Efficacy and Safety Evaluation of EN3348 (Mycobacterial Cell Wall-DNA Complex [MCC]) as Compared With Mitomycin C in the Intravesical Treatment of Subjects With BCG Recurrent/Refractory Non-muscle Invasive Bladder Cancer



Status:Terminated
Conditions:Cancer, Infectious Disease
Therapuetic Areas:Immunology / Infectious Diseases, Oncology
Healthy:No
Age Range:18 - Any
Updated:8/25/2017
Start Date:November 2010
End Date:December 2013

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A Phase 3, Randomized, Active-Controlled, Open-Label, Multicenter Study to Evaluate the Efficacy and Safety of EN3348 (MCC) as Compared With Mitomycin C in the Intravesical Treatment of Subjects With BCG Recurrent or Refractory Non-Muscle Invasive Bladder Cancer

This is a phase 3 randomized, active-controlled, open-label, multicenter study that will be
conducted in approximately 120 investigational sites worldwide. Subjects with either
recurrent or refractory NMIBC (Ta high grade, T1 low or high grade, CIS) will be eligible for
participation in this study.

Refractory disease is defined as evidence of persistent high grade bladder cancer (Ta HG, T1,
and/or CIS) at least 6 months from the start of a full induction course of BCG with or
without maintenance/re-treatment at 3 months.

Recurrent disease is defined as reappearance of disease after achieving a tumor-free status
by 6 months following a full induction course of BCG with or without maintenance/re-treatment
at 3 months. Subjects with recurrent disease must have recurred within 18 months following
the last dose of BCG.

Approximately 450 subjects will be randomized. The primary objective of this study is to
evaluate the efficacy of intravesical EN3348 as compared with mitomycin C in the treatment of
subjects with recurrent or refractory NMIBC. The secondary objective is to evaluate the
safety of EN3348 as compared with mitomycin C in the treatment of subjects with BCG recurrent
or refractory NMIBC. This study will consist of 4 phases: Screening, Induction, Maintenance
and Follow-Up and will be conducted over 3 years.


Inclusion Criteria:

- Is 18 years of age and older at time of consent signing

- Have either BCG recurrent or refractory NMIBC:

- Refractory disease is defined as evidence of persistent high grade bladder cancer
(Ta HG, T1 and/or CIS) at least 6 months from the start of a full induction
course of BCG with or without maintenance/re-treatment at 3 months

- Recurrent disease is defined as reappearance of disease after achieving a
tumor-free status by 6 months following a full induction course of BCG with or
without maintenance/re-treatment at 3 months. Subjects with recurrent disease
must have recurred within 18 months following the last dose of BCG

- A full induction course of BCG is defined as at least 5 out of 6 total
expected instillations of BCG within a period of 2 months, regardless of
dose strength

- Have histologically confirmed NMIBC (according to 2004 WHO classification) within 8
weeks prior to randomization

- High grade Ta papillary lesion(s)

- High or low grade T1 papillary lesion(s)(biopsy sample must include evidence of
muscularis propria)

- CIS, with or without Ta or T1 papillary tumor(s) of any grade

- Have had all visible papillary and resectable CIS lesion(s) removed by TURBT within 8
weeks prior to randomization

- Available for the duration of the study including follow-up (approximately 36 months)

- Have an Eastern Cooperative Oncology Group (ECOG) performance status grade of 2 or
less

- Have no evidence of urothelial carcinoma involving the upper urinary tract or the
urethra (confirmed by extravesical work up, which may include radiological imaging
and/or biopsy) within 6 months of randomization:

- If previous work up occurred more than 6 months from randomization, extravesical
work up must be repeated prior to randomization in order to determine eligibility

- Subjects (male and female) of child-bearing potential (including female subjects who
are post-menopausal for less than 1 year) must be willing to practice effective
contraception (as defined by the Investigator) during the study and be willing and
able to continue contraception for 30 days after their last dose of study treatment

- Is able to understand and give written informed consent

Exclusion Criteria:

