Urinary Bladder NeoplasmsPhase 2NCT04172675
A Study of Erdafitinib Versus Investigator Choice of Intravesical Chemotherapy in Participants Who Received Bacillus Calmette-Guérin (BCG) and Recurred With High Risk Non-Muscle-Invasive Bladder Cancer (NMIBC)
A Phase 2 study testing Erdafitinib, Investigator Choice (Gemcitabine) and Investigator Choice (Mitomycin C) in people with Urinary Bladder Neoplasms, run by Janssen Research & Development, LLC at 150 sites in 17 countries.
Trial summary
The purpose of this study is to evaluate recurrence-free survival (RFS) in participants treated with erdafitinib vs Investigator's Choice, for participants with high-risk non-muscle-invasive bladder cancer (NMIBC) who harbor fibroblast growth factor receptor (FGFR) mutations or fusions, and who recurred after bacillus… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Urinary Bladder Neoplasms
- What is being tested?
- Erdafitinib, Investigator Choice (Gemcitabine) and Investigator Choice (Mitomycin C)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 107 participants
- Where
- 150 sitesin 17 countries
- Study dates
- 28 Feb 2020to 27 Feb 2025
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically confirmed, recurrent, non-muscle-invasive urothelial carcinoma of the bladder. Variant pathology are allowed
- Tumor with specified fibroblast growth factor receptor (FGFR) mutations or fusions
- Bacillus Calmette- Guerin (BCG)-unresponsive after adequate BCG therapy or BCG experienced participants
- Refuses or is not eligible for cystectomy (Cohort 1 and Cohort 2 only)
- Eastern Cooperative Oncology Group (ECOG) performance status Grade 0-1
- Must sign an informed consent form (ICF) (or their legally acceptable representative must sign) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study
- A woman of childbearing potential must have a negative pregnancy test (beta-human chorionic gonadotropin [beta-hCG]) (urine or serum) within 7 days before randomization (Cohort 1) or the first dose of study drug (Cohort 2 and Cohort 3)
- Adequate bone marrow, liver, and renal function as specified in the protocol
Who cannot join
- Histologically confirmed, muscle-invasive (T2 or higher stage) urothelial carcinoma of the bladder
- Histopathology demonstrating any small cell component, pure adenocarcinoma, pure squamous cell carcinoma, or pure squamous CIS of the bladder
- Prior treatment with an FGFR inhibitor
- Active malignancies other than the disease being treated under study. The only allowed exceptions are: (a) skin cancer treated within the last 24 months that is considered completely cured (b) adequately treated lobular carcinoma in situ (LCIS) and ductal CIS (c) history of localized breast cancer and receiving antihormonal agents, or history of localized prostate cancer (N0M0) and receiving androgen deprivation therapy
- Current central serous retinopathy or retinal pigment epithelial detachment of any grade
Trial locations and contacts
150 sites in 17 countries.
150 sites in 17 countries
United States22 sites
Albany Medical College
Albany, New York, 12208
Emory University Winship Cancer Institute
Atlanta, Georgia, 30322
MidLantic Urology
Bala-Cynwyd, Pennsylvania, 19004
Levine Cancer Institute
Charlotte, North Carolina, 28204
Northwestern University
Chicago, Illinois, 60611
The Urology Group
Cincinnati, Ohio, 45212
The Ohio State University- James Cancer Hospital
Columbus, Ohio, 43221
UT Southwestern Medical Center
Dallas, Texas, 75390
The Urology Center of Colorado
Denver, Colorado, 80211
Urological Research Network
Hialeah, Florida, 33016
USC Institute of Urology
Los Angeles, California, 90033
Medical College of Wisconsin Froedtert Hospital
Milwaukee, Wisconsin, 53226
Urology Associates
Nashville, Tennessee, 37209
NYU Langone Health
New York, New York, 10016
University of Pittsburgh Medical Center - Cancer Centers
Pittsburgh, Pennsylvania, 15232
Oregon Health And Science University
Portland, Oregon, 97239
Great Lakes Physician PC d/b/a Western New York Urology Associates
Sanborn, New York, 14132
University of Washington
Seattle, Washington, 98008
Simmons Cancer Institute
Springfield, Illinois, 62702
Montefiore Medical Center
The Bronx, New York, 10461
Urological Associates of Southern Arizona, P.C.
