Metastatic Urothelial CarcinomaPhase 2NCT04701918
Cryoablation With Pembrolizumab Or Avelumab In Urothelial Carcinoma
A Phase 2 study testing Pembrolizumab, Cryoablation and Avelumab in people with Metastatic Urothelial Carcinoma and Bladder Cancer, run by Massachusetts General Hospital at 2 sites in United States.
Trial summary
This research study is examining the effectiveness of pembrolizumab plus cryoablation or aveluma plus cryoablation on people with urothelial carcinoma, including bladder cancer, that has spread. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Metastatic Urothelial Carcinoma, Bladder Cancer
- What is being tested?
- Pembrolizumab, Cryoablation and Avelumab
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 9 participants
- Where
- 2 sitesUnited States
- Study dates
- 4 Jun 2021to 1 Dec 2025
- Phase
- Phase 2
- 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
- The subject has read, signed and dated the Informed Consent Form (ICF), having been advised of the risks and benefits of the trial in a language understood by the subject.
- Age > 18 years at date of ICF signature having the ability to comply with the protocol.
- Proof of medical insurance coverage.
- Histologically or cytologically documented metastatic (M1, Stage IV) urothelial carcinoma (including renal pelvis, ureters, urinary bladder, urethra)
- Measurable metastatic disease with at least one site of metastatic disease > 2 cm in size and amenable to percutaneous image-guided cryoablation based on routine Interventional Radiology criteria. Metastasis sites amenable to cryoablation to include lymph node, peritoneum, liver, soft tissue, adrenal glands, kidney, lung, and bone. Must have measurable disease (by RECIST v1.1) independent of the lesion to be ablated (ie patient must have more than one metastasis)
- Life expectancy > 12 weeks.
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- PS ECOG 0 or 1
- Laboratory requirements:
- ANC > 1 x 109/L
- Platelets > 75 x 109/L
- ALT / AST < 5 x ULN
- Total bilirubin <3 mg/dL
- INR <1.7
- CrCl >30 ml/min
Who cannot join
- Lesion to undergo cryoablation cannot have had prior radiation therapy or other locoregional therapy
- Inability to lie flat for the cryoablation procedure.
- Known significant immunodeficiency due to underlying illness (e.g. HIV / AIDS) and/or blood CD4+ T cells <200/ul
- History of autoimmune disease, including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with anti-phospholipid syndrome, granulomatosis with polyangiitis, Sjogren's syndrome, Guillain- Barre syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
- Patients with a history of autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone are eligible for this trial.
- Patients with controlled Type I diabetes mellitus on a stable dose of insulin regimen are eligible for this trial.
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- Patients with history of vitiligo and controlled psoriasis are eligible for the trial.
- Continued adverse events from a previously administered chemotherapeutic agents.
- Grade 1 adverse events and ongoing toxicities such as alopecia are exempt
- Treatment with systemic corticosteroids exceeding the equivalent of 10 mg/day of prednisone or other systemic immunosuppressive medications (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, and anti-tumor necrosis factor [anti-TNF] agents) within 2 weeks prior to Day 1, or anticipated requirement for systemic immunosuppressive medications during the trial
- Patients who receive acute, low-dose, systemic corticosteroid medications (e.g., a onetime dose of dexamethasone for nausea) or for prevention of hypersensitivity reactions to contrast agents may be enrolled in the trial.
- Anticoagulant or anti-platelet medication that cannot be interrupted prior to cryoablation
- Pregnant or lactating
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicated the use of an investigational drug or that could affect the interpretation of the results or render the patient at high risk from treatment complications.
- Prior treatment with immune checkpoint blockade therapies, including anti-CTLA-4, anti-PD-1, and anti-PD-L1 therapeutic antibodies
- Treatment with systemic immunostimulatory agents (including but not limited to IFNs, interleukin [IL]-2) within 6 weeks or five half- lives of the drug, whichever was shorter, prior to Day 1.
- Signs or symptoms clinically significant of infection within 2 weeks prior to Day 1.
- Any other systemic anti-cancer treatment (including investigational agents) within 4 weeks prior to the first dose of study drug. Note: Participants must have recovered from all AEs due to previous therapies to ≤Grade 1 or baseline. Participants with ≤Grade 2 neuropathy may be eligible
Trial locations and contacts
2 sites in 1 country.
United States2 sites
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215
About this study
Official title: A Multicenter, Single-Arm Open Label Phase II Trial of Cryoablation in Combination With Pembrolizumab or Avelumab in Patients With Metastatic Urothelial Carcinoma
This research study is examining the effectiveness of pembrolizumab plus cryoablation or aveluma plus cryoablation on people with urothelial carcinoma, including bladder cancer, that has spread.
Read the detailed description
This is an open label Phase 2, single-arm, multi-institutional clinical trial designed to study the combination of pembrolizumab and cryoablation or avelumab and cryoablation on people with urothelial carcinoma, including bladder cancer, that has spread.
