ClinicalTrials.gg
TerminatedNCT04294277PEGASUSUpdated Apr 18, 2025Results posted

Safety and Efficacy of Pemigatinib in Patients With High-risk Urothelial Cancer After Radical Surgery

A Phase 2 interventional study of Pemigatinib in Urothelial Cancer, sponsored by European Association of Urology Research Foundation. Terminated at 5 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-04-18.

Sponsored by European Association of Urology Research Foundation · Phase 2, Interventional, and Treatment

Why this study was terminated
Screening success and patient recruitment was much lower than projected and a clinical/scientific interpretation will not be possible.
Phase
Phase 2
Study type
Interventional
Enrollment
2
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this clinical trial is to demonstrate the benefit of Pemigatinib, a drug that has indicated promising effects for relapse free survival in molecularly-selected, high-risk patients with urothelial carcinoma (UC) who have received radical surgery. Patients will receive Pemigatinib at a once-daily dose on a continuous schedule, continued until 12 months.

Read the detailed description

This is an open-label, single-arm, Phase II study, evaluating safety and efficacy of INCB054828 (Pemigatinib) as adjuvant therapy for molecularly-selected, high-risk patients with urothelial carcinoma (UC) who have received radical surgery. Patients will receive Pemigatinib at a once-daily (QD) dose of 13.5 mg on a continuous schedule. Treatment will be continued until 12 months, or until the evidence of disease relapse or onset of unacceptable toxicity.

Hyperphosphatemia can be managed with diet modification, phosphate binders, or dose modification. Since mineralization of the cornea and retinal changes consisting of serous retinal detachment have been reported in humans, ophthalmic exams are done at baseline and once every 12 weeks during treatment and should include a visual acuity test, slit-lamp examination and fundoscopy. Additional assessments (e.g. Orbital computerized tomography (CT) should be done if clinically relevant retinal findings are observed on ophthalmologic exams and in participants with reported visual adverse events (AEs) or change in visual acuity, if the events or changes are suspected to be of retinal origin.

02

Conditions studied

  • Urothelial Cancer

Keywords

  • Urothelial carcinoma
  • FGFR inhibitor
  • Pemigatinib
03

In context

Carcinoma, Transitional Cell

633 studies on the registry are indexed under Carcinoma, Transitional Cell; 181 are open to participants now.

This study's enrollment of 2 is below the median of 50 across 500 interventional studies indexed under Carcinoma, Transitional Cell.

Browse Carcinoma, Transitional Cell studies →

Lead sponsor

European Association of Urology Research Foundation is the lead sponsor of 10 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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

  • Histological evidence of pT3-4 and/or pN1-3 UC of the urinary bladder or upper urinary tract after radical cystectomy / radical nephroureterectomy. Patients with mixed histologies are required to have a dominant (i.e. at least 50%) urothelial cell carcinoma pattern.
  • Previous administration of at least 3 cycles of cisplatin-based chemotherapy OR, if neoadjuvant chemotherapy was not administered, ineligibility to receive cisplatin-based adjuvant chemotherapy based on Galsky's criteria, that include at least one of the following: (1) ≥ 2 and/or (2) creatinine-clearance \< 60 ml/min and/or (3) Gr ≥ 2 hearing loss and/or (4) CTCAE Gr ≥ 2 neuropathy.
  • Evidence of FGFR alterations (mutations or translocations as specified in protocol) as assessed by a centralized Foundation Medicine test (Foundation One).
  • Recovered with no evidence of disease confirmed by radiological images, prior to start of adjuvant therapy within 13 weeks after radical surgery.
  • Willingness to avoid pregnancy or fathering children
  • Written .