Tucson, Arizona, 85741
University of Kansas
Westwood, Kansas, 66205
Japan16 sites
Juntendo University Hospital
Bunkyō City, 113 8431
Tokyo Medical and Dental University Hospital
Bunkyō City, 113 8519
Asahi General Hospital
Chiba, 289-2511
Hakodate Goryoukaku Hospital
Hakodate, 040 8611
Saitama Medical University International Medical Center
Hidaka, 350-1298
Hitachi General Hospital
Hitachi, 317-0077
St Marianna University Hospital
Kanagawa, 216 8511
Nagoya University Hospital
Nagoya, 466 8560
JOHAS Osaka Rosai Hospital
Osaka, 591-8025
Gunma Prefectural Cancer Center
Ōta-ku, 373 8550
Osaka Medical and Pharmaceutical University Hospital
Takatsuki, 569-8686
Toranomon Hospital
Tokyo, 105-8470
The Cancer Institute Hospital of JFCR
Tokyo, 135 8550
Fujita Health University Hospital
Toyoake, 470-1192
University of Tsukuba Hospital
Tsukuba, 305 8576
Yokohama City University Medical Center
Yokohama, 232 0024
France15 sites
Hopital Pellegrin CHU Bordeaux
Bordeaux, 33076
CHU Gabriel-Montpied
Clermont-Ferrand, 63000
Hopital Huriez
Lille, 59037
Hôpital Edouard Herriot
Lyon, 69437
Institut Paoli Calmettes
Marseille, 13273
Hôpital Universitaire Pitié-Salpêtrière
Paris, 75013
Groupe Hospitalier Diaconesses Croix Saint Simon
Paris, 75020
Hopital Bichat Claude Bernard
Paris, 75877
CHU De Poitiers
Poitiers, 86021
Chu Rennes Hopital Pontchaillou
Rennes, 35033
Hopital Charles Nicolle
Rouen, 76031
CHP Saint Gregoire
Saint-Grégoire, 35760
Institut Universitaire du Cancer Toulouse Oncopole
Toulouse, 31000
Centre Hospitalier Universitaire de Nancy - Hôpital Central
Vandœuvre-lès-Nancy, 54519
Gustave Roussy
Villejuif, 94800
Brazil14 sites
Liga Paranaense de Combate ao Cancer
Curitiba, 81520 060
Oncocentro Ceará
Fortaleza, 60135-237
Associacao de Combate ao Cancer em Goias - Hospital de Cancer Araujo Jorge
Goiânia, 74605-070
Liga Norte Riograndense Contra O Cancer
Natal, 59075-740
Irmandade Santa Casa de Misericordia de Porto Alegre
Porto Alegre, 90050-170
Hospital Nossa Senhora da Conceicao S A
Porto Alegre, 91350 200
Instituto de Medicina Integral Professor Fernando Figueira
Recife, 50070-550
Hospital Das Clinicas Da Faculdade De Medicina De RPUSP HCRP
Ribeirão Preto, 14048-900
Oncoclinicas Rio de Janeiro S A
Rio de Janeiro, 22250 905
Instituto de Educacao, Pesquisa e Gestao em Saude Instituto Americas (COI)
Rio de Janeiro, 22775 001
CEPHO Centro de Estudos e Pesquisa de Hematologia e Oncologia
Santo André, 09060-650
Fundacao Faculdade de Medicina Instituto do Cancer do Estado de Sao Paulo
São Paulo, 01246 000
Sociedade Beneficente de Senhoras Hospital Sirio Libanes
São Paulo, 01308 901
Instituto de Assistencia Medica ao Servidor Publico Estadual IAMSPE
São Paulo, 04039-004
Italy11 sites
