Purpose

This randomized phase III trial studies Tokyo-172 strain bacillus Calmette-Guerin (BCG) solution with or without a vaccination using Tokyo-172 strain BCG to see how well it works compared with TICE BCG solution in treating patients with bladder cancer that has not spread to muscle. BCG is a non-infectious bacteria that when instilled into the bladder may stimulate the immune system to fight bladder cancer. Giving different versions of BCG with vaccine therapy may prevent bladder cancer from returning.

Category

IRB Number
20170087HU
NCT Number
NCT03091660
Open to Enrollment
Yes
Sponsor
Southwest Oncology Group -



Study Contact

Principal Investigator
Robert Svatek

Frances Crawford
(210) 450-5037
crawfordf1@uthscsa.edu

Sonia Creighton
(210) 450-1366
creighton@uthscsa.edu

Myrna Montenegro
(210) 450-5954
montenegro@uthscsa.edu

Courtney Nichols
(210) 450-1794
nicholsc2@uthscsa.edu

Mailbox Ctrc Regulatory Affairs
regaffapp@uthscsa.edu

Regulatory Staff
regaffstaff@uthscsa.edu

Kathleen Rodriguez
(210) 450-1365
rodriguezk3@uthscsa.edu

Benjamin Schleif
(210) 450-1366
schleifb@uthscsa.edu

Morgan Seekatz
(210) 450-1133
seekatz@uthscsa.edu

Robert Svatek
(210) 567-5676
svatek@uthscsa.edu



Eligibility

Eligible Ages
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

    • Patients must have histologically proven Ta, carcinoma in situ (CIS) or T1 stage urothelial cell carcinoma of the bladder within 90 days of registration
    • Patients must have had all grossly visible papillary tumors removed within 30 days prior to registration or cystoscopy confirming no grossly visible papillary tumors within 30 days prior to registration
    • Patients with T1 disease must have cross-sectional imaging of abdomen/pelvis demonstrating no evidence of metastatic disease (magnetic resonance imaging [MRI] or computed tomography [CT] scan) within 90 days prior to registration; patients with T1 disease must have re-resection confirming =< T1 disease within 90 days prior to registration
    • Patients must have high-grade bladder cancer as defined by 2004 World Health Organization (WHO)/International Society of Urological Pathology (ISUP) classification
    • Patients must not have pure squamous cell carcinoma or adenocarcinoma
    • Patients' disease must not have micropapillary components
    • Patients must have no evidence of upper tract (renal pelvis or ureters) cancer confirmed by one of the following tests performed within 90 days prior to registration: CT urogram, intravenous pyelogram, magnetic resonance (MR) urogram, or retrograde pyelograms
    • Patients must not have nodal involvement or metastatic disease
    • No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for five years; patients with localized prostate cancer who are being followed by an active surveillance program are also eligible
    • Patients must have a Zubrod performance status of 0-2
    • Patients must not have received prior intravesical BCG
    • Patients must not have known history of tuberculosis
    • Patients must be PPD negative within 90 days prior to registration; PPD negativity is defined as < 10 mm diameter induration (palpable, raised hardened area) in the volar forearm at 48-72 hours following injection with standard tuberculin dose (5 units, 0.1 ml)
    • Patients must be >= 18 years of age
    • Patients must not be taking oral glucocorticoids at the time of registration
    • Patients must not be planning to receive concomitant biologic therapy, hormonal therapy, chemotherapy, surgery, or other cancer therapy while on study
    • Prestudy history and physical must be obtained within 90days prior to registration
    • Patients must not be pregnant or nursing; women/men of reproductive potential must have agreed to use an effective contraceptive method; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures
    • Patients must be offered the opportunity to participate in specimen banking for future studies to include translational medicine studies

Exclusion Criteria

    >

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)
Condition
  • Stage 0 Bladder Urothelial Carcinoma
  • Stage 0is Bladder Urothelial Carcinoma
  • Stage I Bladder Urothelial Carcinoma
  • Arm Groups

    ArmDescriptionIntervention
    Active Comparator

    Arm I (BCG solution)

    INDUCTION: Patients receive TICE BCG solution intravesically once a week for 6 weeks. MAINTENANCE: Patients receive TICE BCG solution once a week for 3 consecutive weeks at months 3, 6, 12, 18, 24, 30, and 36 for up to 7 doses.
  • Biological: BCG Solution

    Given intravesically

    Other names:

    • Bacillus Calmette-Guerin Solution
    • TICE BCG Solution

  • Other: Laboratory Biomarker Analysis

    Correlative studies

  • Experimental

    Arm III (Tokyo-172 strain BCG solution with priming)

    PRIME: Patients receive Tokyo-172 strain BCG vaccine once ID. INDUCTION: Within 21 days, patients receive Tokyo-172 strain BCG solution as in Arm II. MAINTENANCE: Patients receive Tokyo-172 strain BCG solution as in Arm II.
  • Biological: BCG Tokyo-172 Strain Vaccine

    Given ID

    Other names:

    • Bacillus Calmette-Guerin Tokyo-172 Strain Vaccine

  • Biological: BCG Tokyo-172 Strain Solution

    Given intravesically

    Other names:

    • Bacillus Calmette-Guerin Tokyo-172 Strain Solution
    • Immunobladder

  • Other: Laboratory Biomarker Analysis

    Correlative studies

  • Experimental

    Arm II (Tokyo-172 strain BCG solution)

    INDUCTION: Patients receive Tokyo-172 strain BCG solution intravesically once a week for 6 weeks. MAINTENANCE: Patients receive Tokyo-172 strain BCG solution once a week for 3 consecutive weeks at months 3, 6, 12, 18, 24, 30, and 36 for up to 7 doses.
  • Biological: BCG Tokyo-172 Strain Solution

    Given intravesically

    Other names:

    • Bacillus Calmette-Guerin Tokyo-172 Strain Solution
    • Immunobladder

  • Other: Laboratory Biomarker Analysis

    Correlative studies