Non-muscle Invasive Bladder CancerPhase 3ACCRUENCT04490993
Safety and Efficacy of APL-1202 in Combination With Epirubicin Hydrochloride Versus Epirubicin Hydrochloride Alone in Intermediate and High-risk Chemo-refractory Non-muscle Invasive Bladder Cancer (NMIBC) Patients
A Phase 3 study testing APL-1202 in combination with Epirubicin in people with Non-muscle Invasive Bladder Cancer, run by Jiangsu Yahong Meditech Co., Ltd aka Asieris at 1 site in China.
Trial summary
To evaluate the clinical efficacy (median event-free survival) of APL-1202 in combination with Epirubicin hydrochloride versus Epirubicin hydrochloride alone in intermediate and high-risk chemo-refractory non-muscle invasive bladder cancer (NMIBC) patients Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-muscle Invasive Bladder Cancer
- What is being tested?
- APL-1202 in combination with Epirubicin
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 359 participants
- Where
- 1 siteChina
- Study dates
- 30 Mar 2017to 30 May 2022
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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
- Must be informed of the investigational nature of this study and must provide written informed consent
- Age ≥18 years, male or female
- Must have clinically and histologically confirmed recurrent intermediate and high-risk non-muscle invasive transitional cell carcinoma of the bladder after treatment with intravesical chemotherapy. EORTC risk score (according to EUA "NMIBC Guideline" 2015 version) must be ≥ 5: Papilloma alone (or with Cis) or Cis alone No visible tumor after TURBT on tumor lesion
- Medical history of intravesical chemotherapy Subjects who received intravesical chemotherapy prior to enrollment, but didn't receive BCG or other intravesical therapy with immune drugs Subjected who are refractory to the recommended intravesical chemotherapy drugs pirarubicin, epirubicin, doxorubicin, hydroxy camptothecin, mitomycin, or gemcitabine (according to "Guideline of Diagnosis and Treatment of Urological Diseases in China", 2014 version)
- Re-TURBT:
- For subjects undergoing secondary TURBT, EORTC risk score must be ≥ 5, which can be assessed based on the results of any TURBTs. The other results will be based on first TURBT For subjects undergoing secondary TURBT, the enrollment time will start from the second TURBT It is recommended to conduct the secondary TURBT under following situations: incomplete first TURBT; no muscle tissue found in the first TURBT specimen, except Ta G1 (low grade) tumor and CIS only; T1 tumor; G3 (high grade) tumor (except CIS) The secondary TURBT is recommended 2-6 weeks, but better at 4 weeks, after the first TURBT
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- Willing to provide biopsy specimen for assessment
- ECOG PS ≤ 1, and did not deteriorate in 7 days
- Patients must have normal organ and marrow function within 42 days of study entry (according to normal range in clinical site) Absolute neutrophil count >1.0×109/L Platelets > 100 ×109/L Hemoglobin > 9.0 g/dl Alkaline phosphatase < 2.5 ULN (<10 X ULN in presence of bone metastasis) GFR (Cockcroft-Gault formula calculated) ≥ 50 ml/min INR <1.5, except for subjects receiving warfarin therapy
- Eligibility of patients receiving any medications or substances known to affect or with the potential to affect the activity or pharmacokinetics of APL-1202 will be determined following review of their case by the Principal Investigator
- Female should be either surgically sterilized or menopause or agree to use effective contraceptive measures during treatment
- Male subjects must be surgically sterilized or agreed to use effective contraceptive measures. Subjects must continue to take contraceptive measures within 3 months of the end of the study treatment. The definition of effective contraceptive measures will be based on the Principal Investigator or appointed delegate;
- Expected life expectancy is more than 30 months
Who cannot join
- TBIL, ALT or AST >1.5 x normal range (according to normal range in clinical sites)
- Urothelial cell carcinoma in upper urethra or ureter
- Received intravesical therapy in last TURBT/cystoscopy prior to enrollment period, but not including immediate intravesical therapy once (the subjects who received the immediate intravesical therapy need to be recorded in e-CRF)
- Received surgery (not includes TURBT/cystoscopy), radiation therapy, or systemic therapy within 6 weeks before enrollment
- Malignancies within 2 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in-situ' of the cervix
- NCI CTCAE grade 3 hemorrhage within 6 weeks of starting study treatment
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- Any of the following within 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism
- Hypertension that cannot be controlled by medications
- systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90mmHg
- Uncontrolled active infections such as acute pneumonia, active hepatitis B, etc.
