Bladder Cancer
Conditions
Brief summary
This study is a randomized, blinded, placebo-controlled study evaluating the drug, SUO11248 (SUTENT), for maintenance therapy in advanced urothelial cancer.
Interventions
DRUGSUTENT
50 mg/PO once daily for four consecutive weeks with a two week rest period. Study participants who show evidence of disease progression (or are considered for removal from study for any other reason) will be unblinded. Participants receiving SU011248 will be removed from the study. Participants receiving placebo will be given the opportunity to crossover and receive SU011248.
OTHERPlacebo
Sponsors
Pfizer
University of Michigan Rogel Cancer Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologic/cytologic diagnosis of urothelial carcinoma (transitional cell carcinoma either pure or mixed histology) * All patients must have received four - six cycles of standard first line chemotherapy (protocol details suggested combinations) for treatment of locally recurrent or metastatic disease AND must have achieved stable disease (SD), partial response (PR), or complete response (CR) to this chemotherapy. * Type of response, number of cycles and specific regimen given must be carefully recorded and submitted at time of registration. * Reports from pre and post treatment imaging will be required at time of registration to document response. * Patients must be registered within 1 month (or the next business day if falls on a weekend or holiday) of scans demonstrating stable disease or better and no more than 42 days after receiving the last standard chemotherapy dose. For example, if patients are receiving treatment on days 1 and 8 of each cycle, day 8 of the last cycle would be considered the last standard chemotherapy dose. * Patients may have received previous adjuvant or neoadjuvant therapy. * No prior antiangiogenic therapy for this stage of the disease.
Exclusion criteria
* Major surgery within 4 weeks of starting the study treatment. * NCI CTCAE grade 3 hemorrhage or higher within 4 weeks of starting the study treatment. * History of or known spinal cord compression, or carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease on screening CT or MRI scan. However treated, stable and asymptomatic brain metastases are allowed. * Known HIV - positive patients may not participate. This is to avoid additional complications that immune suppression and HIV infection may cause due to the intense nature of the chemotherapy in this trial. * Any of the following within 6 months prior to study administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (CHF), cerebrovascular accident or transient ischemic attack, or pulmonary embolism. * Patients with history of or who are suspected to have CHF can be included as long as they are asymptomatic and have an ejection fraction that is equal to or above the institutional lower limit of normal by baseline MUGA(obtained within one month of registration or the next business day if falls on a weekend or holiday). * Ongoing cardiac dysrhythmias of NCI CTCAE Grade \> 2. * Unresolved bacterial infection. * Uncontrolled hypertension. * Pre-existing thyroid abnormality that can not be controlled medically. * Concurrent treatment on another clinical trial. * Pregnant or breast-feeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants That Experience Progression by 6 Months for Participants Receiving Sunitinib and Participants Receiving Placebo | 6 Months Post Treatment | The primary endpoint of this unblinded, randomized trial is to compare the 6-month progression rate in patients randomized to maintenance SU011248 as compared with placebo following primary chemotherapy. Progression is defined as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. |
Countries
United States
Participant flow
Recruitment details
Participants were originally randomized to SUTENT or Placebo (Double Blind Period). 26 participants were randomized to SUTENT. Of the 28 participants randomized to Placebo, those that progressed were offered SUTENT if they were eligible.
Participants by arm
| Arm | Count |
|---|---|
| SUTENT Study participants randomized to received SUTENT will receive a dose of 50 mg PO (capsules) as a single agent to be taken once daily for four consecutive weeks followed by a two week rest period to form a complete cycle of six weeks. | 26 |
| Placebo Study participants randomized to receive placebo will receive 50 mg/day PO (capsules) of an inactive substance to be taken once daily for four consecutive weeks followed by a two week rest period to form a complete cycle of six weeks. | 28 |
| Total | 54 |
Baseline characteristics
| Characteristic | SUTENT | Placebo | Total |
|---|---|---|---|
| Age, Continuous | 69 years | 69 years | 69 years |
| Bladder Primary Tumor | 20 participants | 18 participants | 38 participants |
| ECOG Performance Status PS=0 | 10 participants | 11 participants | 21 participants |
| ECOG Performance Status PS=1 | 15 participants | 17 participants | 32 participants |
| ECOG Performance Status PS=2 | 1 participants | 0 participants | 1 participants |
| Mixed Histology | 2 participants | 4 participants | 6 participants |
| Prior Chemotherapy Regimen Cisplatin and gemcitabine | 10 participants | 14 participants | 24 participants |
| Prior Chemotherapy Regimen MVAC | 3 participants | 2 participants | 5 participants |
| Prior Chemotherapy Regimen Non-cisplatin-containing chemotherapy | 13 participants | 12 participants | 25 participants |
| Response to Prior Chemotherapy CR | 3 participants | 1 participants | 4 participants |
| Response to Prior Chemotherapy PR | 10 participants | 12 participants | 22 participants |
| Response to Prior Chemotherapy SD | 13 participants | 15 participants | 28 participants |
| Sex: Female, Male Female | 6 Participants | 9 Participants | 15 Participants |
| Sex: Female, Male Male | 20 Participants | 19 Participants | 39 Participants |
| Visceral Metastasis | 9 participants | 12 participants | 21 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 42 / 42 | 28 / 28 |
| serious Total, serious adverse events | 17 / 42 | 6 / 28 |
Outcome results
Primary
Percentage of Participants That Experience Progression by 6 Months for Participants Receiving Sunitinib and Participants Receiving Placebo
The primary endpoint of this unblinded, randomized trial is to compare the 6-month progression rate in patients randomized to maintenance SU011248 as compared with placebo following primary chemotherapy. Progression is defined as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time frame: 6 Months Post Treatment
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| SUTENT | Percentage of Participants That Experience Progression by 6 Months for Participants Receiving Sunitinib and Participants Receiving Placebo | 71.7 percentage of participants |
| Placebo | Percentage of Participants That Experience Progression by 6 Months for Participants Receiving Sunitinib and Participants Receiving Placebo | 64.3 percentage of participants |