Ente Ecclesiastico Ospedale Generale Regionale F. Miulli
Acquaviva delle Fonti, 70021
Ospedale Regionale Umberto Parini
Aosta, 11100
Fondazione Istituto G. Giglio
Cefalù, 90015
Ospedale Civile di Guastalla
Guastalla, 42016
Azienda Ospedaliera ''Vito Fazzi''
Lecce, 73100
IRCCS Ospedale San Raffaele
Milan, 20132
Fondazione IRCCS Istituto Nazionale dei Tumori
Milan, 20133
Fondazione G Pascale Istituto Nazionale Tumori IRCCS
Naples, 80138
UOC Oncologia Ospedale Provinciale di Macerata
Province of Macerata, 62100
Azienda Ospedaliera Sant Andrea
Roma, 00189
Azienda Ospedaliera Universitaria Integrata Verona
Verona, 37126
South Korea10 sites
Pusan National University Hospital
Busan, 49241
Chungbuk National University Hospital
Cheongju-si, 361-711
Kyungpook National University Chilgok Hospital
Daegu, 41404
National Cancer Center
Goyang-si, 10408
Chonnam National University Hwasun Hospital
Jeollanam-do, 58128
Korea University Anam Hospital
Seoul, 02841
Seoul National University Hospital
Seoul, 03080
Kangbuk Samsung Hospital
Seoul, 03181
Severance Hospital Yonsei University Health System
Seoul, 03722
Samsung Medical Center
Seoul, 06351
Germany9 sites
Urologicum Duisburg
Duisburg, 47169
Klinikum Herne - Urologie
Herne, 44625
Universitatsklinikum Schleswig Holstein Campus Lubeck
Lübeck, 23538
Praxisklinik Urologie Rhein/Ruhr - Germany
Mülheim, 45468
Klinikum rechts der Isar - III. Med. Klinik und Poliklinik
München, 81675
Universitaetsklinikum Muenster
Münster, 48149
MVZ Urologie 24 gGmbH
Nuremberg, 90491
Studienpraxis Urologie Drs. Feyerabend
Nürtingen, 72622
CUROS - Uberörtliche urologische Gemeinschaftspraxis
Wesseling, 50389
Spain8 sites
Fund. Puigvert
Barcelona, 08025
Hosp Clinic de Barcelona
Barcelona, 8036
Hosp. Univ. Ramon Y Cajal
Madrid, 28034
Hosp. Univ. 12 de Octubre
Madrid, 28041
Hosp. Univ. La Paz
Madrid, 28046
Corporacio Sanitari Parc Tauli
Sabadell, 08208
Hosp. Univ. Marques de Valdecilla
Santander, 39008
Instituto Valenciano de Oncologia
Valencia, 46009
Argentina7 sites
Sociedade Beneficente de Senhoras Hospital Sirio Libanes
Buenos Aires, C1419AHN
CEMIC Saavedra
Buenos Aires, C1431FWN
Hospital Britanico de Buenos Aires
Buenos Aires
Hospital Italiano de Buenos Aires
Ciudad Autonoma de, C1199ABB
Cemaic Centro Privado de Especialidades Medicas Ambulatorias e Investigacion Clinica
Córdoba, 5000
Centro Urologico Profesor Bengio
Córdoba, X5000KPH
Hospital Privado de Cordoba
Córdoba, XX5016KEH
Poland7 sites
Uniwersyteckie Centrum Kliniczne
Gdansk, 80 214
Pratia MCM Krakow
Krakow, 30-727
Uniwersytecki Szpital Kliniczny im. Fryderyka Chopina w Rzeszowie
Rzeszów, 35-055
Samodzielny Publiczny Szpital Kliniczny nr 2 PUM
Szczecin, 70-111
Medical Concierge Centrum Medyczne
Warsaw, 02 798
City Clinic Sp. z o.o.
