Bladder Cancer Clinical Trial
Official title:
A Phase II Study of Neoadjuvant Cisplatin and Gemcitabine Plus Sorafenib for Patients With Transitional-Cell Carcinoma of the Bladder
RATIONALE: Drugs used in chemotherapy, such as cisplatin and gemcitabine hydrochloride, work
in different ways to stop the growth of tumor cells, either by killing the cells or by
stopping them from dividing. Sorafenib tosylate may stop the growth of tumor cells by
blocking some of the enzymes needed for cell growth or by blocking blood flow to the tumor.
Giving cisplatin and gemcitabine hydrochloride together with sorafenib tosylate may kill
more tumor cells. Giving them before surgery may make the tumor smaller and reduce the
amount of normal tissue that needs to be removed.
PURPOSE: This phase II trial is studying how well giving cisplatin and gemcitabine
hydrochloride together with sorafenib tosylate works in treating patients with node-negative
transitional cell cancer of the bladder.
OBJECTIVES:
Primary
- To evaluate the activity (pathological complete response) of neoadjuvant cisplatin and
gemcitabine hydrochloride in combination with sorafenib tosylate in patients with
muscle-invasive, node-negative transitional cell carcinoma of the bladder.
Secondary
- To evaluate the safety and tolerability of this regimen in these patients.
- To determine the potential biological correlates of disease response and drug activity
in tumor tissue samples before and after treatment.
- To evaluate the correlation between fludeoxyglucose F 18 positron emission tomography
(18FDG-PET) and standard computed tomography (CT) results and the ability of changes of
18FDG-PET (as measured by EORTC criteria for response) to predict subsequent favorable
response to treatment (pathological complete response rate and progression-free
survival).
OUTLINE: Patients receive cisplatin IV over 20-30 minutes on day 1 and gemcitabine
hydrochloride IV over 30 minutes on days 1 and 8. Patients also receive sorafenib tosylate
twice daily on days 1-21. starting on day 1and continuing up to Treatment repeats every 21
days for 2 courses. Patients are reassessed after course 2, those who experience disease
progression or deemed unresectable are off study. Other patients continue the treatment for
2 more courses*.
NOTE: *Sorafenib tosylate are stopped 14 days prior to planned cystectomy.
No more than 30 days after completion of neoadjuvant therapy, patients undergo planned
radical cystectomy with pelvic lymph-node dissection off study.
Tumor tissue and serum samples may be collected during study for additional biological
studies.
;
Masking: Open Label, Primary Purpose: Treatment
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