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The Effectiveness and Safety of Intravesical Gemcitabine Instillation to Prevent Intravesical Recurrence

Phase 2
Conditions
Urothelial Carcinoma
Interventions
Other: Normal saline
Drug: Intravesical 2000mg/52.6ml gemcitabine instillation
Registration Number
NCT03062059
Lead Sponsor
National Cancer Center, Korea
Brief Summary

The aim of this study is to evaluate the effectiveness and safety of intravesical gemcitabine instillation during operation to prevent intravesical recurrence after radical nephroureterectomy in upper urinary tract urothelial carcinoma.

Detailed Description

Study Design: Intervention Model: Single Group Assignment

Masking: Open Label

Primary Outcome Measures:

Two year recurrence-free survival in intravesical 2000mg/52.6ml gemcitabine instillation group and control group.

Secondary Outcome Measures:

Time to recurrence in intravesical 2000mg/52.6ml gemcitabine instillation group and control group.

Overall survival in intravesical 2000mg/52.6ml gemcitabine instillation group and control group.

Safety of intravesical 2000mg/52.6ml gemcitabine instillation.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
134
Inclusion Criteria
  • The subjects who will undergo nephroureterectomy due to ureter or renal pelvis urothelial carcinoma
  • Male or female aged 18 or over 18 years and not more than 85 years who were diagnosed as upper urinary tract urothelial carcinoma
  • Normal bone marrow function: Hemoglobin >10 g/dL, ANC >1,500/mm3, platelet count>100,000/mm3
  • Normal bladder volume and function
  • Normal liver function:
  • Bilirubin ≤ 1.5 times of upper normal limit
  • AST/ALT ≤ 1.8 times of upper normal limit
  • Alkaline phosphatase ≤ 1.8 times of upper normal limit
  • Subjects who voluntarily decided to participate and signed the written informed consent
Exclusion Criteria
  • Concomitant bladder cancer
  • Subjects who underwent any treatment due to bladder cancer within 3 years
  • Prior hypersensitivity reaction history to gemcitabine
  • Neurogenic bladder
  • Subjects who underwent chemotherapy due to any cancer within 6 months
  • Subjects who underwent neoadjuvant chemotherapy due to ureter or renal pelvis urothelial carcinoma
  • Hypersensitivity to gemcitabine or component of gemcitabine
  • In case of co-administration of gemcitabine and cisplatin in severe renal failure patients
  • Moderate to severe liver dysfunction or renal dysfunction (Glomerular filtration rate < 30 mL/min)
  • Severe bone marrow suppression
  • Severe infection
  • Female who are pregnant or has a possibility of pregnancy
  • Nursing female
  • Interstitial pneumonia or pulmonary fibrosis which is evident on chest x-ray and symptomatic
  • Subjects who are undergoing radiotherapy on chest

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Normal salineNormal salineIntravesical 52.6ml normal saline instillation during radical nephroureterectomy followed by normal saline bladder irrigation
GemcitabineIntravesical 2000mg/52.6ml gemcitabine instillationIntravesical 2000mg/52.6ml gemcitabine instillation during radical nephroureterectomy followed by normal saline bladder irrigation
Primary Outcome Measures
NameTimeMethod
Two year recurrence-free survival in intravesical 2000mg/52.6ml gemcitabine instillation group and control group. The recurrence will be assessed by CT scan and cystoscopic exam.Two years

Analysis of recurrence status at 2 years from intravesical instillation of 2000mg/52.6ml gemcitabine

Secondary Outcome Measures
NameTimeMethod
Time to recurrence in intravesical 2000mg/52.6ml gemcitabine instillation group and control group. The recurrence will be assessed by CT scan and cystoscopic exam.six years

Analysis of time from starting intravesical instillation of 2000mg/52.6ml gemcitabine to recurrence

Overall survival in intravesical 2000mg/52.6ml gemcitabine instillation group and control group.six years

Analysis of survival status due to any cause at six years from intravesical instillation of 2000mg/52.6ml gemcitabine

CT cystography finding at one week after surgery.one week

Evaluation of leakage at CT cystography at one week from intravesical instillation of 2000mg/52.6ml gemcitabine

International Prostate Symptom Score questionnaire at one week after surgery.one week

Evaluation of survey with International Prostate Symptom Score questionnaire a one week after surgery

Trial Locations

Locations (5)

National Cancer Center

🇰🇷

Goyang, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Korea University Anam Hospital

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

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