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NCT03294304

BLASST-1 (Bladder Cancer Signal Seeking Trial): Nivolumab, Gemcitabine, and Cisplatin in Treatment of Muscle Invasive Bladder Cancer (MIBC) Undergoing Cystectomy

Completed Phase 2 Results posted Last updated 16 December 2021
What this trial tests

Phase 2 trial testing Nivolumab in Muscle Invasive Bladder Cancer in 43 participants. Completed in 1 July 2021.

Timeline
29 January 2018
Primary endpoint
5 June 2020
1 July 2021

Quick facts

Lead sponsorMasonic Cancer Center, University of Minnesota
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment43
Start date29 January 2018
Primary completion5 June 2020
Estimated completion1 July 2021
Sites3 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Masonic Cancer Center, University of Minnesota

Who can join

18 and older, any sex, with Muscle Invasive Bladder Cancer. 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.

Pathologic Response Rate (PaR) at Time of Radical Cystectomy. PaR is Defined as Absence of Residual MIBC at Cystectomy in the Surgical Specimen (Pathologic Down-staging to ≤pT1pN0 Which Includes pT0, pT1, pTa and pTis) Primary · Surgery Day 1

Incidence of Measurable Disease "pT" in the TNM staging system refers to the size and extend of the primary tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b. pTa refers to noninvasive papillary carcinoma. pTis refers to carcinoma in situ (CIS) or a "flat tumor" stage. pN refers to lymph nodes. N0 mans cancer has not spread to nearby lymph nodes.

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine27
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 1) Secondary · Treatment Day 1 of cycle 1

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine7
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 1) Secondary · Treatment Day 8 of cycle 1

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine27
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 2) Secondary · Treatment Day 1 of cycle 2

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine18
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 2) Secondary · Treament day 8 of cycle 2

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine15
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 3) Secondary · Treatment day 1 of cycle 3

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine16
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 3) Secondary · Treatment day 8 of cycle 3

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine13
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 4) Secondary · Treatment day 1 of cycle 4

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine8
Safety of Nivolumab With Gemcitabine/Cisplatin (Cycle 4) Secondary · Treatment day 8 of cycle 4

Count of participants with Adverse Events related to Nivolumab with Gemcitabine/Cisplatin

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine11
Safety of Nivolumab With Gemcitabine/Cisplatin Secondary · 30 Days +/- 7 Days after last chemotherapy

Incidence of Adverse Events

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine5
Safety of Nivolumab With Gemcitabine/Cisplatin Secondary · 4 weeks post radical cystectomy

Incidence of Adverse Events

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine24
Count of Participants Experiencing Progression Free Survival (PFS) Secondary · Every 3 Months for 2 Years

Count of participants experiencing Progression Free Survival (PFS)

GroupValue95% CI
Nivolumab, Cisplatin, & Gemcitabine36

Adverse events — posted to ClinicalTrials.gov

Time frame: 120 days after last dose nivolumab. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Nivolumab, Cisplatin, & Gemcitabine
Serious: 11/43 (26%)
Deaths: 7/43

Serious adverse events (15 terms)

ReactionSystemNivolumab, Cisplatin, & Ge…
General disorders and administration site conditions - Other, specifyGeneral disorders
Thromboembolic eventVascular disorders
AnemiaBlood and lymphatic system disorders
DehydrationMetabolism and nutrition disorders
FatigueGeneral disorders
Febrile neutropeniaBlood and lymphatic system disorders
FeverGeneral disorders
HyponatremiaMetabolism and nutrition disorders
Nervous system disorders - Other, specifyNervous system disorders
Neutrophil count decreasedInvestigations
Platelet count decreasedInvestigations
Reproductive system and breast disorders - Other, specifyReproductive system and breast disorders
Respiratory, thoracic and mediastinal disorders - Other, specifyRespiratory, thoracic and mediastinal disorders
Urinary retentionRenal and urinary disorders
Urinary tract infectionInfections and infestations
Other adverse events (133 terms — click to expand)

