locally Advanced Bladder Urothelial Carcinoma, Locally Advanced Renal Pelvis Urothelial Carcinoma, Locally Advanced Ureter Urothelial Carcinoma, Locally Advanced Urethral Urothelial Carcinoma, Locally Advanced Urothelial Carcinoma, Metastatic Bladder Urothelial Carcinoma
- Being tested
- Pembrolizumab, Nivolumab, Atezolizumab, Durvalumab, Avelumab
- Medical subject headings
- Carcinoma, Transitional Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PembrolizumabDrug
Given IV
NivolumabDrug
Given IV
AtezolizumabDrug
Given IV
DurvalumabDrug
Given IV
AvelumabDrug
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Arm A (immune checkpoint inhibitor) | Active comparator | CONTINUATION OF ICI TREATMENT:
Patients receive either pembrolizumab intravenously (IV) over 30 minutes on day 1, nivolumab IV over 30 minutes on days 1 and 15, atezolizumab IV over 30-60 minutes on day 1, durvalumab IV over 60 minutes on days 1 and 15, or avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 21 or 42 days for pembrolizumab, every 21 days for atezolizumab, and 28 days for nivolumab, durvalumab, and avelumab in the absence of disease progression or unacceptable toxicity. Receives: Drug: Pembrolizumab; Drug: Nivolumab; Drug: Atezolizumab; Drug: Durvalumab; Drug: Avelumab |
| Arm B (immune checkpoint inhibitor) | Experimental | DISCONTINUATION OF ICI TREATMENT:
Patients receiving ICI treatment will discontinue ICI treatment within 1 cycle length after randomization. Cycle length is determined by the ICI regimen the patient is receiving at randomization. At disease progression patients may restart the same ICI treatment they were receiving upon randomization at physician discretion. Receives: Drug: Pembrolizumab; Drug: Nivolumab; Drug: Atezolizumab; Drug: Durvalumab; Drug: Avelumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS) Rate at 12 Months
OS is the length of time patients are alive after registering to receive protocol treatment. Patients who are lost to follow-up or are not known to be deceased at the time of study analysis will be censored at the time of last patient contact. Cox models will be used to compare the outcome between the two treatment groups.
Measured: 12 months
Secondary outcomes (5)
Progression-free Survival (PFS) Rate at 12 Months
Progression-free survival (PFS) is the length of time patients are alive without disease progression. Progression will be assessed using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Stratified Cox models will be used to compare the outcomes between the two treatment groups.
Measured: 12 months
Immune-related Progression-free Survival (iPFS) Rate at 12 Months
Immune-related progression-free survival (iPFS) is the length of time patients are alive without immune-related progression. Progression will be assessed using immune related (ir)RECIST criteria. Stratified Cox models will be used to compare the outcomes between the two treatment groups.
Measured: 12 months
Treatment-free Interval (Arm B)
Treatment-free Interval is the length of time patients are off treatment. A Stratified Cox model will be used to evaluate this outcome.
Measured: From last dose of immune checkpoint inhibitor (ICI) to initiation of a subsequent systemic treatment or death, assessed up to 5 years
Rate of Response After Immune Checkpoint Inhibitor (ICI) Rechallenge (Arm B)
Rate of response is the percentage of patients with response after re-initiation of immune checkpoint inhibitor (ICI) therapy after progression post-registration. Rate of response will be assessed using RECIST 1.1. A chi-square test (or Fisher's exact test) will be used to determine whether there is an association between the best tumor response prior to trial enrollment and that achieved upon ICI re-challenge.
Measured: Up to 5 years
Number of Patients Experiencing Grade 3 or Greater Adverse Events (AEs)
Adverse events (AEs) are ailments occurring during treatment. AEs will be assessed using Common Terminology Criteria for Adverse Events version 5.0.
Measured: 2.5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Nov 2020
- Study start27 May 2022
- Primary completion1 Jun 2024
- Study completionSep 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Locally Advanced Bladder Urothelial CarcinomaStudies of the same condition, open and under way.
- More trials run by Alliance for Clinical Trials in OncologyThe 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 3 participants (actual)
Sponsor and investigators
- Lead sponsor
- Alliance for Clinical Trials in Oncology
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Xiao X. Wei, MD, MAS, Study chair, Dana-Farber Cancer Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04637594
- Sponsor's protocol ID
- A031901
- Other IDs
- NCI-2020-08395, U10CA180821
- Acronym
- IMAGINE
- Status last verified
- Mar 2026
- First submitted
- 16 Nov 2020
- Last updated
- 20 Mar 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes