Spots Global Cancer Trial Database for Four Cycles Versus Six Cycles of Cisplatin-based Chemotherapy in Metastatic Urothelial Carcinoma
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Trial Identification
Brief Title: Four Cycles Versus Six Cycles of Cisplatin-based Chemotherapy in Metastatic Urothelial Carcinoma
Official Title: Four Cycles of Cisplatin-Based Chemotherapy in Metastatic Urothelial Carcinoma Compared to Six Cycles: Randomized Phase III Trial - FOCUS Study -
Study ID: NCT03296306
Interventions
Study Description
Brief Summary: The objective is to show non-inferiority of overall survival between four cycles and six cycles of first-line cisplatin based chemotherapy to determine the optimal duration of chemotherapy in patients with advanced urothelial carcinoma.
Detailed Description: Urothelial carcinoma is the fifth most common cancer in men and seventh among women all around the world. Although a complete surgical resection with or without perioperative treatment is the most effective way to offer a potentially curative therapy to patients with these cancers, 25% of the patients initially present with locally or systemically advanced disease. Systemic chemotherapy is the only current modality that provides the potential for a long-term survival in patients with advanced or metastatic urothelial disease. Cisplatin based combination chemotherapies such as GP, GP-S, MVAC, and dose dense MVAC with G-CSF supports are regarded as a backbone treatment for patients with advanced bladder cancer on the basis of the results from previous studies. However, there is no consensus on appropriate number of chemotherapy cycles. In phase III trial comparing MVAC with GP, patients were treated with 6 cycles (every 4 weeks) of chemotherapy. In another phase III trial comparing MVAC with HD-MVAC, there is no pre-determined number of cycles, but the median number of cycles were 4 for MVAC and 6 for HD-MVAC. However, it is hard to complete six or more cycles of cisplatin based chemotherapy due to cumulative toxicities of cisplatin such as neuropathy and development of resistance. The median age of patients with urothelial cancer is 70 years old and significant proportion of the patients already showed impaired performance status (ECOG PS ≥2). There has already been reported in several trials of NSCLC, which showed that 4 cycles of chemotherapy containing cisplatin has no significant differences in survival or QoL with lower incidences of toxicities compared with 6 cycles of chemotherapy. The objective of this trial is to assess whether there is any difference in OS between patients who are treated with four cycles of cisplatin based chemotherapy and patients who are treated with 6 cycles of chemotherapy to determine the optimal duration of chemotherapy in patients with advanced urothelial cancer.
Eligibility
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Locations
Kwonoh Park, Yangsan, Gyeongsangnam-do, Korea, Republic of
Hallym University Medical Center, Hallym University College of Medicine, Anyang, , Korea, Republic of
Fatima Hospital, Daegu, , Korea, Republic of
Keimyeong University Dongsan Medical Center, Daegu, , Korea, Republic of
Chungnam University Hospital, Daejeon, , Korea, Republic of
National Health Insurance Service Ilsan Hospital, Goyang, , Korea, Republic of
Gil Medical Center, Incheon, , Korea, Republic of
Inje University Haeundae Paik Hospital, Pusan, , Korea, Republic of
Kosin University Hospital, Pusan, , Korea, Republic of
Pusan National University Hospital, Pusan National University School of Medicine, Pusan, , Korea, Republic of
Asan Medical Center, Seoul, , Korea, Republic of
Chung Ang University Hospital, Seoul, , Korea, Republic of
Inje University Sanggye Paik Hospital, Seoul, , Korea, Republic of
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, , Korea, Republic of
Korea University Anam Hospital, Seoul, , Korea, Republic of
Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, , Korea, Republic of
VHS medical center, Seoul, , Korea, Republic of
Yonsei Cancer Center, Seoul, , Korea, Republic of
St. Vincent's Hospital, The Catholic University of Korea, Suwon, , Korea, Republic of
Contact Details
Name: Jae-Lyun Lee, MD., PhD.
Affiliation: Asan Medical Center
Role: PRINCIPAL_INVESTIGATOR
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