Bladder Cancer Clinical Trial
Official title:
Multi-Institutional Phase II Study of Radiation Therapy and Anti-PD-L1 Checkpoint Inhibition (Durvalumab) With or Without Anti-CTLA-4 Inhibition (Tremelimumab) in Patients With Unresectable, Muscle-Invasive or Metastatic Urothelial Bladder Cancer That Are Ineligible or Refusing Chemotherapy
This is a multi-site, randomized, prospective, open-label phase II study. Patients in this study will have localized (cT3-cT4), or metastatic bladder cancer with a symptomatic, intact primary bladder tumor. In this study, patients will undergo stereotactic body radiation therapy (SBRT) to the bladder tumor and will receive durvalumab with or without tremelimumab.
The study will commence with a safety lead-in phase at UCSF in which 6 patients are accrued
to Regimen A1 (RT + durvalumab). If this is not tolerated then an alternative Regimen A2,
containing a lower total radiation dose will accrue 6 patients. If either A1 or A2 is
tolerated then patients will be accrued to Regimen B1 (durvalumab, tremelimumab x 2 doses,
and RT dose determined from Regimen A) following a 3+3 design for safety. If Regimen B1 is
not tolerated an alternative Regimen B2 (durvalumab, tremelimumab x 1 dose, and RT dose
determined from regimen A) will accrue following a 3+3 design for safety.
After the safety lead-in for each group is completed, an expansion cohort will accrue
patients. In this expansion cohort, patients will be randomized 1:1 to be treated with either
regimen A or regimen B dose selected from the safety lead-in stratified by patient population
(localized patients and metastatic patients).
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