Clinical Trials /

Evaluation the Treatment of Tamoxifen of Low/Intermediate Risk Bladder Tumors

NCT02197897

Description:

Evaluate the treatment of tamoxifen of low/intermediate-risk bladder tumors

Related Conditions:
  • Bladder Papillary Urothelial Carcinoma
  • Bladder Urothelial Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Evaluation the Treatment of Tamoxifen of Low/Intermediate Risk Bladder Tumors
  • Official Title: Phase II Trial of Estrogen Receptor Targeted Treatment of Non-Muscle Invasive Bladder Cancer With Tamoxifen.

Clinical Trial IDs

  • ORG STUDY ID: H-25233
  • SECONDARY ID: K23CA160664
  • NCT ID: NCT02197897

Conditions

  • Bladder Cancer

Interventions

DrugSynonymsArms
Tamoxifen CitrateNolvadexTamoxifen

Purpose

Evaluate the treatment of tamoxifen of low/intermediate-risk bladder tumors

Detailed Description

      Patients with primary or recurrent low/intermediate-risk papillary urothelial carcinoma of
      the bladder will undergo resection of all but one marker lesion, measuring at least 6mm but
      no greater than 10mm, and biopsy of normal-appearing mucosa. Patients with a solitary tumor
      will undergo only biopsy prior to treatment. A 2mm cold cup biopsy of the marker lesion will
      always be performed to rule out a potential high-grade lesion and for assessment of
      pretreatment immunohistochemistry expression levels of ERα, ERβ1, Ki-67 (proliferation
      marker) and TUNEL (apoptosis marker). If there are multiple tumors, all lesions, except the
      marker lesion will be resected and sent for analysis. These patients will not receive single
      immediate post-operative intravesical instillation of mitomycin-C. They will then undergo a
      12-week course of treatment with tamoxifen administered as a single daily oral dose of 20mg.
      At the completion of therapy, patients will undergo resection of the marker lesion (or biopsy
      of the tumor bed, if a complete response is observed) and biopsy of normal-appearing bladder
      mucosa again. Toxicity evaluations will be performed at the beginning (day 3), midway (week
      6), and at completion of treatment (week 12), prior to resection of the marker lesion. A
      final assessment for toxicity will also be performed 30 days after completion of therapy as
      well as a second definitive resection of the marker lesion. Urine samples will be obtained
      with the index tumor in place (marker lesion), and after completion of treatment, at the time
      of definitive transurethral resection of the index tumor, as part of the standard clinical
      care of these patients, and at the discretion of the surgeon for assessment of urinary
      cytology. The urine samples will not be utilized for the research study. All normal-appearing
      bladder biopsies (pre and post-treatment), the additional tumors (in case of multiple
      lesions), and the definitive resection of the marker lesion (in the absence of response to
      therapy) will provide sufficient material for immunohistochemistry assessment of the
      expression levels of ERα, ERβ-1, ERβ-2, ERβ-5, Ki-67, and TUNEL, and also for RT-qPCR for
      mRNA analyses of ERα, ERβ-1, ERβ-2, and ERβ-5. The pretreatment biopsy of the marker lesion
      will be performed with a smaller biopsy forceps and will provide limited material, sufficient
      only for immunohistochemistry assessment of the expression levels of ERα, ERβ-1, Ki-67, and
      TUNEL.
    

Trial Arms

NameTypeDescriptionInterventions
TamoxifenExperimentalAs a single-arm study (single group assignment), Tamoxifen citrate will be given to all patients at a 20mg/day dose for 12 weeks using a marker-lesion study design.
  • Tamoxifen Citrate

Eligibility Criteria

        Inclusion Criteria:

        Males and females age 21 or older. Histologic evidence of urothelial carcinoma of the
        bladder. Low/Intermediate-risk papillary urothelial carcinoma of the bladder, at initial
        occurrence or recurrent with >6 months interval free of disease.

        Patients with multifocal tumors must have resectable lesions. Patients may be
        treatment-naïve or have failed 1 previous regimen of intravesical therapy.

        At least one endoscopically measurable tumor 6 - 10mm in diameter. Adequate hepatic and
        renal function. Patient or authorized proxy needs to have signed the informed consent form.

        -

        Exclusion Criteria:

        Patients with sessile appearing tumors, which may be invasive or high-grade. Diagnosis of
        urothelial carcinoma involving the prostatic urethra or upper urinary tract.

        Plans for pelvic radiation while participating in the study. Concurrent use of warfarin,
        heparin, or chronic use of NSAIDs, including aspirin (other than cardioprotective doses of
        80mg daily) within 30 days prior to registration or during the trial.

        Concurrent use of selective serotonin reuptake inhibitors or aromatase inhibitors.

        Chronic or acute renal or hepatic disorder or any other condition, medical or psychological
        that, in the opinion of the investigator, could jeopardize the subject's safe
        participation.

        Any other investigational drug within 30 days prior to registration and during the study.

        Women Exclusion Pregnant or lactating women. Personal history of endometrial cancer or any
        abnormal uterine bleeding. Previous or concurrent treatment with SERM and/or hormonal
        replacement therapy within 3 months of the study.

        -
      
Maximum Eligible Age:N/A
Minimum Eligible Age:21 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Evaluate the efficacy for treatment of low/intermediate- risk bladder tumors, assessing for the clinical response of the marker lesion
Time Frame:4 years
Safety Issue:
Description:Evaluate the efficacy of tamoxifen for treatment of low/intermediate-risk bladder tumors, utilizing the RECIST criteria combined with the final biopsy of the marker lesion or the bed of the lesion in case of a complete response

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Baylor College of Medicine

Trial Keywords

  • Tamoxifen citrate
  • Bladder Cancer

Last Updated

May 8, 2018