The U.S. Food and Drug Administration (FDA) has approved both cryoablation, pembrolizumab, and avelumab as treatment options for urothelial carcinoma, including bladder cancer, that has spread. However, the FDA has not yet approved the combination of the drugs, pembrolizumab or avelumab, and intervention, cryoablation, for urothelial carcinoma, including bladder cancer, that has spread.
Pembrolizumab is believed to work by binding to a chemical called PD-1 that is found on a special type of white blood cell in your body. Avelumab is believed to work by binding a similar molecule called PD-L1. This may help your body to be better at finding and destroying tumor cells.
Cryoablation is an intervention which may kill cancer cells using extreme cold. It may help the immune system better recognize tumors and act against it.
The research study procedures include screening for eligibility and study treatment, including evaluations and follow up visits.
Participants will receive study treatment as long as their disease does not get worse or they do not have any unacceptable side effects for up to two years. Participants will be followed for up to 2 years after ending the study treatment.
It is expected that about 30 people will take part in this research study.
Biocompatibles UK Ltd, a device company under Boston Scientific, is supporting this research study by providing funding for the needles used in the study intervention.
- Conditions
- Metastatic Urothelial Carcinoma, Bladder Cancer
- Being tested
- Pembrolizumab, Cryoablation, Avelumab
- Keywords
- Metastatic Urothelial Carcinoma, Bladder Cancer
- Medical subject headings
- Carcinoma, Transitional Cell, Urinary Bladder Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PembrolizumabDrug
Also called Keytruda
Intravenous injection through a vein (IV) every 3 weeks
CryoablationProcedure or surgery
Needle inserted through the skin and into the tumor using CT guidance
AvelumabDrug
Also called Bavencio
Intravenous injection through a vein (IV) every 2 weeks
| Study group | Role | What they receive |
|---|---|---|
| Pembrolizumab/Avelumab + Cryoablation | Experimental | If patient is receiving pembrolizumab: Participants will be given 200 mg pembrolizumab intravenously once every 3 weeks. This will continue for up to 2 years as per standard of care. Participants will receive cryoablation between the 1st and 2nd doses of pembrolizumab. Cryoablation consists of using a CT scan to guide one or more thin needles to the tumor through your skin, where extreme cold is applied.
If patient is receiving avelumab: Participants will be given 800 mg avelumab intravenously once every 2 weeks. This will continue for up to 2 years as per standard of care. Participants will receive cryoablation between the 1st and 2nd doses of avelumab. Cryoablation consists of using a CT scan to guide one or more thin needles to the tumor through your skin, where extreme cold is applied. Receives: Drug: Pembrolizumab; Procedure: Cryoablation; Drug: Avelumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Objective Response Rate
Evaluate objective response rate of non-ablated lesion(s) for combination pembrolizumab/avelumab and adjunctive cryoablation per RECIST v1.1 criteria
Measured: up to 2 years
Secondary outcomes (4)
Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE Version 5.0
The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 will be utilized for AE reporting.
Measured: up to 2 years
Progression-Free Survival (PFS)
Defined using RECIST v1.1
Measured: up to 2 years
Overall survival (OS)
Reported with Kaplan Meier estimates.
Measured: up to 2 years
Duration of response (DOR)
Defined using RECIST v1.1
Measured: up to 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jan 2021
- Study start4 Jun 2021
- Primary completion1 Dec 2025
- Study completion1 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Metastatic Urothelial CarcinomaStudies of the same condition, open and under way.
- More trials run by Massachusetts General HospitalThe 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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 9 participants (actual)
Sponsor and investigators
- Lead sponsor
- Massachusetts General Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Biocompatibles UK Ltd
- Responsible party
- Principal investigator, Eric Wehrenberg-Klee, MD, Massachusetts General Hospital
- Investigators
- Eric Wehrenberg-Klee, MD, Principal investigator, Massachusetts General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04701918
- Sponsor's protocol ID
- 20-531
- Status last verified
- Jan 2026
- First submitted
- 14 Dec 2020
- Last updated
- 22 Jan 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: \[contact information for Sponsor Investigator or designee\]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
Study at a glance
From the registry record, last updated by the sponsor on 22 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multicenter, Single-Arm Open Label Phase II Trial of Cryoablation in Combination With Pembrolizumab or Avelumab in Patients With Metastatic Urothelial Carcinoma
- ClinicalTrials.gov ID
- NCT04701918
- Acronym / sponsor ID
- 20-531
- Conditions
- Metastatic Urothelial Carcinoma, Bladder Cancer
- Keywords
- Metastatic Urothelial Carcinoma, Bladder Cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 9 participants (actual)
- Lead sponsor
- Massachusetts General HospitalUniversity, hospital or other
- Collaborators
- Biocompatibles UK Ltd
- Study start
- 4 Jun 2021 (actual)
- Primary completion
- 1 Dec 2025 (actual)
- Study completion
- 1 Dec 2025 (actual)
- First posted
- 8 Jan 2021 (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.
This research study is examining the effectiveness of pembrolizumab plus cryoablation or aveluma plus cryoablation on people with urothelial carcinoma, including bladder cancer, that has spread.