Warsaw, 02-473
Uniwersytecki Szpital Kliniczny
Wroclaw, 50-556
India6 sites
Health Care Global Enterprises pvt Ltd
Bangalore, 560027
Rajiv Gandhi Cancer Institute & Research Centre
Delhi, 110085
King Georges Medical University
Lucknow, 226003
Meenakshi Mission Hospital and Research Center
Madurai, 625107
Muljibhai Patel Urological Hospital
Nadiād, 387001
CIMET s Inamdar Multispeciality Hospital
Pune, 411040
Taiwan6 sites
Kaohsiung Medical University Chung Ho Memorial Hospital
Kaohsiung City, 80756
China Medical University Hospital
Taichung, 40447
Taichung Veterans General Hospital
Taichung, 40705
National Taiwan University Hospital
Taipei, 10002
Taipei Veterans General Hospital
Taipei, 11217
Chang Gung Memorial Hospital- Linkou
Taoyuan County, 33305
Australia4 sites
Flinders Medical Centre
Bedford Park, 5042
St Vincent s Hospital Sydney
Darlinghurst, 2010
Macquarie University
Macquarie University, 2109
Peter MacCallum Cancer Centre
Melbourne, 3000
Belgium4 sites
AZ Maria Middelares
Ghent, 9000
UZ Leuven
Leuven, 3000
CHU Sart-Tilman
Liège, 4000
Algemeen Ziekenhuis Delta
Roeselare, 8800
China4 sites
Nanjing Drum Tower Hospital
Nanjing, 210008
Fudan University Shanghai Cancer Center
Shanghai, 200032
Renji Hospital, Shanghai Jiaotong University School of Medicine
Shanghai, 200240
Tongji Hospital Tongji Medical College of Huazhong University of Science and Technology
Wuhan, 430030
Czechia4 sites
Fakultni nemocnice u sv. Anny v Brne
Brno, 656 91
Krajská nemocnice Liberec
Liberec, 460 63
Vseobecna fakultni nemocnice v Praze
Prague, 128 08
Fakultni nemocnice v Motole
Prague, 150 06
United Kingdom3 sites
The Christie NHS Foundation Trust Christie Hospital
Manchester, M20 4BX
Universirty of Sheffield Teaching Hospitals NHS Trust
Sheffield, S10 2JF
Lister Hospital
Stevenage, SG1 4AB
About this study
Official title: A Randomized Phase 2 Study of Erdafitinib Versus Investigator Choice of Intravesical Chemotherapy in Subjects Who Received Bacillus Calmette-Guérin (BCG) and Recurred With High Risk Non-Muscle-Invasive Bladder Cancer (NMIBC) and FGFR Mutations or Fusions
The purpose of this study is to evaluate recurrence-free survival (RFS) in participants treated with erdafitinib vs Investigator's Choice, for participants with high-risk non-muscle-invasive bladder cancer (NMIBC) who harbor fibroblast growth factor receptor (FGFR) mutations or fusions, and who recurred after bacillus calmette-guerin (BCG) therapy.
Read the detailed description
This study enrolls participants with high risk NMIBC and FGFR mutations or fusions. Erdafitinib is an oral pan-fibroblast growth factor receptor (FGFR) 1-4 inhibitor with demonstrated clinical activity in participants with solid tumors, including urothelial carcinoma, with alterations in the FGFR pathway. In Cohort 1, participants will be randomized to erdafitinib or to Investigators Choice (intravesical gemcitabine or intravesical mitomycin C [MMC] or hyperthermic MMC). The study consists of screening period, treatment phase, follow-up phase, and long-term extension phase.
- Conditions
- Urinary Bladder Neoplasms
- Being tested
- Erdafitinib, Investigator Choice (Gemcitabine), Investigator Choice (Mitomycin C)
- Keywords
- Non muscle invasive bladder cancer (NMIBC), Bacillus calmette- guerin (BCG) failure, BCG unresponsive
- Medical subject headings
- Urinary Bladder Neoplasms, Non-Muscle Invasive Bladder Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ErdafitinibDrug
Also called JNJ-42756493
Participants will receive erdafitinib orally beginning on Cycle 1 Day 1 until 2 years of treatment have been completed, disease recurrence, intolerable toxicity, withdrawal of consent, a decision by the investigator to discontinue treatment, or study termination, whichever occurs first. Each cycle is of 28 days.
Investigator Choice (Gemcitabine)Drug
Investigator's Choice treatment will be given once weekly for at least 4 doses of induction followed by monthly maintenance for at least 6 months.
Investigator Choice (Mitomycin C)Drug
Investigator's Choice treatment will be given once weekly for at least 4 doses of induction followed by monthly maintenance for at least 6 months.
