ClinicalTrials.gg
CompletedNCT03319745Updated Jun 25, 2024Results posted

Pembrolizumab in Treating Patients With Bladder Cancer Undergoing Radical Cystectomy

A Phase 2 interventional study of Pembrolizumab in Stage I Bladder Cancer AJCC v8, Stage II Bladder Cancer AJCC v8 and Stage III Bladder Cancer AJCC v8, sponsored by M.D. Anderson Cancer Center. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-06-25.

Sponsored by M.D. Anderson Cancer Center · Phase 2, Interventional, and Treatment

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Phase
Phase 2
Study type
Interventional
Enrollment
23
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-15

Among 40 studies testing pembrolizumab in Urinary Bladder Neoplasms — 14 open to participants now, 21 under way, 5 of them phase 3. pembrolizumab · Urinary Bladder Neoplasms.

Enrollment
34th of 40
23 · median 58
Started
2018
with 2 others
Phase 2
25 of 40
11 open now
Registered
15th of 40
by date

Among the 40 studies testing pembrolizumab in Urinary Bladder Neoplasms, this one is the 34th largest by enrollment, is one of 3 that started in 2018, is one of 25 in phase 2, and was the 15th registered.

Urinary Bladder Neoplasms

1,800 studies on the registry are indexed under Urinary Bladder Neoplasms; 446 are open to participants now.

Browse Urinary Bladder Neoplasms studies →

Open to participants now

14 of the 40 studies testing pembrolizumab in Urinary Bladder Neoplasms are open now, in 12 countries. Recruiting first, the newest first:

9 more — sign in →

By country, each count listing its studies:

All 14 open studies →

About pembrolizumab

pembrolizumab: first FDA approval 2014 (KEYTRUDA), first EMA approval 2015. What it is approved for, and how studies give it, is on its page →

Who these studies take

Of the 336 Urinary Bladder Neoplasms studies recruiting now, 256 (76%) set no upper age limit and 22 (7%) stop at 75 or younger; 22 take children under 18; 21 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 40 studies testing pembrolizumab in Urinary Bladder Neoplasms, or all of them as a file.
02

Study summary

This phase II trial studies the side effects of pembrolizumab and to see how well it works in treating patients with bladder cancer who are undergoing surgery to remove the bladder. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread.

Read the detailed description

PRIMARY OBJECTIVE:

I. To characterize the safety profile of pembrolizumab in patients with urothelial carcinoma undergoing radical cystectomy.

SECONDARY OBJECTIVES:

I. To explore a signal of anti-cancer immunological activity by evaluating surgical specimens for evidence of post-treatment lymphocytic infiltration and residual tumor compared to pre-treatment biopsy samples.

II. To explore a signal of biomarker activity by evaluating surgical specimens and blood samples for established and not-so-established markers of response to pembrolizumab.

III. To report the tumor yield and sufficiency of tumor for immunological and biomarker activity.

IV. To examine the interaction of the human microbiome and pathologic response to pembrolizumab.

OUTLINE:

Patients receive pembrolizumab intravenously (IV) over 30 minutes on day 1. Treatment repeats every 3 weeks for up to 2 cycles in the absence of disease progression or unacceptable toxicity. About 4 weeks after treatment, patients then undergo radical cystectomy per standard of care.

After completion of study treatment, patients are followed up to 30 and 90 days.

03

Conditions studied

  • Stage I Bladder Cancer AJCC v8
  • Stage II Bladder Cancer AJCC v8
  • Stage III Bladder Cancer AJCC v8
  • Stage IIIA Bladder Cancer AJCC v8
  • Stage IIIB Bladder Cancer AJCC v8
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Be willing and able to provide written .
  • Have absence of disease as determined by conventional imaging studies and be considered a good surgical candidate by the treating physician.
  • Be willing to participate in the collection of blood and tissue for banking and future correlative studies.
  • Have a performance status of 0 or 1 on the (ECOG) performance scale.
  • (ANC) >= 1,500 /mcL.
  • >= 100,000/mcL.
  • (Hgb) >= 9 g/dL or >= 5.6 mmol/L without (w/o) transfusion within 7 days of assessment.
  • Creatinine OR calculated =\< 1.5 x (ULN) OR >= 30 mL/min for subject with creatinine levels > 1.5 x institutional ULN. Creatinine clearance should be calculated per institutional standard.
  • Total =\< 1.5 x ULN OR direct bilirubin =\< ULN for subjects with total bilirubin levels > 1.5 x ULN
  • (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =\< 2.5 x ULN OR =\< 5 x ULN for subjects with liver metastases.
  • Albumin > 2.5 mg/dL.
  • Coagulation (INR) or prothrombin time (PT) activated partial thromboplastin time (aPTT) =\< 1.5 x ULN unless subject is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants.
  • Female subject of should have a negative urine or serum pregnancy within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
  • Female subjects of childbearing potential must be willing to use an adequate method of for the course of the study through 120 days after the last dose of study medication. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
  • Male subjects of childbearing potential must agree to use an adequate method of contraception, starting with the first dose of study therapy through 120 days after the last dose of study therapy. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.

