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Muscle Invasive Bladder CarcinomaPhase 2NCT05406713

Pembrolizumab in Muscle-invasive Bladder Cancer

A Phase 2 study testing Pembrolizumab in people with Muscle Invasive Bladder Carcinoma and Localized Cancer, run by Matthew Galsky at 4 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

Subjects with cT2-T3N0M0 urothelial cancer of the bladder will be enrolled. After completing two cycles of pembrolizumab, subjects will undergo a restaging MRI of the abdomen and pelvis with a standard acquisition protocol (as outlined in the protocol) as well as CT chest. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Pembrolizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
4 sitesUnited States
Study dates
13 Jul 2022to 31 Jan 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

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

  • Subject must meet all of the following applicable inclusion criteria to participate in this study:
  • Written informed consent and HIPAA authorization for release of personal health information prior to registration. NOTE: HIPAA authorization may be included in the informed consent or obtained separately.
  • Age ≥ 18 years at the time of consent.
  • ECOG Performance Status of ≤ 1 within 28 days prior to registration.
  • Histological evidence of clinically localized muscle-invasive urothelial cancer of the bladder. Clinical stage cT2-3N0M0. N0 will be considered the absence of radiographically enlarged lymph nodes on baseline imaging. Patients with lymph nodes <1 cm in long axis on imaging may be eligible but must be discussed with the sponsor investigator.
  • Have undergone a standard of care maximal transurethral resection of bladder tumor ≤ 60 days prior C1D1. Maximal TURBT is defined as a macroscopically complete resection of bladder tumor when safely possibly per the treating urologist. Patients who cannot safely undergo maximal TURBT as per their treating urologist are eligible for enrollment but should be discussed with the sponsor investigator.
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  • All subjects must have adequate transurethral resection of bladder tumor tissue available for submission (i.e., at least 15 unstained slides or paraffin block) identified during screening. This tissue can be from the maximal restaging TURBT, a prior diagnostic TURBT revealing muscle-invasive bladder cancer, or both specimens. Subjects without available archival tissue must be discussed with the sponsor-investigator.
  • Decline cisplatin-based neoadjuvant chemotherapy or be considered cisplatin-ineligible based on at least one of the following modified criteria (as ECOG 0-1 is required for eligibility):
  • Creatinine clearance < 60 mL/min (but ≥ 30 mL/min)
  • Grade ≥ 2 hearing loss (per CTCAE criteria v5)
  • Grade ≥ 2 neuropathy (per CTCAE criteria v5)
  • New York Heart Association Class III heart failure
  • Demonstrate adequate organ function as defined below. All screening labs to be obtained within 28 days prior to registration.
  • Hematological
  • Absolute Neutrophil Count (ANC): ≥ 1.5 x 10^9/L
  • Hemoglobin (Hgb): ≥ 9 g/dL
  • Platelets: ≥ 100 x 10^9/L
  • Renal
  • Creatinine OR: Creatinine ≤ 1.5 × ULN OR
  • Calculated creatinine clearance: creatinine clearance ≥ 30 mL/min
  • Hepatic
  • Bilirubin: ≤ 1.5 ×ULN OR direct bilirubin ≤ ULN for participants with total bilirubin levels > 1.5 × ULN
  • Aspartate aminotransferase (AST): ≤ 2.5 × ULN
  • Alanine aminotransferase (ALT): ≤ 2.5 × ULN
  • Women of childbearing potential (WOCP) must have a negative serum or urine pregnancy test a maximum of 24-hours before the first dose of study drug. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. WOCBP must agree to use contraception.
  • A male participant must agree to use contraception.

Who cannot join

  • Subjects meeting any of the criteria below may not participate in the study:
  • Prior systemic chemotherapy for muscle-invasive urothelial cancer of the bladder.
  • Prior malignancy active within the previous 2 years except for locally curable cancers that have been apparently cured. Patients with intermediate or lower risk prostate cancer as defined by the National Comprehensive Cancer Network (NCCN) risk stratification guidelines may be eligible for enrollment.
  • Prior radiation therapy for bladder cancer.
  • Active infection requiring systemic therapy.
  • Has a known history of Hepatitis B or C. NOTE: Patients with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible. Patients positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA. NOTE: no testing for Hepatitis B and Hepatitis C is required unless mandated by local health authority.
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  • Has a known history of Human Immunodeficiency Virus (HIV) infection. NOTE: no testing for HIV is required unless mandated by local health authority.
  • Has a known history of active TB (Bacillus Tuberculosis).
  • Pregnant or breastfeeding (NOTE: breast milk cannot be stored for future use while the mother is being treated on study).
  • Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX 40, CD137).
  • Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study drug. Administration of killed vaccines is allowed.
  • Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug.
  • Has severe hypersensitivity (≥ Grade 3) to pembrolizumab and/or any of its excipients.
  • Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment and is allowed.
  • Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  • Has had an allogenic tissue/solid organ transplant.
  • Is currently receiving an investigational agent or has received an investigational agent or used an investigational device within 28 days of study registration.

