Bladder Cancer
Conditions
Keywords
stage III bladder cancer, stage IV bladder cancer, transitional cell carcinoma of the bladder
Brief summary
RATIONALE: Drugs used in chemotherapy, such as gemcitabine and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. PURPOSE: This randomized phase II trial is studying how well giving gemcitabine together with oxaliplatin works compared to gemcitabine alone in treating patients with locally advanced or metastatic bladder cancer.
Detailed description
OBJECTIVES: Primary * Determine the objective response rate in patients with advanced urothelial cancer treated with gemcitabine hydrochloride with vs without oxaliplatin. Secondary * Determine the tolerance of these regimens in these patients. * Determine the overall survival and progression-free survival of patients treated with these regimens. * Determine the quality of life of patients treated with these regimens. * Determine the duration of response in patients treated with these regimens. OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive gemcitabine hydrochloride IV over 120 minutes on days 1, 8, and 15. * Arm II: Patients receive gemcitabine IV over 100 minutes on days 1 and 15 and oxaliplatin IV over 120 minutes on days 2 and 16. Treatment in both arms repeats every 4 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed every 3 months.
Interventions
DRUGgemcitabine hydrochloride
DRUGoxaliplatin
Sponsors
Institut du Cancer de Montpellier - Val d'Aurelle
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 120 Years
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed urothelial carcinoma, or transitional cell carcinoma of the bladder or upper urinary tract * Locally advanced disease (T4b) or metastatic disease (N2, N3, or M1) * Unable to receive cisplatin-based chemotherapy due to creatinine clearance 30-60 mL/min or performance status 2 * At least 1 unidimensionally measurable lesion according to RECIST criteria * No nonmeasurable lesions only, including any of the following: * Ascites * Pleural or pericardial effusion * Bone metastases * Lymphangitis * No symptomatic cerebral metastases unless they have been stabilized PATIENT CHARACTERISTICS: * See Disease Characteristics * Performance status 0-2 * ANC ≥ 1,500/mm³ * Platelet count ≥ 100,000/mm³ * Alkaline phosphatase ≤ 2 times normal (unless bone metastases are present) * Transaminases ≤ 2 times normal (5 times normal if hepatic metastases present) * Bilirubin ≤ 1.5 times normal * Not pregnant or nursing * Fertile patients must use effective contraception during and for at least 6 months after completion of treatment * No prior malignancy within the past 5 years except carcinoma in situ of the cervix or basal cell skin cancer * No peripheral neuropathy ≥ grade 2 * No uncontrolled infection * No other medical conditions that could interfere with evaluating tolerability, including any of the following: * Congestive heart failure * Angina pectoris that cannot be stabilized with medication * Myocardial infarction within the past 12 months * Serious thromboembolic disease * No psychologic, social, or geographic reason that would make follow-up impossible PRIOR CONCURRENT THERAPY: * See Disease Characteristics * No prior chemotherapy for advanced disease * More than 4 weeks since prior radiotherapy to a target measurable lesion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Objective response rate | From baseline to the end of treatment, up to 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Adverse events according to Common Terminology Criteria for Adverse Events (CTCAE) | From baseline to the end of treatment, up to 6 months |
| Overall survival | From baseline to the end of treatment, up to 6 months |
| Progression-free survival | From baseline to the end of treatment, up to 6 months |
| Quality of life as assessed by QLQ-C30 and QLQ-LC13 | From baseline to the end of treatment, up to 6 months |
| Duration of response | From baseline to the end of treatment, up to 6 months |
Countries
France
Outcome results
None listed