Exclusion criteria

Exclusion Criteria:

  • Is currently participating and receiving pembrolizumab or has participated in a study of an agent and received pembrolizumab or used an investigational device within 4 weeks of the first dose of study treatment.
  • Has a diagnosis of immunodeficiency or is receiving systemic therapy or any other form of therapy within 7 days prior to the first dose of study treatment.
  • Has a known history of active TB (Bacillus tuberculosis).
  • Has a known history of to pembrolizumab or any of its .
  • Has had prior systemic anti-cancer therapy for the treatment of bladder cancer. Prior intravesical therapies, whether Bacillus Calmette-Guerin (BCG) (including but not limited to: persistent high-grade disease or recurrence within 6 months of receiving at least two courses of intravesical BCG [at least five of six induction doses and at least two of three maintenance doses]; or T1 high-grade disease at the first evaluation following induction BCG alone [at least five of six induction doses]), chemotherapy or otherwise, will remain eligible.
  • Has any other diagnosed within 2 years of screening with the exception of basal or squamous cell skin cancer, or non-invasive cancer of the cervix, or any other cancer deemed by the treating physician to be of low-risk for progression or patient morbidity during the study period.
  • Has known disease as determined by conventional staging studies.
  • Has active disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • Has known history of, or any evidence of active, non-infectious pneumonitis.
  • Has a active infection requiring systemic therapy.
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating physician.
  • Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment.
  • Has received prior therapy with an , anti-PD-L1, or anti-PD-L2 agent.
  • Has a known history of (HIV) (HIV 1/2 antibodies).
  • Has known active (e.g., hepatitis B surface antigen [HBsAg] reactive) or (e.g., hepatitis C virus [HCV] ribonucleic acid [RNA] [qualitative] is detected).
  • Has received a within 30 days of initiation of study therapy. Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist) are live attenuated vaccines, and are not allowed.
Terms in these criteria, in plain language(26)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
23 participants (actual)

Study arms

  • Experimental
    Treatment (pembrolizumab)

    Patients receive pembrolizumab IV over 30 minutes on day 1. Treatment repeats every 3 weeks for up to 2 cycles in the absence of disease progression or unacceptable toxicity. About 4 weeks after treatment, patients then undergo radical cystectomy per standard of care.

    Biological: Pembrolizumab

Interventions

  • BiologicalPembrolizumab

    Given IV

    Also known as: Keytruda, Lambrolizumab, MK-3475, SCH 900475

06

What researchers measure

Primary outcomes

  1. Toxicity for Safety Monitoring (TOX)

    The primary endpoint is a joint endpoint classifying patients as having a toxicity of concern (TOX), defined as the presence of any of these: 1) any 30-day grade 3 or higher surgical complication at least possibly related to the treatment, 2) any toxicity at least possibly related to the treatment that prevents surgery, or 3) death between the start of the study and the 30-day post-surgical assessment as long as it is at least possibly related to pembrolizumab or surgery.

    Time frame: From initiation of pembrolizumab, until 90 days post-surgery, up to a maximum of 5.5 months

Secondary outcomes

  1. Efficacy Endpoint

    To explore anti-cancer immunological activity by evaluating surgical specimens for evidence of post-treatment and residual tumor compared to pre-treatment biopsy samples. The main mechanism for doing so will be via histopathologic review of the radical cystectomy specimen. MIBC participants are defined as responders if they achieve a pT1 stage or less. In the case of NMIBC a pT0 status will be used to identify complete response.

    Time frame: Efficacy endpoint will be measured at time of surgery

07

Results

Posted Jun 25, 2024

Participant flow

23 participants consented, 6 screen failed. 18 participants were found eligible to receive study treatment. 16 out of the 18 were able to undergo surgery.

