A Single-arm, Multicenter, Open Clinical Trial of the Efficacy and Safety of Tislelizumab in Combination With Nab-Paclitaxel for the Perioperative Treatment of Muscle-invasive Bladder Cancer
Overview
- Phase
- Phase 2
- Intervention
- Tislelizumab Nab paclitaxel
- Conditions
- Muscle Invasive Bladder Cancer Urothelial Carcinoma
- Sponsor
- Tianjin Medical University Second Hospital
- Enrollment
- 74
- Locations
- 1
- Primary Endpoint
- complete response (CR) rate
- Status
- Recruiting
- Last Updated
- 3 years ago
Overview
Brief Summary
This is a single-arm, open-label, multicenter clinical trial to investigate the safety and efficacy of tislelizumab when given in combination with nab-paclitaxel as perioperative treatment in patients with muscle-invasive bladder cancer (MIBC) prior to cystectomy or complete TURBT. Patients will receive perioperative treatment with tislelizumab in combination with nab-paclitaxel every 3 weeks for 3 treatment cycles over 9 weeks followed by radical cystectomy or complete TURBT.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Willing and able to provide written informed consent.
- •Ability to comply with the protocol.
- •Age ≥ 18 years.
- •Suitable and planned for complete transurethral resection of bladder tumor or radical cystectomy
- •At least one measurable lesion meeting RECISTv1.1 criteria prior to transurethral bladder tumor electrosurgery (MR/CT long diameter of ≥10 mm or short diameter of ≥15 mm of enlarged lymph node required for this measurable lesion according to RECISTv1.1)
- •Histopathologically confirmed urothelial carcinoma. Patients with mixed histologies are required to have a dominant (i.e. 50% at least) urothelial cell pattern.
- •Clinical stage T2-T4a NxM0 disease by CT (or MRI).
- •Expected survival time is greater than 12 weeks.
- •Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 1 or
- •Agree to provide tissue examination specimens (used to detect PD-L1 expression, tumor mutation burden, etc.)
Exclusion Criteria
- •Receive live attenuated vaccines within 4 weeks before treatment or plan to receive live attenuated vaccines during the study period.
- •Active, known or suspected autoimmune diseases.
- •Known history of primary immunodeficiency.
- •Known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation.
- •Female patients who are pregnant or breastfeeding.
- •Untreated acute or chronic active hepatitis B or C infection. In the case of patients receiving antiviral therapy, the doctor will judge whether they are eligible for enrollment according to the individual conditions of the patient while monitoring the virus copy number.
- •Have used immunosuppressive drugs in the past 4 weeks before starting treatment, excluding nasal spray and inhaled corticosteroids or physiological doses of systemic steroids (that is, prednisolone or equivalent physiological doses of no more than 10 mg/day) Other corticosteroids).
- •Those who are known or suspected to be allergic to tislelizumab and nab paclitaxel.
- •Have a clear history of active tuberculosis.
- •Have received PD-1/PD-L1/CTLA-4 antibody or other immunotherapy in the past.
Arms & Interventions
Experimental: Tislelizumab and Nab Paclitaxel
Experimental: Tislelizumab and Nab Paclitaxel Tislelizumab 200mg IV on day 1 in combination with nab paclitaxel 200mg IV on day 2 every 3 weeks for 3 cycles followed by surgery.
Intervention: Tislelizumab Nab paclitaxel
Outcomes
Primary Outcomes
complete response (CR) rate
Time Frame: At the time of complete transurethral resection of bladder tumor or radical cystectomy (within 12 weeks of the first dose of tislelizumab)
defined as the percentage of participants having CR. CR is defined as absence of viable tumor in examined tissue
Secondary Outcomes
- Number of subjects that reach pathological downstaging to <pT2(At the time of complete transurethral resection of bladder tumor or radical cystectomy (within 12 weeks of the first dose of tislelizumab))
- Event-free survival (EFS)(up to 3 years)
- Objective response rate (ORR)(At the time of complete transurethral resection of bladder tumor or radical cystectomy (within 12 weeks of the first dose of tislelizumab))
- Overall Survival (OS)(up to 3 years)
- Number of adverse events and severity by grade (CTCAE)(up to 1 years)