- Dysphagia or known drug absorption disorders
- Anuria
- One week prior to enrollment, having hematuria
- Active duodenal ulcers, ulcerative colitis and other gastrointestinal diseases or other conditions that the investigator may determine to cause gastrointestinal bleeding or perforation
- Subjects that may increase the risk associated with study participation or study drug administration, judged by investigator, or other severe acute or chronic medical condition or optic nerve disorders may interfere with the interpretation and judgment of study results
- Pregnancy or breastfeeding. Female patients with reproductive potential have a positive pregnancy test prior to enrollment
- Psychological or mental abnormality, subjects are estimated to have insufficient adherence to this clinical study
- Four weeks prior to enrollment, participate in other clinical trials
- Patients who had previously received anthracycline for systemic chemotherapy
Trial locations and contacts
1 site in 1 country.
China1 site
Fudan University Shanghai Cancer Center
Shanghai, Shanghai Municipality
About this study
Official title: A Multi-center, Randomized, Double-blind, Placebo-controlled Phase Ⅲ Clinical Trial to Evaluate the Clinical Safety and Efficacy of APL-1202 in Combination With Epirubicin Hydrochloride Versus Epirubicin Hydrochloride Alone in Intermediate and High-risk Chemo-refractory Non-muscle Invasive Bladder Cancer (NMIBC) Patients
To evaluate the clinical efficacy (median event-free survival) of APL-1202 in combination with Epirubicin hydrochloride versus Epirubicin hydrochloride alone in intermediate and high-risk chemo-refractory non-muscle invasive bladder cancer (NMIBC) patients
Read the detailed description
A multi-center, randomized, double-blind, placebo controlled Phase Ⅲ trial; including 3 stages: screening period, treatment period, and follow-up period.
- Screening period: 6 weeks prior to treatment
- Treatment period:
- Induction period: APL-1202 is administered for 12 consecutive weeks
- Maintenance period: after 12-week drug free period, APL-1202 is administered for another12 consecutive weeks as maintenance treatment
- Follow up period: APL-1202 is administered at every 3-month interval if no events occurred in the treatment period and until the occurrence of events or the end of the entire clinical trial Intravesical Epirubicin hydrochloride will be administered once weekly for consecutive 6-8 weeks in the induction period, followed by once monthly in the maintenance period until end of 12 months
- Conditions
- Non-muscle Invasive Bladder Cancer
- Being tested
- APL-1202 in combination with Epirubicin, Placebo in combination with Epirubicin
- Medical subject headings
- Non-Muscle Invasive Bladder Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
APL-1202 in combination with EpirubicinDrug
- Induction period: APL-1202 is administered for 12 consecutive weeks
- Maintenance period: after 12-week drug free period, APL-1202 is administered for another12 consecutive weeks as maintenance treatment
- Follow up period: APL-1202 is administered at every 3-month interval if no events occurred in the treatment period and until the occurrence of events or the end of the entire clinical trial Intravesical Epirubicin hydrochloride will be administered once weekly for consecutive 6-8 weeks in the induction period, followed by once monthly in the maintenance period until end of 12 months
Placebo in combination with EpirubicinDrug
- Induction period: placebo is administered for 12 consecutive weeks
- Maintenance period: after 12-week drug free period, placebo is administered for another12 consecutive weeks as maintenance treatment