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1: Erdafitinib | Experimental | Participants with high-risk non-muscle-invasive bladder cancer (NMIBC) presenting as papillary tumor only (carcinoma in situ [CIS], absent), with disease recurrence after bacillus Calmette- Guerin (BCG) therapy will receive treatment with erdafitinib. Receives: Drug: Erdafitinib |
| Cohort 1: Investigators Choice | Active comparator | Participants with high-risk NMIBC presenting as papillary tumor only (CIS, absent), with disease recurrence after BCG therapy will receive the investigator's choice of either intravesical gemcitabine or intravesical mitomycin C (MMC) or hyperthermic MMC. Participants who are randomized to gemcitabine or MMC or hyperthermic MMC in Cohort 1 and demonstrate a recurrence via investigator disease assessment will have the opportunity to cross over to treatment with erdafitinib. Receives: Drug: Investigator Choice (Gemcitabine); Drug: Investigator Choice (Mitomycin C) |
| Cohort 2 | Experimental | Participants with high-risk, BCG- unresponsive NMIBC presenting as CIS with or without concurrent papillary tumor will receive treatment with erdafitinib. Receives: Drug: Erdafitinib |
| Cohort 3 | Experimental | Marker lesion study in intermediate-risk NMIBC presenting as papillary disease only. All enrolled participants will receive treatment with erdafitinib. Receives: Drug: Erdafitinib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Cohort 1: Recurrence-Free Survival (RFS)
RFS was defined as the time from the date of randomization until the date of the reappearance of high-risk disease (high-grade Ta, T1 or carcinoma in situ [CIS]), or death, whichever was reported first. Recurrence was assessed using cystoscopy, bladder mapping, urine cytology, and computed tomography (CT)/ magnetic resonance imaging (MRI) urogram. Participants who were recurrence-free and alive or had unknown status were censored at the last tumor assessment. The Kaplan-Meier method was used to estimate the distribution of overall RFS for each treatment group.
Measured: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months
Secondary outcomes (5)
Cohort 1: Recurrence-Free Survival Rate at 6 Months and 12 Months
RFS rate was the proportion of participants who were recurrence-free and alive based on Kaplan-Meier estimates. RFS was defined as the time from the date of randomization until the date of the reappearance of high-risk disease (high-grade Ta, T1 or CIS), or death, whichever was reported first. Recurrence was assessed using cystoscopy, bladder mapping, urine cytology, and CT/ MRI urogram. Participants who were recurrence-free and alive or had unknown status were censored at the last tumor assessment.
Measured: At Month 6 and Month 12
Cohort 1: Time to Progression
Time to progression (TTP) was defined as the time from the date of randomization until the date of first documented evidence of any of the following: disease progression (PD) or death. PD included development of or increase in stage to lamina propria invasion (for example- increase from Ta to T1), development of or increase in stage to muscle-invasive disease (stage greater than or equal to [>=] T2), development of or increase in stage to lymph node (N+) or distant metastasis (M1) disease (participants must have previously been diagnosed with N0 and/or M0 disease), increase in tumor grade from low to high (including CIS).
Measured: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months
Cohort 1: Overall Survival
Overall survival was defined as the time from the date of randomization to the date of the participant's death due to any cause.
Measured: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
An adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. TEAEs were the events between first dose of study drug and up to 30 (+7 days) days after last dose or before start of subsequent anticancer therapy, whichever occurred first. All TEAEs including serious and non-serious events were reported in this outcome measure (OM).
Measured: From start of treatment (Day 1) up to 25.2 months
Plasma Concentrations of Erdafitinib
Plasma concentrations of erdafitinib were reported. Plasma samples were analyzed using liquid chromatography/mass spectrometry method.
Measured: All cohorts: Pre-dose on Cycle 1 Day 14, pre-dose and 3 hours post-dose on Cycle 2 Day 1 (each cycle was of 28 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Nov 2019
- Study start28 Feb 2020
- Primary completion12 Jul 2024
- Study completion27 Feb 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Urinary Bladder NeoplasmsStudies of the same condition, open and under way.