Participant flow — Overall Study
MilestonePembrolizumab
Started18
Completed16
Not completed2
Withdrew: Death1
Withdrew: Toxicity precluding surgery1

Outcome measures

PrimaryToxicity for Safety Monitoring (TOX)

The primary endpoint is a joint endpoint classifying patients as having a toxicity of concern (TOX), defined as the presence of any of these: 1) any 30-day grade 3 or higher surgical complication at least possibly related to the treatment, 2) any toxicity at least possibly related to the treatment that prevents surgery, or 3) death between the start of the study and the 30-day post-surgical assessment as long as it is at least possibly related to pembrolizumab or surgery.

Time frame:
From initiation of pembrolizumab, until 90 days post-surgery, up to a maximum of 5.5 months
Reported as:
Number · percentage of participants
Toxicity for Safety Monitoring (TOX)
percentage of participantsPembrolizumab
Toxicity for Safety Monitoring (TOX)15 (3 to 33)
SecondaryEfficacy Endpoint

To explore anti-cancer immunological activity by evaluating surgical specimens for evidence of post-treatment and residual tumor compared to pre-treatment biopsy samples. The main mechanism for doing so will be via histopathologic review of the radical cystectomy specimen. MIBC participants are defined as responders if they achieve a pT1 stage or less. In the case of NMIBC a pT0 status will be used to identify complete response.

Time frame:
Efficacy endpoint will be measured at time of surgery
Reported as:
Number · Participants
Efficacy Endpoint
ParticipantsPembrolizumab
Efficacy Endpoint5

Adverse events

Collected over From initiation of pembrolizumab, until 90 days post-surgery, up to a maximum of 5.5 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Pembrolizumab1/18 (5.6%)9/18 (50%)17/18 (94.4%)
Most frequent serious events
Showing 10 of 17
Most frequent serious events
EventPembrolizumab
Thromboemolic EventVascular disorders3/18
Nausea/VomitingGastrointestinal disorders2/18
Pelvic InfectionInfections and infestations2/18
UTIRenal and urinary disorders2/18
Lung InfectionRespiratory, thoracic and mediastinal disorders2/18
AnorexiaGastrointestinal disorders2/18
DehydrationMetabolism and nutrition disorders2/18
SepsisInfections and infestations1/18
MyocarditisCardiac disorders1/18
DyspneaRespiratory, thoracic and mediastinal disorders1/18
Most frequent other events
Showing 10 of 39
Most frequent other events
EventPembrolizumab
AnemiaBlood and lymphatic system disorders14/18
FatigueGeneral disorders9/18
HyponatremiaInvestigations7/18
Creatinine IncreasedRenal and urinary disorders4/18
HypokalemiaInvestigations3/18
ALT IncreasedInvestigations3/18
ArthralgiaMusculoskeletal and connective tissue disorders3/18
Nausea/VomitingGastrointestinal disorders3/18
UTIRenal and urinary disorders3/18
PruritusSkin and subcutaneous tissue disorders3/18

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Pembrolizumab
<=18 years0
Between 18 and 65 years9
>=65 years9
Sex: Female, Male
Sex: Female, Male(Participants)Pembrolizumab
Female4
Male14
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Pembrolizumab
Hispanic or Latino2
Not Hispanic or Latino16
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Pembrolizumab
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White17
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Pembrolizumab
United States18
08

Study locations

1 site
  • M D Anderson Cancer Center
    Houston, Texas 77030, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jan 2018 to primary completion in May 2023, 63 months.

Results were first posted in Jun 2024, 1 year 1 month after primary completion.

Of 155 non-industry phase 2 interventional studies under Urinary Bladder Neoplasms, half reached primary completion within 58 months of starting (the median), counting those still running; a quarter within 39 and three quarters within 103. This study's 63 months is close to that.

Counting every sponsor, half of 194 studies reached it within 52 months; a quarter within 36 and three quarters within 91.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 20, 2017
First posted
Oct 24, 2017
StartActual
Jan 11, 2018
Primary completionActual
May 1, 2023
CompletionActual
May 1, 2023
Results first posted
Jun 25, 2024
Last update
Jun 25, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 25, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03319745
Responsible party
Sponsor
First posted
Oct 24, 2017
Start date
Jan 11, 2018
Primary completion
May 1, 2023
Completion
May 1, 2023
Results posted
Jun 25, 2024
Last update
Jun 25, 2024

Study contacts

Neema Navai
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Pembrolizumab

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