Detailed description
This is an open label Phase 2, single-arm, multi-institutional clinical trial designed to study the combination of pembrolizumab and cryoablation or avelumab and cryoablation on people with urothelial carcinoma, including bladder cancer, that has spread.
The U.S. Food and Drug Administration (FDA) has approved both cryoablation, pembrolizumab, and avelumab as treatment options for urothelial carcinoma, including bladder cancer, that has spread. However, the FDA has not yet approved the combination of the drugs, pembrolizumab or avelumab, and intervention, cryoablation, for urothelial carcinoma, including bladder cancer, that has spread.
Pembrolizumab is believed to work by binding to a chemical called PD-1 that is found on a special type of white blood cell in your body. Avelumab is believed to work by binding a similar molecule called PD-L1. This may help your body to be better at finding and destroying tumor cells.
Cryoablation is an intervention which may kill cancer cells using extreme cold. It may help the immune system better recognize tumors and act against it.
The research study procedures include screening for eligibility and study treatment, including evaluations and follow up visits.
Participants will receive study treatment as long as their disease does not get worse or they do not have any unacceptable side effects for up to two years. Participants will be followed for up to 2 years after ending the study treatment.
It is expected that about 30 people will take part in this research study.
Biocompatibles UK Ltd, a device company under Boston Scientific, is supporting this research study by providing funding for the needles used in the study intervention.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Pembrolizumab/Avelumab + Cryoablation | Experimental | Drug: Pembrolizumab, Procedure: Cryoablation, Drug: AvelumabIf patient is receiving pembrolizumab: Participants will be given 200 mg pembrolizumab intravenously once every 3 weeks. This will continue for up to 2 years as per standard of care. Participants will receive cryoablation between the 1st and 2nd doses of pembrolizumab. Cryoablation consists of using a CT scan to guide one or more thin needles to the tumor through your skin, where extreme cold is applied. If patient is receiving avelumab: Participants will be given 800 mg avelumab intravenously once every 2 weeks. This will continue for up to 2 years as per standard of care. Participants will receive cryoablation between the 1st and 2nd doses of avelumab. Cryoablation consists of using a CT scan to guide one or more thin needles to the tumor through your skin, where extreme cold is applied. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- The subject has read, signed and dated the Informed Consent Form (ICF), having been advised of the risks and benefits of the trial in a language understood by the subject.
- Age > 18 years at date of ICF signature having the ability to comply with the protocol.
- Proof of medical insurance coverage.
- Histologically or cytologically documented metastatic (M1, Stage IV) urothelial carcinoma (including renal pelvis, ureters, urinary bladder, urethra)
- Measurable metastatic disease with at least one site of metastatic disease > 2 cm in size and amenable to percutaneous image-guided cryoablation based on routine Interventional Radiology criteria. Metastasis sites amenable to cryoablation to include lymph node, peritoneum, liver, soft tissue, adrenal glands, kidney, lung, and bone. Must have measurable disease (by RECIST v1.1) independent of the lesion to be ablated (ie patient must have more than one metastasis)
Key exclusion criteria (19 listed)
- Lesion to undergo cryoablation cannot have had prior radiation therapy or other locoregional therapy
- Inability to lie flat for the cryoablation procedure.
- Known significant immunodeficiency due to underlying illness (e.g. HIV / AIDS) and/or blood CD4+ T cells <200/ul
- History of autoimmune disease, including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with anti-phospholipid syndrome, granulomatosis with polyangiitis, Sjogren's syndrome, Guillain- Barre syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
- Patients with a history of autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone are eligible for this trial.
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 |
|---|---|---|
| PembrolizumabAlso: KeytrudaIntravenous injection through a vein (IV) every 3 weeks | Drug | Pembrolizumab/Avelumab + Cryoablation |
| CryoablationNeedle inserted through the skin and into the tumor using CT guidance | Procedure or surgery | Pembrolizumab/Avelumab + Cryoablation |
| AvelumabAlso: BavencioIntravenous injection through a vein (IV) every 2 weeks | Drug | Pembrolizumab/Avelumab + Cryoablation |
Primary outcome
Objective Response Rate
Time frame: up to 2 years
Evaluate objective response rate of non-ablated lesion(s) for combination pembrolizumab/avelumab and adjunctive cryoablation per RECIST v1.1 criteria
4 secondary outcomes
Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE Version 5.0
Time frame: up to 2 years
Progression-Free Survival (PFS)
Time frame: up to 2 years
Overall survival (OS)
Time frame: up to 2 years
Duration of response (DOR)
Time frame: up to 2 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jan 2026.
- Individual participant dataSharing planned: Yes. The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
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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.
Eric Wehrenberg-Klee, MD principal investigator
Massachusetts General Hospital
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Pembrolizumab, Cryoablation and Avelumab in people with Metastatic Urothelial Carcinoma and Bladder Cancer, run by Massachusetts General Hospital at 2 sites in United States.
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 14 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: finished, as of the sponsor's last update on 22 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United States. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Objective Response Rate (time frame: up to 2 years). 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 Jan 2026.