Phase II Trial of Gemcitabine, Carboplatin, and Bevacizumab in Chemotherapy Naive Patients With Advanced/Metastatic Urothelial Carcinoma

Status:	Completed
Conditions:	Prostate Cancer, Cancer, Cancer, Hematology
Therapuetic Areas:	Hematology, Oncology
Healthy:	No
Age Range:	18 - Any
Updated:	4/21/2016
Start Date:	May 2006
End Date:	December 2011

Gemcitabine and carboplatin are two standard chemotherapy drugs used to treat tumors of the
urothelial tract. These drugs do not shrink tumors in all patients and when they do, it is
generally for a limited amount of time. This has led scientists to look for different ways
to treat cancer.

New drugs have been developed to treat cancer that work differently than standard
chemotherapy drugs. One new class of drugs are called 'angiogenesis-inhibitors'. These drugs
attempt to decrease the blood supply to tumors. By doing so, this may limit the tumor's
source of oxygen and nutrients and prevent the tumor from growing. Bevacizumab is an
anti-angiogenic drug.

In some other cancers such as colon cancer and lung cancer, combining bevacizumab with
standard chemotherapy shrinks tumors in a greater proportion of patients and makes patients
live longer than using standard chemotherapy alone. This has never been tested in urothelial
cancer and we do not know if bevacizumab will have the same effects in this disease. The
purpose of this study is to find out what effects, good and/or bad, the combination of
gemcitabine, carboplatin, and bevacizumab has on you and your cancer.

This is a phase II trial of gemcitabine, carboplatin, and bevacizumab in chemotherapy naïve
patients with advanced/metastatic transitional cell carcinoma (TCC) of the urothelial tract.

Inclusion Criteria:

- Histologic documentation: diagnosis of transitional cell carcinoma of the
bladder,urethra, ureter, or renal pelvis.

- Unresectable or metastatic disease

- Ineligible for cisplatin (or incurable with cisplatin)

- ≥ 4 weeks since prior RT

- Karnofsky Performance Status ≥ 60%

- Age ≥ 18 years of age

- Required Initial Laboratory Values: Absolute neutrophil count ≥ 1.2 x 109/L;
Platelets ≥ 100 x 109/L; Bilirubin ≤ 1.5 times the upper limit of normal (x ULN) for
the institution; Aspartate transaminase (AST) and alanine transaminase(ALT) ≤ 3.0 x
ULN;Serum creatinine < 2.0 or calculated creatinine clearance (CrCl) ≥ 30 mL/min

Exclusion Criteria:

- Prior treatment with systemic chemotherapy (prior intravesical therapy is permitted)

- Current, recent (within 4 weeks of the first infusion of this study), or planned
participation in an experimental drug study other than a Genentech-sponsored
bevacizumab cancer study

- Blood pressure of >150/100 mmHg

- Unstable angina

- New York Heart Association (NYHA) Grade II or greater congestive heart failure

- History of myocardial infarction within 6 months

- History of stroke within 6 months

- Clinically significant peripheral vascular disease

- Evidence of bleeding diathesis or coagulopathy

- Presence of central nervous system or brain metastases

- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to Day 0

- Anticipation of need for major surgical procedure during the course of the study

- Minor surgical procedures such as fine needle aspirations or core biopsies within 7
days prior to Day 0

- Pregnant (positive pregnancy test) or lactating

- Albuminuria as demonstrated by a urinary albumin of greater or = to 1.0 g/24 hr at
screening

- History of abdominal fistula, gastrointestinal perforation, or intra abdominal
abscess within 6 months prior to Day 0

- Serious, non-healing wound, ulcer, or bone fracture

- Inability to comply with study and/or follow-up procedures

- History of persistent gross hematuria

We found this trial at

sites

Memorial Sloan Kettering Cancer Center

1275 York Ave
New York, New York 10021

(212) 639-2000