- More trials run by Janssen Research & Development, LLCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 107 participants (actual)
Sponsor and investigators
- Lead sponsor
- Janssen Research & Development, LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Janssen Research & Development, LLC Clinical Trial, Study director, Janssen Research & Development, LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04172675
- Sponsor's protocol ID
- CR108699
- Other IDs
- 42756493BLC2003, 2019-002449-39, 2023-510306-40-00, 2023, 2019
- Status last verified
- Feb 2026
- First submitted
- 20 Nov 2019
- Last updated
- 24 Feb 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale open Data Access (YODA) Project site at yoda.yale.edu
Publications
Han MA, Maisch P, Jung JH, Hwang JE, Narayan V, Cleves A, Hwang EC, Dahm P. Intravesical gemcitabine for non-muscle invasive bladder cancer. Cochrane Database Syst Rev. 2021 Jun 14;6(6):CD009294. doi: 10.1002/14651858.CD009294.pub3.
PubMed 34125951
Study at a glance
From the registry record, last updated by the sponsor on 24 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase 2 Study of Erdafitinib Versus Investigator Choice of Intravesical Chemotherapy in Subjects Who Received Bacillus Calmette-Guérin (BCG) and Recurred With High Risk Non-Muscle-Invasive Bladder Cancer (NMIBC) and FGFR Mutations or Fusions
- ClinicalTrials.gov ID
- NCT04172675
- Acronym / sponsor ID
- CR108699
- Conditions
- Urinary Bladder Neoplasms
- Keywords
- Non muscle invasive bladder cancer (NMIBC), Bacillus calmette- guerin (BCG) failure, BCG unresponsive
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 107 participants (actual)
- Lead sponsor
- Janssen Research & Development, LLCIndustry (pharma, biotech, devices)
- Study start
- 28 Feb 2020 (actual)
- Primary completion
- 12 Jul 2024 (actual)
- Study completion
- 27 Feb 2025 (actual)
- First posted
- 21 Nov 2019 (actual)
- Results
- Posted 1 Aug 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate recurrence-free survival (RFS) in participants treated with erdafitinib vs Investigator's Choice, for participants with high-risk non-muscle-invasive bladder cancer (NMIBC) who harbor fibroblast growth factor receptor (FGFR) mutations or fusions, and who recurred after bacillus calmette-guerin (BCG) therapy.
Detailed description
This study enrolls participants with high risk NMIBC and FGFR mutations or fusions. Erdafitinib is an oral pan-fibroblast growth factor receptor (FGFR) 1-4 inhibitor with demonstrated clinical activity in participants with solid tumors, including urothelial carcinoma, with alterations in the FGFR pathway. In Cohort 1, participants will be randomized to erdafitinib or to Investigators Choice (intravesical gemcitabine or intravesical mitomycin C [MMC] or hyperthermic MMC). The study consists of screening period, treatment phase, follow-up phase, and long-term extension phase.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Cohort 1: Erdafitinib | Experimental | Drug: ErdafitinibParticipants with high-risk non-muscle-invasive bladder cancer (NMIBC) presenting as papillary tumor only (carcinoma in situ [CIS], absent), with disease recurrence after bacillus Calmette- Guerin (BCG) therapy will receive treatment with erdafitinib. |
| Cohort 1: Investigators Choice | Active comparator | Drug: Investigator Choice (Gemcitabine), Drug: Investigator Choice (Mitomycin C)Participants with high-risk NMIBC presenting as papillary tumor only (CIS, absent), with disease recurrence after BCG therapy will receive the investigator's choice of either intravesical gemcitabine or intravesical mitomycin C (MMC) or hyperthermic MMC. Participants who are randomized to gemcitabine or MMC or hyperthermic MMC in Cohort 1 and demonstrate a recurrence via investigator disease assessment will have the opportunity to cross over to treatment with erdafitinib. |
| Cohort 2 | Experimental | Drug: ErdafitinibParticipants with high-risk, BCG- unresponsive NMIBC presenting as CIS with or without concurrent papillary tumor will receive treatment with erdafitinib. |
| Cohort 3 | Experimental | Drug: ErdafitinibMarker lesion study in intermediate-risk NMIBC presenting as papillary disease only. All enrolled participants will receive treatment with erdafitinib. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Histologically confirmed, recurrent, non-muscle-invasive urothelial carcinoma of the bladder. Variant pathology are allowed
- Tumor with specified fibroblast growth factor receptor (FGFR) mutations or fusions
