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NCT02581982

Paclitaxel and Pembrolizumab in Treating Patients With Refractory Metastatic Urothelial Cancer

Completed Phase 2 Results posted Last updated 10 January 2023
What this trial tests

Phase 2 trial testing Laboratory Biomarker Analysis in Transitional Cell Carcinoma in 27 participants. Completed in 19 December 2022.

Timeline
6 April 2016
Primary endpoint
11 May 2021
19 December 2022

Quick facts

Lead sponsorWake Forest University Health Sciences
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment27
Start date6 April 2016
Primary completion11 May 2021
Estimated completion19 December 2022
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Wake Forest University Health Sciences

Who can join

18 and older, any sex, with Transitional Cell Carcinoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Overall Response Rate Primary · Up to 6 months

The overall response rate will be performed in all patients that are evaluable for efficacy and will have one interim analysis. Overall response is complete response (CR) = Disappearance of all target lesions (PR) = at least a 30% decrease in sum of diameters, taking as reference the baseline sum diameters; stable disease (SD) = neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference smallest sum diameters while on study; and progressive disease (PD) = at least a 20% increase in the sum of diameters of target lesions, taking as reference th

GroupValue95% CI
Treatment (Pembrolizumab, Paclitaxel)3
Treatment (Pembrolizumab, Paclitaxel)6
Treatment (Pembrolizumab, Paclitaxel)9
Treatment (Pembrolizumab, Paclitaxel)7
Number of Adverse Events Graded According to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 Secondary · Up to 1 year

All adverse events will be tabulated and presented by preferred term and/or system organ class and grade. All deaths and serious adverse events will be tabulated.

Serious adverse events
GroupValue95% CI
Treatment (Pembrolizumab, Paclitaxel)34
Adverse events
GroupValue95% CI
Treatment (Pembrolizumab, Paclitaxel)61
Progression Free Survival (Kaplan Meier Method) Secondary · At 6 months

The Kaplan Meier methods will be used to estimate progression free survival. The 6-month PFS will be compared to historical rates using a chi-square test. Progressive disease is at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study based on all target lesions recorded since the treatment started. The sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression)

GroupValue95% CI
Treatment (Pembrolizumab, Paclitaxel)4426 – 62

Adverse events — posted to ClinicalTrials.gov

Time frame: 1 year. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Treatment (Pembrolizumab, Paclitaxel)
Serious: 27/27 (100%)
Deaths: 4/27

Serious adverse events (34 terms)

ReactionSystemTreatment (Pembrolizumab, …
DeathGeneral disorders
Urinary tract infectionInfections and infestations
AnemiaBlood and lymphatic system disorders
DiarrheaGastrointestinal disorders
Lymphocyte count decreasedInvestigations
Chronic kidney diseaseRenal and urinary disorders
Colonic obstructionGastrointestinal disorders
ConfusionPsychiatric disorders
Creatinine increasedInvestigations
DehydrationMetabolism and nutrition disorders
Duodenal obstructionGastrointestinal disorders
DyspneaRespiratory, thoracic and mediastinal disorders
FeverGeneral disorders
FractureInjury, poisoning and procedural complications
Gastric hemorrhageGastrointestinal disorders
HematuriaRenal and urinary disorders
HypermagnesemiaMetabolism and nutrition disorders
HypertensionVascular disorders
HypethyroidismEndocrine disorders
HypotensionVascular disorders
Joint effusionMusculoskeletal and connective tissue disorders
Lung infectionInfections and infestations
Memory impairmentNervous system disorders
PneumonitisRespiratory, thoracic and mediastinal disorders
PresyncopeNervous system disorders
Other adverse events (59 terms — click to expand)

