A Phase 3, Open-Label, Multi-Center, Randomized Study Evaluating the Efficacy and Safety of TAR-200 in Combination with Cetrelimab or TAR-200 Alone Versus Intravesical Bacillus Calmette-Guérin (BCG) in Participants with BCG-naïve High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC)
- Conditions
- BCG-naïve High-Risk Non-Muscle Invasive Bladder CancerTherapeutic area: Diseases [C] - Cancer [C04]MedDRA version: 20.0Level: LLTClassification code 10046714Term: Urothelial carcinoma bladderSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
- Registration Number
- EUCTR2020-004506-64-DE
- Lead Sponsor
- Janssen-Cilag International NV
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 1050
Age
1. Age =18 years (or the legal age of consent in the jurisdiction in which the study is taking place) at the time of informed consent.
Disease Characteristic
2. Criterion modified per Global Amendment 1
2.1 Criterion modified per Global Amendment 2
2.2 Histologically confirmed initial diagnosis by local pathology (within 90 days of the most recent signed informed consent) of HR-NMIBC (high-grade Ta,any T1 or CIS), [AJCC 2017], in participants who are BCG-naïve. Mixed histology tumors are allowed if urothelial differentiation (transitional cell histology) is predominant. However, the presence of neuroendocrine, micropapillary, signet ring cell, plasmacytoid, or sarcomatoid features will make a participant ineligible. Participants may have had a history of HR-NMIBC (defined as high-grade Ta, any T1, or CIS) as long as it has been >3 years from current/novel diagnosis of HR-NMIBC (high-grade Ta, any T1 or CIS).
3. BCG-naïve (participants who have not received prior intravesical BCG or who previously received but stopped BCG more than 3 years before date of randomization are eligible) (Kamat 2016).
4. Participants must be willing to undergo all study procedures (eg, multiple cystoscopies from Screening through the end of study and TURBT/bladder biopsy for assessment of
recurrence/progression).
5. Criterion modified per Global Amendment 2
5.1 All visible papillary disease must be fully resected (absent) prior to date of randomization and documented at baseline cystoscopy. Local urine cytology at screening must be negative or atypical (for HGUC) for patients with papillary only disease (without CIS).
6. All AEs associated with any prior surgery and/or intravesical therapy must have resolved to CTCAE version 5.0 Grade <2 prior to date of randomization.
Type of Participant
7. Eastern Cooperative Oncology Group (ECOG) performance status Grade 0, 1, or 2.
8. Thyroid function tests within normal range or stable per Investigator assessment. Investigators may consult an endocrinologist for participant eligibility assessment in the case of equivocal or marginal tests results.
9.1 Criterion modified per Global Amendment 1
9.2 Criterion modified per Global Amendment 2
Adequate bone marrow, liver, and renal function:
A. Bone marrow function (without the support of cytokines or erythropoiesis stimulating agent in the preceding 2 weeks):
i. Absolute neutrophil count (ANC) =1,000/mm3
ii. Platelet count =75,000/mm3
iii. Hemoglobin =8.0 g/dL
B. Liver function:
i. Total bilirubin =1.5 x ULN or direct bilirubin < ULN for participants with total bilirubin levels
>1.5xULN (except participants with Gilbert’s Syndrome, who must have a total bilirubin <3.0 mg/dL),
ii. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =2.5x institutional ULN
C. Renal function:
i. Creatinine clearance >30 mL/min using the Cockcroft-Gault formula. (See Section 10.15: Appendix 15).
Sex and Contraceptive/Barrier Requirements
For inclusion criteria 10-11 Please see the protocol.
Informed Consent
12. Criterion modified per Global Amendment 1
12.1 Participants must sign an informed consent form (ICF) (or their legally acceptable representative must sign) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study and agree to store samples when applicable.
13. Participants must be willing and able to adhere to the lifestyle restrictions specified in this protocol.
Are the tri
Disease Characteristics
1.Criterion modified per Global Amendment 1
1.1 Presence or history of histologically confirmed, muscle invasive, locally advanced, nonresectable, or metastatic urothelial carcinoma (ie, =T2).
2. Must not have had urothelial carcinoma or histological variant at any site outside of the urinary bladder (ie, urethra, ureter, or renal pelvis). Ta/any T1/CIS of the upper urinary tract (including renal pelvis and ureter) is allowable if treated with complete nephroureterectomy more than 24 months prior to randomization.
3. Criterion modified per Global Amendment 2
3.1 N+ and/or M+ per blinded independent central review (BICR) of computed tomography/magnetic resonance (CT/MR) Urography and chest CT.
Any history of HR-NMIBC (high-grade Ta, any T1 or CIS) <3 years from current diagnosis.
Medical Conditions
4.1 Active malignancies (ie, progressing or requiring treatment change in the last 24 months prior to randomization) other than the disease being treated under study. Potential allowed exceptions include the following (others may be allowed with Sponsor approval).
a. skin cancer (non-melanoma or melanoma) that is considered completely cured.
b. non-invasive cervical cancer treated that is considered completely cured.
c. adequately treated lobular carcinoma in situ (LCIS) and ductal CIS
d. history of localized breast cancer and receiving antihormonal agents
e. history of localized prostate cancer (N0M0) and receiving androgen deprivation therapy
f. Locerion modified per Global Amendment 2alized prostate cancer (N0M0):
i. with a Gleason score of 6, treated within the last 24 months or untreated and under surveillance,
ii. with a Gleason score of 3+4 that has been treated more than 6 months prior to full study Screening and considered to have a very low risk of recurrence,
iii. or history of localized prostate cancer and receiving androgen deprivation therapy and considered to have a very low risk of recurrence.
5. Presence of any bladder or urethral anatomic feature (eg, urethral stricture) that, in the opinion of the Investigator, may prevent the safe insertion, indwelling use, removal of TAR-200, or administration of intravesical BCG. Participants with tumors involving the prostatic urethra in men will be excluded.
6. A history of clinically significant polyuria with recorded 24-hour urine volumes greater than 4000 mL.
7.1 Received a live virus vaccine within 30 days prior to the initiation of study treatment. Inactivated (non-live, or non-replicating) vaccines approved or authorized for emergency use (eg,COVID-19) by local health authorities are allowed.
8.1. Participants should not have a history of acute ischemic heart disease within 42 days of randomization, or history of uncontrolled cardiovascular disease including any of the following in the 3 months prior to randomization:
a. unstable angina,
b. myocardial infarction,
c. ventricular fibrillation,
d. Torsades de Pointes,
e. cardiac arrest, or known congestive New York Heart Association Class III-IV heart failure,
f. cerebrovascular accident,
g. transient ischemic attack, or
h. pulmonary embolism or other venous thromboembolism in the 3 months prior to randomization.
9. Indwelling catheters are not permitted; however, intermittent catheterization is acceptable.
10. Participants must not have clinically significant liver disease that precludes participant treatment regimens prescribed on the study (including, but not limited to active viral, alcoholic, or othe
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method