- Bacillus Calmette- Guerin (BCG)-unresponsive after adequate BCG therapy or BCG experienced participants
- Refuses or is not eligible for cystectomy (Cohort 1 and Cohort 2 only)
- Eastern Cooperative Oncology Group (ECOG) performance status Grade 0-1
Key exclusion criteria (5 listed)
- Histologically confirmed, muscle-invasive (T2 or higher stage) urothelial carcinoma of the bladder
- Histopathology demonstrating any small cell component, pure adenocarcinoma, pure squamous cell carcinoma, or pure squamous CIS of the bladder
- Prior treatment with an FGFR inhibitor
- Active malignancies other than the disease being treated under study. The only allowed exceptions are: (a) skin cancer treated within the last 24 months that is considered completely cured (b) adequately treated lobular carcinoma in situ (LCIS) and ductal CIS (c) history of localized breast cancer and receiving antihormonal agents, or history of localized prostate cancer (N0M0) and receiving androgen deprivation therapy
- Current central serous retinopathy or retinal pigment epithelial detachment of any grade
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ErdafitinibAlso: JNJ-42756493Participants will receive erdafitinib orally beginning on Cycle 1 Day 1 until 2 years of treatment have been completed, disease recurrence, intolerable toxicity, withdrawal of consent, a decision by the investigator to discontinue treatment, or study termination, whichever occurs first. Each cycle is of 28 days. | Drug | Cohort 1: Erdafitinib, Cohort 2, Cohort 3 |
| Investigator Choice (Gemcitabine)Investigator's Choice treatment will be given once weekly for at least 4 doses of induction followed by monthly maintenance for at least 6 months. | Drug | Cohort 1: Investigators Choice |
| Investigator Choice (Mitomycin C)Investigator's Choice treatment will be given once weekly for at least 4 doses of induction followed by monthly maintenance for at least 6 months. | Drug | Cohort 1: Investigators Choice |
Primary outcome
Cohort 1: Recurrence-Free Survival (RFS)
Time frame: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months
RFS was defined as the time from the date of randomization until the date of the reappearance of high-risk disease (high-grade Ta, T1 or carcinoma in situ [CIS]), or death, whichever was reported first. Recurrence was assessed using cystoscopy, bladder mapping, urine cytology, and computed tomography (CT)/ magnetic resonance imaging (MRI) urogram. Participants who were recurrence-free and alive or had unknown status were censored at the last tumor assessment. The Kaplan-Meier method was used to estimate the distribution of overall RFS for each treatment group.
5 secondary outcomes
Cohort 1: Recurrence-Free Survival Rate at 6 Months and 12 Months
Time frame: At Month 6 and Month 12
Cohort 1: Time to Progression
Time frame: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months
Cohort 1: Overall Survival
Time frame: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Time frame: From start of treatment (Day 1) up to 25.2 months
Plasma Concentrations of Erdafitinib
Time frame: All cohorts: Pre-dose on Cycle 1 Day 14, pre-dose and 3 hours post-dose on Cycle 2 Day 1 (each cycle was of 28 days)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Feb 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 34125951Han MA, Maisch P, Jung JH, Hwang JE, Narayan V, Cleves A, Hwang EC, Dahm P. Intravesical gemcitabine for non-muscle invasive bladder cancer. Cochrane Database Syst Rev. 2021 Jun 14;6(6):CD009294. doi: 10.1002/14651858.CD009294.pub3.
- Individual participant dataSharing planned: Yes. The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale open Data Access (YODA) Project site at yoda.yale.edu
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Janssen Research & Development, LLC Clinical Trial study director
Janssen Research & Development, LLC
150 sites in 17 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Erdafitinib, Investigator Choice (Gemcitabine) and Investigator Choice (Mitomycin C) in people with Urinary Bladder Neoplasms, run by Janssen Research & Development, LLC at 150 sites in 17 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 150 sites in United States, Japan, France, Brazil, Italy and 12 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 1 Aug 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Cohort 1: Recurrence-Free Survival (RFS) (time frame: From randomization (Cycle 1 Day 1, pre-dose) up to 48.2 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04172675, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Feb 2026.