ReactionSystemTreatment (Pembrolizumab, …
FatigueGeneral disorders
AnemiaBlood and lymphatic system disorders
HypoalbuminemiaMetabolism and nutrition disorders
HyperglycemiaMetabolism and nutrition disorders
White blood cell decreasedInvestigations
Lymphocyte count decreasedInvestigations
Chronic kidney diseaseRenal and urinary disorders
HyponatremiaMetabolism and nutrition disorders
NauseaGastrointestinal disorders
AlopeciaSkin and subcutaneous tissue disorders
Creatinine increasedInvestigations
ConstipationGastrointestinal disorders
Platelet count decreasedInvestigations
HypocalcemiaMetabolism and nutrition disorders
InsomniaPsychiatric disorders
Abdominal painGastrointestinal disorders
Alkaline phosphatase increasedInvestigations
Aspartate aminotransferase increasedInvestigations
CoughRespiratory, thoracic and mediastinal disorders
DyspneaRespiratory, thoracic and mediastinal disorders
HematuriaRenal and urinary disorders
HypomagenesemiaMetabolism and nutrition disorders
Nasal congestionRespiratory, thoracic and mediastinal disorders
Back painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
HypokalemiaMetabolism and nutrition disorders
ParesthesiaNervous system disorders
Peripheral sensory neuropathyNervous system disorders
VomitingGastrointestinal disorders
ChillsGeneral disorders
FeverGeneral disorders
Rash maculo-papularSkin and subcutaneous tissue disorders
Alanine aminotransferase increasedInvestigations
DiarrheaGastrointestinal disorders
Edema limbsGeneral disorders
Neutrophil count decreasedInvestigations
Urinary tract infectionInfections and infestations
ArthralgiaMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
HyperkalemiaMetabolism and nutrition disorders

Most-reported serious reactions: Death, Urinary tract infection, Anemia, Diarrhea, Lymphocyte count decreased, Chronic kidney disease, Colonic obstruction, Confusion.

Data from ClinicalTrials.gov NCT02581982 adverse events section.

Sponsor's own description

This phase II trial studies how well paclitaxel and pembrolizumab works in treating patients with urothelial cancer that has not responded to previous treatment and has spread to other places in the body. Drugs used in chemotherapy, such as paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Monoclonal antibodies, such as pembrolizumab, may interfere with the ability of tumor cells to grow and spread. Giving paclitaxel together with pembrolizumab may be an effective treatment for urothelial cancer.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Biomarkers for immunotherapy in bladder cancer: a moving target.
    Aggen DH, Drake CG. · · 2017 · cited 133× · PMID 29157296 · DOI 10.1186/s40425-017-0299-1
  2. Current Strategies and Novel Therapeutic Approaches for Metastatic Urothelial Carcinoma.
    Mollica V, Rizzo A, Montironi R, Cheng L, et al · · 2020 · cited 75× · PMID 32498352 · DOI 10.3390/cancers12061449
  3. Immune checkpoint inhibitors in urothelial cancer: recent updates and future outlook.
    Gopalakrishnan D, Koshkin VS, Ornstein MC, Papatsoris A, et al · · 2018 · cited 52× · PMID 29892196 · DOI 10.2147/tcrm.s158753
  4. Combination therapy with PD-1/PD-L1 blockade: An overview of ongoing clinical trials.
    Johnson CB, Win SY. · · 2018 · cited 26× · PMID 29632719 · DOI 10.1080/2162402x.2017.1408744
  5. Pembrolizumab in the treatment of locally advanced or metastatic urothelial carcinoma: clinical trial evidence and experience.
    Crist M, Iyer G, Hsu M, Huang WC, et al · · 2019 · cited 15× · PMID 31057668 · DOI 10.1177/1756287219839285
  6. A Comprehensive Review of Immunotherapy Clinical Trials for Metastatic Urothelial Carcinoma: Immune Checkpoint Inhibitors Alone or in Combination, Novel Antibodies, Cellular Therapies, and Vaccines.
    Patel DM, Mateen R, Qaddour N, Carrillo A, et al · · 2024 · cited 13× · PMID 38254823 · DOI 10.3390/cancers16020335
  7. Immunotherapy for Patients with Advanced Urothelial Cancer: Current Evidence and Future Perspectives.
    Zichi C, Tucci M, Leone G, Buttigliero C, et al · · 2017 · cited 10× · PMID 28680882 · DOI 10.1155/2017/5618174
  8. Treatment Options for Metastatic Urothelial Carcinoma After First-Line Chemotherapy.
    Tassinari E, Mollica V, Nuvola G, Marchetti A, et al · · 2022 · cited 8× · PMID 35720644 · DOI 10.2147/cmar.s287904

Verify or expand the search:

Other trials of Laboratory Biomarker Analysis

Trials testing the same drug.

Other recruiting trials for Transitional Cell Carcinoma

Currently open trials in the same condition.

Other Wake Forest University Health Sciences trials

Trials by the same sponsor.

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Data sources for this page

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