Phase II Evaluating Efficacy of Temsirolimus in 2 Line Therapy for Patients With Advanced Bladder Cancer

Phase 2

Completed

Brief Summary: In the absence of standard treatment in this indication, this test evaluates a new drug type targeted therapy in this indication, evaluating its efficacy in terms of tumor response and survival.

Detailed Description: In the absence of standard treatment in this indication, this test evaluates a new drug type targeted therapy in this indication, evaluating its efficacy in terms of tumor response and survival. This study will also search for genes involved in the response to treatment.

Recruitment & Eligibility

Inclusion Criteria

Men or women of at least 18 years of age
Histologically proven Bladder cancer
Locally advanced or metastatic disease (stage IV)
Functional status (ECOG / OMS) ≤ 2
Relapse after first-line chemotherapy
Measurable lesions (RECIST criteria)
Absence of anti-neoplasic treatment in the 4 weeks preceding inclusion.
Biological levels :
Neutrophil count >1,5.109/L.
Platelets >100.109/L
Total serum bilirubin < 1.5 × ULN
Clearance of créatinine 40 ml/mm
If not liver metastasis alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <2.5 × ULN
With liver alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <5 × ULN
Signed informed consent
Both women and men must agree to use a medically acceptable method of contraception throughout the study. Women of childbearing potential must have a negative serum pregnancy test of or less than 7 days before the first perfusion of study.
France only : Patients affiliated to a social security program

Exclusion Criteria

Presence of metastatic brain or meningeal tumors on selection scanner, weither symptomatic or asymptomatic
Chemotherapy, immunotherapy, or radiotherapy within 4 weeks of inclusion
Known hypersensitivity to temsirolimus, or its metabolites (as sirolimus), or polysorbate 80 or to their excipients
Previous malignancy (except for cervical carcinoma in situ, basal cell carcinoma curatively treated) or incidental (≤ pT2) prostate cancer found on a radical cystoprostatectomy material
The drugs known as CYP3A4/5 inhibitors or inducers will specifically be excluded on the 30th day ( or at least 7 halves-lives, according to the shortest duration) before the first perfusion and throughout the study. Any food known to inhibit CYP3A4/5 (for example grapefruit, grapefruit juice, star-fruit or star-fruit juice) will also be purposely excluded.
Auto-immune pathology, psychiatric or neurological disorder
Any unstable medical condition
Unstable cardiac disease
Severe renal failure
Unstable diabetes
Pregnancy
Patient enrolled in another therapeutic clinical trial
Patient unable to follow and comply with the study procedures because of any geographical, social or medical condition
Patient partially or totally deprived of his civil rights

Arm && Interventions

Group	Intervention	Description
Temsirolimus	Temsirolimus	Temsirolimus was administered intravenously at a dose of 25 mg in a weekly 30 min infusion and was associated to anti-H1 treatment. One cycle corresponded to 4 weeks of treatment.

Primary Outcome Measures

Name	Time	Method
Non-progression Rate at 2 Months	2 months	Non-progression rate is defined as the rate of participants in complete or partial response or stable disease according to RECIST V1.1. Complete response is defined as the disappearance of all target lesions, partial response is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters and stable disease occurs when neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progression, taking as reference the smallest sum diameters while on study.

Secondary Outcome Measures

Name	Time	Method
Overall Survival	Through Database Cutoff Date of 23-Jan-2015 (up to approximately 5 years and 7 months - median follow-up time of 14 months)	OS was was defined as the time from the treatment initiation to death due to any cause. Participants without documented death were censored at the date of the last follow-up or last patient contact. The OS was calculated using the product-limit (Kaplan-Meier) method for censored data.
Progression-free Survival	Through Database Cutoff Date of 23-Jan-2015 (up to approximately 5 years and 7 months - median follow-up time of 14 months)	Progression-free survival (PFS) was defined as the time from the initiation of treatment to the first documented progression (as per RECIST v1.1) or death (due to any cause), whichever occurs first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Patients alive and progression free were censored at the date of last follow-up or last patient contact. The PFS per RECIST 1.1 was calculated using the product-limit (Kaplan-Meier) method for censored data.

Locations (9): CHU de Bordeaux
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Bordeaux, France
Centre François Baclesse
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Caen, France
Centre Léon Bérard
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Lyon, France
CHU Henri Mondor
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Créteil, France
Hôpital d'instruction des armées du Val-de-Grâce
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Paris, France
CHU de Rouen
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Rouen, France
Centre Jean Perrin
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Clermont Ferrand, France
Institut Claudius Regaud
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Toulouse, France
CHU de Toulouse
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Toulouse, France