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • University of New Mexico Comprehensive Cancer Center

    Albuquerque, New Mexico, 87102

  • City of Hope

    Duarte, California, 91010

  • Indiana University Melvin and Bren Simon Comprehensive Cancer Center

    Indianapolis, Indiana, 46202

  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10029

Other trials in United States

About this study

Official title: Neoadjuvant Pembrolizumab in Patients With Muscle-invasive Bladder Cancer With Selective Bladder Sparing

Subjects with cT2-T3N0M0 urothelial cancer of the bladder will be enrolled. After completing two cycles of pembrolizumab, subjects will undergo a restaging MRI of the abdomen and pelvis with a standard acquisition protocol (as outlined in the protocol) as well as CT chest. A CT of the abdomen and pelvis may be performed if there are contraindications to MRI. Patients will also undergo a restaging cystoscopy and biopsies/TURBT as outlined in the protocol.

Patients achieving a clinical complete response to treatment (defined in the protocol) will proceed with "maintenance" single agent pembrolizumab followed by surveillance. All other patients will proceed with standard of care local therapy as per their treating physicians followed by "adjuvant" pembrolizumab.

Being tested
Pembrolizumab
Medical subject headings
Carcinoma, Transitional Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT05406713
Study groupRoleWhat they receive
Experimental GroupExperimentalCycles 1-2 (Pembrolizumab): 400 mg of Pembrolizumab intravenously (Administered Day 1 of 42 day Cycle) If complete response of treatment is observed then maintenance therapy will be given. All other patients will receive with standard of care local therapy (cystectomy or chemo-radiation) as per their treating physicians followed by "adjuvant" pembrolizumab. Cycle 3-9 (Maintenance or Adjuvant Single agent Pembrolizumab): 400 mg of Pembrolizumab intravenously (Administered Day 1 of 42 day Cycle)
Receives: Drug: Pembrolizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical Complete Response Rate (CRR)

    Estimate the clinical complete response rate defined as cT0 or cTa disease after pembrolizumab

    Measured: 2 years

  2. Benefit from Treatment

    Estimate the ability of clinical complete response (cT0 or cTa) to predict benefit from treatment. For patients achieving a clinical complete response, benefit will be defined as 2 year metastasis-free survival in patients among the patients achieving a clinical complete response.

    Measured: 2 years

Secondary outcomes (20)
  1. Assess adverse events

    Describe the safety of neoadjuvant pembrolizumab.Safety will be determined according to the NCI Common Terminology Criteria for Adverse Events (NCI CTCAE) v5

    Measured: 6 months

  2. Positive Predictive Value between PD-L1 Expression and clinical complete response

    Positive predictive value of PD-L1 CPS, in predicting benefit from treatment in patients achieving a clinical complete response. Combined Positive Score (CPS) is defined as the number of PD-L1 staining cells divided by the total number of viable tumor cells, multiplied by 100.

    Measured: 2 years

  3. Positive Predictive Value between TMB and clinical complete response

    Positive predictive value of TMB in predicting benefit from treatment in patients achieving a clinical complete response. Tumor mutational burden (TMB) is defined as the total number of somatic nonsynonymous mutations per coding area of a tumor genome.

    Measured: 2 years

  4. Metastasis Free Survival

    Estimate metastasis free survival in the overall study population. Metastasis-free survival is defined as the time from initiation of treatment to the development of metastatic disease. Microscopic metastatic disease involving regional lymph nodes resected at cystectomy performed with curative intent will not be considered an event. Confirmation of metastatic recurrence with a biopsy is recommended in all situations.

    Measured: 2 years

  5. Metastasis Free Survival

    Estimate the 2 year metastasis-free survival. Metastasis-free survival is defined as the time from initiation of treatment to the development of metastatic disease. Microscopic metastatic disease involving regional lymph nodes resected at cystectomy performed with curative intent will not be considered an event. Confirmation of metastatic recurrence with a biopsy is recommended in all situations.

