Neoplasms Clinical Trial
Official title:
Evaluation of the Safety of Pre-TURBT Intravesical Instillation of Escalating Doses of TC-3 Gel Mixed With Mitomycin C (MMC) in Non-muscle Invasive Bladder Cancer (NMIBC) Patients
A prospective, open label, modified 3+3 dose escalation study. This dose-escalation study is designed to carefully assess the safety of successive cohorts of patients (3 patients/cohort), each cohort treated with a fixed dose of TC-3 and MMC Intravesical instillations.
A prospective, open label, modified 3+3 dose escalation study. This dose-escalation study is
designed to carefully assess the safety of successive cohorts of patients. A total of 10
patients will be treated in the first cohort with 120mg MMC-TC-3 Gel unless DLT is reached
in more than 1/3 of the patients in the cohort. The next cohorts will have 3
patients/cohort, each cohort treated with a fixed dose of TC-3 and MMC Intravesical
instillations. Since data is already available for 40 and 80 mg MMC in TC-3 gel, the initial
cohort is 120mg MMC mixed with of 60 mL TC-3. Subsequent cohorts will be given dose levels
of 140mg & 160mg MMC mixed with 60 mL TC-3. Thus, if 160mg MMC mixed in 60ml TC-3 will be
found to be safe and tolerable, no higher doses will be further explored at this stage.
If 120 mg MMC in 60 ml TC-gel (2 mg/ml) is found to be intolerable, higher concentrations
will not be tested. Instead, a dose of 120 mg in 90 cc TC gel and a subsequent doses of 140
and 160 mg MMC in 90 cc TC gel will be tested in the same dose escalating manner. This will
allow testing similar doses at lower concentrations (up to 1.78 mg/ml) but with a longer
dwell time due to the larger volume of TC-gel.
Dose escalation is to be halted when the maximum tolerated dose (MTD) will be reached; MTD
is defined as one dose level below which dose limited toxicity (DLT) is Any adverse event
(AE) related to TC-3+MMC and qualified per National Cancer Institute (NCI) Common
Terminology Criteria for Adverse Events (CTCAE) as grade 3 or 4 will be evaluated by board
of 2 independent physicians to determine if it qualifies as DLT based on the known safety
profile of MMC. If the NCI grade will not apply, the adverse event to be graded as mild,
moderate, or severe.
If one of the three patients in a cohort experienced a DLT, three more patients will be
added to the cohort for AE confirmation, only if 3 patients from the given cohort will
experienced DLT, the MTD will be reached If no further DLTs are observed in the cohort, the
three patients will be enrolled in the next successive cohort.
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