ReactionSystemNivolumab, Cisplatin, & Ge…
NauseaGastrointestinal disorders
FatigueGeneral disorders
AnemiaBlood and lymphatic system disorders
ConstipationGastrointestinal disorders
Neutrophil count decreasedInvestigations
White blood cell decreasedInvestigations
HypertensionVascular disorders
General disorders and administration site conditions - Other, specifyGeneral disorders
Platelet count decreasedInvestigations
Rash maculo-papularSkin and subcutaneous tissue disorders
Alanine aminotransferase increasedInvestigations
HypomagnesemiaMetabolism and nutrition disorders
Aspartate aminotransferase increasedInvestigations
DysgeusiaNervous system disorders
HeadacheNervous system disorders
HypocalcemiaMetabolism and nutrition disorders
HyponatremiaMetabolism and nutrition disorders
TinnitusEar and labyrinth disorders
Urinary tract infectionInfections and infestations
AnxietyPsychiatric disorders
CoughRespiratory, thoracic and mediastinal disorders
VomitingGastrointestinal disorders
AnorexiaMetabolism and nutrition disorders
DiarrheaGastrointestinal disorders
Edema limbsGeneral disorders
Gastroesophageal reflux diseaseGastrointestinal disorders
HypothyroidismEndocrine disorders
Urinary frequencyRenal and urinary disorders
Alkaline phosphatase increasedInvestigations
HypokalemiaMetabolism and nutrition disorders
Lymphocyte count decreasedInvestigations
Creatinine increasedInvestigations
DyspepsiaGastrointestinal disorders
FeverGeneral disorders
HypoalbuminemiaMetabolism and nutrition disorders
HypophosphatemiaMetabolism and nutrition disorders
InsomniaPsychiatric disorders
Mucositis oralGastrointestinal disorders
Peripheral sensory neuropathyNervous system disorders
Thromboembolic eventVascular disorders

Most-reported serious reactions: General disorders and administration site conditions - Other, specify, Thromboembolic event, Anemia, Dehydration, Fatigue, Febrile neutropenia, Fever, Hyponatremia.

Data from ClinicalTrials.gov NCT03294304 adverse events section.

Sponsor's own description

This is a multi-center Phase II study to determine the safety and efficacy of nivolumab when given in combination with cisplatin and gemcitabine as neoadjuvant treatment in patients with muscle-invasive bladder cancer (MIBC) prior to standard of care radical cystectomy. Patients will receive neoadjuvant treatment with nivolumab in combination with gemcitabine-cisplatin (GC) every 3 weeks for 4 treatment cycles over 12 weeks followed by standard of care radical cystectomy.

Publications & conference data

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

  1. PD1/PDL1 inhibitors for the treatment of advanced urothelial bladder cancer.
    Stenehjem DD, Tran D, Nkrumah MA, Gupta S. · · 2018 · cited 94× · PMID 30275703 · DOI 10.2147/ott.s135157
  2. Cisplatin-Membrane Interactions and Their Influence on Platinum Complexes Activity and Toxicity.
    Martinho N, Santos TCB, Florindo HF, Silva LC. · · 2018 · cited 83× · PMID 30687116 · DOI 10.3389/fphys.2018.01898
  3. Immune Checkpoint Inhibitors as a Neoadjuvant/Adjuvant Treatment of Muscle-Invasive Bladder Cancer: A Systematic Review.
    Barone B, Calogero A, Scafuri L, Ferro M, et al · · 2022 · cited 43× · PMID 35626149 · DOI 10.3390/cancers14102545
  4. Improving Anti-PD-1/PD-L1 Therapy for Localized Bladder Cancer.
    de Jong FC, Rutten VC, Zuiverloon TCM, Theodorescu D. · · 2021 · cited 40× · PMID 33802033 · DOI 10.3390/ijms22062800
  5. Checkpoint Inhibition in Bladder Cancer: Clinical Expectations, Current Evidence, and Proposal of Future Strategies Based on a Tumor-Specific Immunobiological Approach.
    Mancini M, Righetto M, Noessner E. · · 2021 · cited 29× · PMID 34885126 · DOI 10.3390/cancers13236016
  6. Neoadjuvant immunotherapy and chemoimmunotherapy for stage II-III muscle invasive bladder cancer.
    Chen H, Yang W, Xue X, Li Y, et al · · 2022 · cited 26× · PMID 36059550 · DOI 10.3389/fimmu.2022.986359
  7. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of urothelial cancer.
    Galsky MD, Balar AV, Black PC, Campbell MT, et al · · 2021 · cited 25× · PMID 34266883 · DOI 10.1136/jitc-2021-002552
  8. Spatial Relationships in the Tumor Microenvironment Demonstrate Association with Pathologic Response to Neoadjuvant Chemoimmunotherapy in Muscle-invasive Bladder Cancer.
    Beckabir W, Wobker SE, Damrauer JS, Midkiff B, et al · · 2024 · cited 19× · PMID 38092611 · DOI 10.1016/j.eururo.2023.11.008

Verify or expand the search:

Other trials of Nivolumab

Trials testing the same drug.

Other recruiting trials for Muscle Invasive Bladder Cancer

Currently open trials in the same condition.

Other Masonic Cancer Center, University of Minnesota trials

Trials by the same sponsor.

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