- Current or previous history of muscle invasive bladder tumors

- Current or previous history of lymph node positive and/or metastatic bladder cancer

- Current evidence of pure squamous cell carcinoma, pure adenocarcinoma or pure
undifferentiated carcinoma of the bladder

- Currently receiving systemic cancer therapy (cytotoxic/cytostatic or immunotherapy)

- Currently receiving treatment with a prohibited therapy

- Current or prior history of systemic lupus erythematosus

- Systemic immunotherapy within 6 months of randomization

- Treatment with an investigational agent within 30 days or 5 half lives from
randomization, whichever is longer

- Prior treatment with an intravesical chemotherapeutic agent within 3 months of
randomization except for single perioperative dose of chemotherapy immediately
post-TURBT

- Prior treatment with EN3348 (MCC) or any other mycobacterial cell wall composition or
formulation

- Refractory to mitomycin C (failure to achieve tumor-free status following minimum of a
6 week induction course of mitomycin C)

- Contraindication to mitomycin C

- Untreated urinary tract or bladder infection

- ANC <1000/µL and hemoglobin <10 g/dL

- Known cardiovascular disease such as myocardial infarction within the past 3 months,
unstable angina pectoris, congestive heart failure (NYHA Class III or IV) or
uncontrolled cardiac arrhythmia

- Female subjects who are pregnant or lactating

- Congenital or acquired immune deficiency

- Have current or history of documented or suspected malignancy of any organ system
(diagnosed, treated or untreated) within the past 5 years (with the exception of
localized transitional cell carcinoma of the ureter treated with ureterectomy or
nephroureterectomy, adequately treated basal cell or squamous cell carcinoma of the
skin or asymptomatic non-metastatic prostate cancer either previously successfully
treated or currently under active surveillance or receiving hormone therapy only)

- Bladder contracture or history of an inability to retain the instillate for a minimum
of 1 hour, even with premedication

- Inability to tolerate intravesical administration or intravesical surgical
manipulation (cystoscopy or biopsy)

- Clinically significant active infections

- Any medical or psychiatric condition which, in the opinion of the investigator, would
preclude the participant from adhering to the protocol or completing the trial per
protocol
We found this trial at
57
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5801 South Ellis Avenue
Chicago, Illinois 60637
 773.702.1234
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1211 Medical Center Dr
Nashville, Tennessee 37232
(615) 322-5000
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4200 Fifth Ave
Pittsburgh, Pennsylvania 15260
(412) 624-4141
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6719 Alvarado Road
San Diego, California 92120
619-287-6000
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Anchorage, Alaska 99508
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Arlington, Texas 76012
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216 North Broad Street
Bala-Cynwyd, Pennsylvania 19004
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Baltimore, Maryland 20742
(301) 405-1000
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Baltimore, Maryland 21204
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Bryn Mawr, Pennsylvania 19010
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Chicago, Illinois 60611
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Cincinnati, Ohio 45212
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Columbus, Ohio 43214
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Coral Springs, Florida 33071
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Cumberland, Maryland 21502
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Dallas, Texas 75231
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Denver, Colorado 80220
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Denver, Colorado 80211
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East Providence, Rhode Island 02915
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Englewood, Colorado 80113
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Evansville, Indiana 47713
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263 Farmington Ave
Farmington, Connecticut 06030
(860) 679-2000
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Fort Wayne, Indiana 46825
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Garden City, New York 11530
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Glen Burnie, Maryland 21061
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Greenbelt, Maryland 20770
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Hialeah, Florida 33016
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850 Hospital Road
Indiana, Pennsylvania 15701
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Kelowna, British Columbia
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15000 Midlantic Drive
Mount Laurel, New Jersey 08054
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823 82nd Parkway, Suite B
Myrtle Beach, South Carolina 29572
(843) 449-1010 ext.268
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New Britain, Connecticut
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630 W 168th St
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212-305-2862
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Ocala, Florida 34474
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243 N Rd
Poughkeepsie, New York 12601
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Richmond, Virginia 23235
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State College, Pennsylvania 16801
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