- Follow up period: APL-1202 is administered at every 3-month interval if no events occurred in the treatment period and until the occurrence of events or the end of the entire clinical trial Intravesical Epirubicin hydrochloride will be administered once weekly for consecutive 6-8 weeks in the induction period, followed by once monthly in the maintenance period until end of 12 months
| Study group | Role | What they receive |
|---|---|---|
| APL-1202 treatment | Experimental | Not described Receives: Drug: APL-1202 in combination with Epirubicin |
| Placebo | Placebo comparator | Not described Receives: Drug: Placebo in combination with Epirubicin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Event-free survival
"Event"is defined as: pathologically confirmed recurrence, progression, or death resulting from bladder cancer
Measured: Up to 30 months
Secondary outcomes (6)
Recurrent-free rate
Recurrent-free rate
Measured: 24 months
Progression-free rate
Progression-free rate
Measured: 24 months
Clinical benefit rate at 12,18, 24 months after enrollment (clinical benefits are defined as the pathological improvement of the recurrence, no high-risk recurrence, progression-free recurrence, no radical therapy and no death)
Clinical benefit rate at 12,18, 24 months after enrollment (clinical benefits are defined as the pathological improvement of the recurrence, no high-risk recurrence, progression-free recurrence, no radical therapy and no death)
Measured: 24 months
Recurrence-free survival
Recurrence-free survival
Measured: Up to 30 months
Progression-free survival
Progression-free survival
Measured: Up to 30 months
Total survival
Total survival
Measured: Up to 30 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Jul 2020
- Study start30 Mar 2017
- Primary completion30 May 2022 (estimated)
- Study completion30 May 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Non-muscle Invasive Bladder CancerStudies of the same condition, open and under way.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 359 participants (actual)
Sponsor and investigators
- Lead sponsor
- Jiangsu Yahong Meditech Co., Ltd aka Asieris
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Dingwei Ye, MD,PhD, Principal investigator, Fudan UniversityHanzhong Li, MD,PhD, Principal investigator, Peking Union Medical College Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04490993
- Sponsor's protocol ID
- YHCT-NIT-R1
- Acronym
- ACCRUE
- Status last verified
- Feb 2022
- First submitted
- 23 Jul 2020
- Last updated
- 22 Feb 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 Feb 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multi-center, Randomized, Double-blind, Placebo-controlled Phase Ⅲ Clinical Trial to Evaluate the Clinical Safety and Efficacy of APL-1202 in Combination With Epirubicin Hydrochloride Versus Epirubicin Hydrochloride Alone in Intermediate and High-risk Chemo-refractory Non-muscle Invasive Bladder Cancer (NMIBC) Patients
- ClinicalTrials.gov ID
- NCT04490993
- Acronym / sponsor ID
- ACCRUE / YHCT-NIT-R1
- Conditions
- Non-muscle Invasive Bladder Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 359 participants (actual)
- Lead sponsor
- Jiangsu Yahong Meditech Co., Ltd aka AsierisIndustry (pharma, biotech, devices)
- Study start
- 30 Mar 2017 (actual)
- Primary completion
- 30 May 2022 (estimated)
- Study completion
- 30 May 2022 (estimated)
- First posted
- 29 Jul 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To evaluate the clinical efficacy (median event-free survival) of APL-1202 in combination with Epirubicin hydrochloride versus Epirubicin hydrochloride alone in intermediate and high-risk chemo-refractory non-muscle invasive bladder cancer (NMIBC) patients
Detailed description
A multi-center, randomized, double-blind, placebo controlled Phase Ⅲ trial; including 3 stages: screening period, treatment period, and follow-up period.
