Trial of Maintenance SUO11248 Versus Placebo Post Chemotherapy for Patients With Advanced Urothelial Carcinoma

• Histologic/cytologic diagnosis of urothelial carcinoma (transitional cell carcinoma either pure or mixed histology)
• All patients must have received four - six cycles of standard first line chemotherapy (protocol details suggested combinations) for treatment of locally recurrent or metastatic disease AND must have achieved stable disease (SD), partial response (PR), or complete response (CR) to this chemotherapy.
• Type of response, number of cycles and specific regimen given must be carefully recorded and submitted at time of registration.
• Reports from pre and post treatment imaging will be required at time of registration to document response.
• Patients must be registered within 1 month (or the next business day if falls on a weekend or holiday) of scans demonstrating stable disease or better and no more than 42 days after receiving the last standard chemotherapy dose. For example, if patients are receiving treatment on days 1 and 8 of each cycle, day 8 of the last cycle would be considered the last standard chemotherapy dose.
• Patients may have received previous adjuvant or neoadjuvant therapy.
• No prior antiangiogenic therapy for this stage of the disease.

Exclusion Criteria:

• Major surgery within 4 weeks of starting the study treatment.
• NCI CTCAE grade 3 hemorrhage or higher within 4 weeks of starting the study treatment.
• History of or known spinal cord compression, or carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease on screening CT or MRI scan. However treated, stable and asymptomatic brain metastases are allowed.
• Known HIV - positive patients may not participate. This is to avoid additional complications that immune suppression and HIV infection may cause due to the intense nature of the chemotherapy in this trial.
• Any of the following within 6 months prior to study administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (CHF), cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
• Patients with history of or who are suspected to have CHF can be included as long as they are asymptomatic and have an ejection fraction that is equal to or above the institutional lower limit of normal by baseline MUGA(obtained within one month of registration or the next business day if falls on a weekend or holiday).
• Ongoing cardiac dysrhythmias of NCI CTCAE Grade > 2.
• Unresolved bacterial infection.
• Uncontrolled hypertension.
• Pre-existing thyroid abnormality that can not be controlled medically.
• Concurrent treatment on another clinical trial.
• Pregnant or breast-feeding