    Measured: 2 years

  6. Metastasis Free Survival

    Estimate metastasis free survival in patients achieving a clinical complete response. Metastasis-free survival is defined as the time from initiation of treatment to the development of metastatic disease. Microscopic metastatic disease involving regional lymph nodes resected at cystectomy performed with curative intent will not be considered an event. Confirmation of metastatic recurrence with a biopsy is recommended in all situations.

    Measured: 2 years

  7. Metastasis Free Survival

    Estimate metastasis free survival in patients not achieving a clinical complete response. Metastasis-free survival is defined as the time from initiation of treatment to the development of metastatic disease. Microscopic metastatic disease involving regional lymph nodes resected at cystectomy performed with curative intent will not be considered an event. Confirmation of metastatic recurrence with a biopsy is recommended in all situations.

    Measured: 2 years

  8. Bladder-intact Event Free Survival

    Bladder-intact event-free survival is defined from initiation of treatment until radical cystectomy, evidence of unresectable or metastatic disease, or death due to any cause.

    Measured: 2 years

  9. Bladder-intact Event Free Survival

    Estimate bladder-intact event free survival in patients achieving a clinical complete response. Bladder-intact event-free survival is defined from initiation of treatment until radical cystectomy, evidence of unresectable or metastatic disease, or death due to any cause.

    Measured: 2 years

  10. Bladder-intact Event Free Survival

    Estimate bladder-intact event free survival in patients not achieving a clinical complete response. Bladder-intact event-free survival is defined from initiation of treatment until radical cystectomy, evidence of unresectable or metastatic disease, or death due to any cause.

    Measured: 2 years

  11. Overall Survival (OS)

    Estimate overall survival. Overall survival is defined as the time from initiation of treatment to death.

    Measured: 2 years

  12. Overall Survival (OS)

    Estimate overall survival in patients achieving a clinical complete response. Overall survival is defined as the time from initiation of treatment to death.

    Measured: 2 years

  13. Overall Survival (OS)

    Estimate overall survival in patients not achieving a clinical complete response. Overall survival is defined as the time from initiation of treatment to death.

    Measured: 2 years

  14. Bladder-Intact Overall Survival

    Estimate bladder-intact overall survival. Bladder-intact overall survival is defined as the time from initiation of treatment until death or cystectomy.

    Measured: 2 years

  15. Bladder-Intact Overall Survival

    Estimate bladder-intact overall survival in patients achieving a clinical complete response. Bladder-intact overall survival is defined as the time from initiation of treatment until death or cystectomy.

    Measured: 2 years

  16. Bladder-Intact Overall Survival

    Estimate bladder-intact overall survival in patients not achieving a clinical complete response. Bladder-intact overall survival is defined as the time from initiation of treatment until death or cystectomy.

    Measured: 2 years

  17. Invasive Bladder Recurrence Free Survival

    Estimate invasive bladder recurrence-free survival in patients achieving a clinical complete response and in all patients not undergoing cystectomy. Invasive bladder recurrence free survival will be defined as the time from initiation of treatment to the development of at least cT/pT1 urothelial cancer in the bladder.

    Measured: 2 years

  18. Recurrence Free Survival (RFS)

    Estimate the RFS. Recurrence-free survival is defined as the time from initiation of treatment to death or recurrence, depending on which occurs first.

    Measured: 2 years

  19. Recurrence Free Survival (RFS)

    Estimate the RFS in patients achieving a clinical complete response. Recurrence-free survival is defined as the time from initiation of treatment to death or recurrence, depending on which occurs first.

    Measured: 2 years

  20. Recurrence Free Survival (RFS)

    Estimate the RFS in patients not achieving a clinical complete response. Recurrence-free survival is defined as the time from initiation of treatment to death or recurrence, depending on which occurs first.

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jun 2022
  2. Study start13 Jul 2022
  3. Primary completion31 Jan 2027 (estimated)
  4. Study completion31 Jan 2028 (estimated)

Resources

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
46 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05406713
Sponsor's protocol ID
HCRN GU20-444
Status last verified
Apr 2026
First submitted
9 May 2022
Last updated
8 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pembrolizumab in people with Muscle Invasive Bladder Carcinoma and Localized Cancer, run by Matthew Galsky at 4 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 26 inclusion and 18 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: under way, not looking for participants, as of the sponsor's last update on 8 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 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?

This study is still under way. Results are not available in the source record yet.

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?

Clinical Complete Response Rate (CRR) (time frame: 2 years). The study lists 2 primary outcomes in all. 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 8 Apr 2026.

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