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A Study of Intravesical BCG in Combination With ALT-803 in Patients With Non-Muscle Invasive Bladder Cancer

Phase 1
Recruiting
Conditions
Non-muscle Invasive Bladder Cancer
Interventions
Biological: BCG( 50mg/Instillation)
Biological: BCG+N-803( 50mg BCG/ Instillation+ N-803( 400 μg/instillation). )
Registration Number
NCT02138734
Lead Sponsor
ImmunityBio, Inc.
Brief Summary

This is a Phase Ib/IIb, randomized, two-cohort, open-label, multicenter study of intravesical N-803 plus BCG versus BCG alone, in BCG naïve patients with high-grade NMIBC.

Detailed Description

The study includes a dose escalation phase (phase Ib) and an expansion phase (phase IIb).

In the phase Ib, patients will be treated with intravesical N-803 in combination with BCG. The purpose of the phase Ib portion of the study is to evaluate the safety, identify the Maximum Tolerated Dose (MTD) of N-803 and determine the Recommended Dose (RD) level of N-803 in combination with BCG for the phase IIb expansion.

In the phase IIb expansion, patients will be randomized to receive either intravesical N-803 in combination with BCG or BCG alone. Patients will be enrolled into one of two study cohorts (Cohort A and Cohort B). These will be two independent study cohorts, evaluated separately for treatment efficacy.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
596
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BCG aloneBCG( 50mg/Instillation)(Phase IIb) for BCG-naive patients
N-803+BCGBCG+N-803( 50mg BCG/ Instillation+ N-803( 400 μg/instillation). )(Phase Ib and IIb) for BCG-naive patients
Primary Outcome Measures
NameTimeMethod
Complete Response (CR) Rate6 Months

Patients in Cohort A: compare complete response rate between treatment arms using cystoscopy, confirmatory bladder biopsy and urine cytology.

Disease Free Survival (DFS)13 Years and 3 Months

Patients in Cohort B: compare disease-free survival between treatment arms using

cystoscopy, confirmatory bladder biopsy and urine cytology.

Secondary Outcome Measures
NameTimeMethod
Cohort B: Disease Free Survival Rate36 Months

To assess DFS rate at 12, 18, 24, 30, and 36 months. The time from randomization until recurrence of high-grade Ta (excluding low grade Ta) or any grade T1, CIS, disease progression, cystectomy, change in therapy indicative of more advance disease or death (any cause), whichever occurs first.

Time to disease worsening13 Years and 3 Months

For phase IIb, Cohorts A \& B: Cystectomy or change in therapy indicative of more advanced disease, including systemic chemotherapy or radiation therapy.

Complete Response Rate( All Recurrent Bladder Cancer Including Low Grade Ta Disease)13 Years and 3 months

To assess the CR rate (all recurrent bladder cancer including low grade Ta disease) of patients treated with N-803 plus BCG compared to patients treated with BCG alone.

Duration of Complete Response ( All Recurrent Bladder Cancer Including Low Grade Ta Disease)13 Years and 3 months

Time from the date of first CR (All Recurrent bladder cancer including low grade Ta Disease) to the date of evidence that the subject no longer meets the definition for CR.

Vital signs and clinical laboratory assessment36 Months

Vital signs include heart rate, systolic and diastolic blood pressures, respiration rate, and body temperature. Labs include the following: complete blood count with differential, complete metabolic panel, and urinalysis.

Cystectomy Free Rate13 years and 3 months

Cystectomy-free rate will be calculated for each treatment group as the ratio of the number of subjects who don't have documented cystectomy in the database divided by the number of subjects in the ITT (Intent to treat) population.

Safety Profile: Number and severity of treatment emergent AEs [Time Frame: 39 Months]39 Months

For phase Ib and phase IIb: Number of participants with TEAEs as assessed by CTCAE v4.03.

Cohort B: Disease Free Survival13 Years and 3 Months

DFS was assessed in the following groups:

1) All recurrent bladder cancer, including low grade Ta disease the time from randomization until recurrence of any grade Ta (including low grade Ta) or any grade T1, CIS, disease progression, cystectomy, change in therapy indicative of more advanced disease, or death (any cause), whichever occurs first 2) Patients who have high-grade Ta, low-grade T1, or CIS at 3-months and received re-induction, and have no evidence of \> low-grade Ta disease at 6-months will be considered disease-free from randomization until a second recurrence \> low-grade Ta 3) Patients who have high-grade Ta, low-grade T1, or CIS at 3-months and received re-induction, and have no evidence of any disease (including low grade Ta) at 6-months will be considered disease-free from randomization until a second recurrence ≥ low grade Ta.

Overall survival13 Years and 3 months

Time from randomization to death resulting from any cause to determine survival.

Duration of Complete Response13 Years and 3 months

To assess the duration of CR of patients treated with N-803 plus BCG compared to patients treated with BCG alone.

Long Term Complete Response Rate13 years and 3 Months

To assess the long-term CR rate (as determined by the Investigator) following completion of QUILT-2.005 phase 2b.

Long Term Follow Up(LTFU) data from subjects who were treated10 Years after treatment period visits

Yearly collection of LTFU data, which includes the following: survival status, bladder cancer status (high or low grade), cystoscopy results including number of cystoscopies done for each subject, biopsy results, upper tract evaluations, posttherapies and responses and outcomes of posttherapies, urine cytology results, and other medical history or treatments, if available, related to bladder cancer.

Progression-free survival (PFS)13 Years and 3 Months

For phase IIb, Cohorts A \& B: Time from randomization to disease progression or death.

Disease specific survival13 Years and 3 months

For phase IIb, Cohorts A \& B: Time from randomization to death resulting from bladder cancer.

Trial Locations

Locations (25)

Skyline Sherman Oaks

🇺🇸

Sherman Oaks, California, United States

Eastern Connecticut Hematology & Oncology Associates

🇺🇸

Norwich, Connecticut, United States

Hoag Cancer Center

🇺🇸

Irvine, California, United States

Clinical Research Center of Florida

🇺🇸

Pompano Beach, Florida, United States

Skyline Urology

🇺🇸

Torrance, California, United States

Manhattan Medical Research

🇺🇸

New York, New York, United States

Arkansas Urology

🇺🇸

Little Rock, Arkansas, United States

Kansas University Medical Center

🇺🇸

Westwood, Kansas, United States

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

University of California, Davis

🇺🇸

Sacramento, California, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Adult & Pediatric Urology

🇺🇸

Omaha, Nebraska, United States

Alaska Clinical Research Center

🇺🇸

Anchorage, Alaska, United States

UCLA Department of Urology

🇺🇸

Los Angeles, California, United States

Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Winthrop University Hospital

🇺🇸

Mineola, New York, United States

Urology Group of New Mexico (AccumetRx Clinical Research)

🇺🇸

Albuquerque, New Mexico, United States

NYU Langone

🇺🇸

New York, New York, United States

Premier Medical Group of the Hudson Valley

🇺🇸

Poughkeepsie, New York, United States

Associated Urologists of North Carolina

🇺🇸

Raleigh, North Carolina, United States

University of Washington School of Medicine

🇺🇸

Seattle, Washington, United States

University of North Carolina Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Virginia Urology

🇺🇸

Richmond, Virginia, United States

University of Hawaii Cancer Center

🇺🇸

Honolulu, Hawaii, United States

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