- Screening period: 6 weeks prior to treatment
- Treatment period:
- Induction period: APL-1202 is administered for 12 consecutive weeks
- Maintenance period: after 12-week drug free period, APL-1202 is administered for another12 consecutive weeks as maintenance treatment
- Follow up period: APL-1202 is administered at every 3-month interval if no events occurred in the treatment period and until the occurrence of events or the end of the entire clinical trial Intravesical Epirubicin hydrochloride will be administered once weekly for consecutive 6-8 weeks in the induction period, followed by once monthly in the maintenance period until end of 12 months
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| APL-1202 treatment | Experimental | Drug: APL-1202 in combination with Epirubicin |
| Placebo | Placebo comparator | Drug: Placebo in combination with Epirubicin |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (13 listed)
- Must be informed of the investigational nature of this study and must provide written informed consent
- Age ≥18 years, male or female
- Must have clinically and histologically confirmed recurrent intermediate and high-risk non-muscle invasive transitional cell carcinoma of the bladder after treatment with intravesical chemotherapy. EORTC risk score (according to EUA "NMIBC Guideline" 2015 version) must be ≥ 5: Papilloma alone (or with Cis) or Cis alone No visible tumor after TURBT on tumor lesion
- Medical history of intravesical chemotherapy Subjects who received intravesical chemotherapy prior to enrollment, but didn't receive BCG or other intravesical therapy with immune drugs Subjected who are refractory to the recommended intravesical chemotherapy drugs pirarubicin, epirubicin, doxorubicin, hydroxy camptothecin, mitomycin, or gemcitabine (according to "Guideline of Diagnosis and Treatment of Urological Diseases in China", 2014 version)
- Re-TURBT:
Key exclusion criteria (19 listed)
- TBIL, ALT or AST >1.5 x normal range (according to normal range in clinical sites)
- Urothelial cell carcinoma in upper urethra or ureter
- Received intravesical therapy in last TURBT/cystoscopy prior to enrollment period, but not including immediate intravesical therapy once (the subjects who received the immediate intravesical therapy need to be recorded in e-CRF)
- Received surgery (not includes TURBT/cystoscopy), radiation therapy, or systemic therapy within 6 weeks before enrollment
- Malignancies within 2 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in-situ' of the cervix
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 |
|---|---|---|
| APL-1202 in combination with Epirubicin* Induction period: APL-1202 is administered for 12 consecutive weeks * Maintenance period: after 12-week drug free period, APL-1202 is administered for another12 consecutive weeks as maintenance treatment * Follow up period: APL-1202 is administered at every 3-month interval if no events occurred in the treatment period and until the occurrence of events or the end of the entire clinical trial Intravesical Epirubicin hydrochloride will be administered once weekly for consecutive 6-8 weeks in the induction period, followed by once monthly in the maintenance period until end of 12 months | Drug | APL-1202 treatment |
| Placebo in combination with Epirubicin* Induction period: placebo is administered for 12 consecutive weeks * Maintenance period: after 12-week drug free period, placebo is administered for another12 consecutive weeks as maintenance treatment * Follow up period: APL-1202 is administered at every 3-month interval if no events occurred in the treatment period and until the occurrence of events or the end of the entire clinical trial Intravesical Epirubicin hydrochloride will be administered once weekly for consecutive 6-8 weeks in the induction period, followed by once monthly in the maintenance period until end of 12 months | Drug | Placebo |
Primary outcome
Event-free survival
Time frame: Up to 30 months
"Event"is defined as: pathologically confirmed recurrence, progression, or death resulting from bladder cancer
6 secondary outcomes
Recurrent-free rate
Time frame: 24 months
Progression-free rate
Time frame: 24 months
Clinical benefit rate at 12,18, 24 months after enrollment (clinical benefits are defined as the pathological improvement of the recurrence, no high-risk recurrence, progression-free recurrence, no radical therapy and no death)
Time frame: 24 months
Recurrence-free survival
Time frame: Up to 30 months
Progression-free survival
Time frame: Up to 30 months
Total survival
Time frame: Up to 30 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Feb 2022.
- Individual participant dataSharing planned: No
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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.
Dingwei Ye, MD,PhD principal investigator
Fudan University
Hanzhong Li, MD,PhD principal investigator
Peking Union Medical College Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing APL-1202 in combination with Epirubicin in people with Non-muscle Invasive Bladder Cancer, run by Jiangsu Yahong Meditech Co., Ltd aka Asieris at 1 site in China.
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 13 inclusion and 19 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: status not confirmed, as of the sponsor's last update on 22 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. 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. Some participants in this study may receive a placebo. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
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?
Event-free survival (time frame: Up to 30 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 22 Feb 2022; AzTrials last refreshed its copy on 8 Nov 2026.