Exclusion criteria

Exclusion Criteria:

  • Any previous receipt of a selective FGFR inhibitor.
  • Presence of primary CIS only.
  • Presence of another in the 3 years before enrolment except for basal cell carcinoma or squamous cell carcinoma of the skin, cis of cervix, localised prostate cancer in active surveillance or other non invasive or other indolent malignancy that has undergone potentially curative therapy.
  • Presence of pregnancy or lactation.
  • Distant (M1 disease).
  • Treatment with other drugs, receipt of anticancer medications (except for cisplatin-based chemotherapy, see second inclusion criterion) or radiotherapy after radical surgery.
  • Use of any potent inhibitors or inducers within 14 days or 5 half lives (whichever is longer) before the first dose of study treatment.
  • Abnormal laboratory parameters:

    • Total ≥ 1.5 × (ULN; ≥ 2.5 × ULN if Gilbert syndrome).
    • and/or ALT > 2.5 × ULN
    • ≤ 30 mL/min based on Cockroft-Gault.
    • Serum phosphate > institutional ULN.
    • Serum calcium outside of the institutional normal range or serum albumin-corrected calcium outside of the institutional normal range when serum albumin is outside of the institutional normal range.
  • History of infection or active tuberculosis infection.
  • Diagnosis of immunodeficiency or receiving chronic systemic therapy (exceeding > 10 mg daily of prednison equivalent; inhalation steroids are permitted).
  • Evidence of virus or virus active infection or risk of reactivation.
  • Severe hepatic impairment
  • Known prior severe to investigational products or its
  • History of or uncontrolled cardiac disease, including unstable angina, acute myocardial infarction within 6 months of enrolment, Class III or IV.
  • Current evidence of corneal disorder/keratopathy (including but not limited to bullous/band keratopathy, corneal abrasion, inflammation/ulceration, keratoconjunctivitis, etc) or retinal disorder (including but not limited to, central serous retinopathy, macular/retinal degeneration, diabetic retino-pathy, retinal detachment, etc) as confirmed by ophthalmologic examination.
  • Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits.
Terms in these criteria, in plain language(20)

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.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

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.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

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.

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.

Metastases

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

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.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

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.

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.

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.

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.

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.

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.

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.

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.

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.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

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

Study arms

  • Experimental
    Treatment arm

    Treatment with Pemigatinib at the protocol-defined dose administered orally once daily as continuous therapy schedule until 12 months.

    Drug: Pemigatinib

Interventions

  • At Day 1, prior to the start of treatment, results from screening visit evaluations are reviewed to determine eligibility requirements. Subsequent visits during treatment phase will take place at Day 8, Day 15 and Day 21 and subsequently at 3 week intervals. Timing of subsequent visits can be prolonged to max. 9 week intervals if no problems exist during the first 12 weeks of therapy. Subjects will self-administer study drug using an oral QD regimen in a continuous dosing schedule. Each dose of Pemigatinib should be taken first thing in the morning upon waking or after a 2-hour fast; subjects should then fast for an additional 1 hour after taking study drug. The starting dose is 13.5 mg Pemigatinib. Study treatment will continue until 12 months, or until the evidence of disease relapse or onset of unacceptable toxicity.

    Also known as: INCB054828

06

What researchers measure

Primary outcomes

  1. Mean Relapse-free Survival (RFS) After Start of Treatment With Pemigatinib.

    In the protocol, RFS at Year 2 was defined as the time from the start of treatment until disease relapse by Investigator determination, study-end or lost to follow-up, or death due to any cause. Due to the Covid-19 crisis causing significant delay of recruitment and the fact that we needed much more patients to identify patients with FGFR3 alterations, the study recruitment was prematurely stopped in November 2021 when 46 patients were screened and only 4 among 42 tested (9.5%) patients were identified with FGFR3 alterations. Two of the FGFR3 positive patients started treatment and the others were ineligible for the study. Since patients withdrawing from the study before completing the study period of 2 years cannot be included in the calculation of the 2-year RFS rate, the outcome results through premature study-end are presented.

    Time frame: Mean Relapse-free survival rate from start of treatment through premature study-end with a maximal follow-up of 62 weeks.

Secondary outcomes

  1. Mean Overall Survival After Start of Treatment With Pemigatinib.

    Mean Overall Survival of patients who started treatment with Pemigatinib is defined as the time from the start of treatment until the last date known alive, or death due to any cause through premature study-end.

    Time frame: Mean Overall Sturvival from start of treatment through premature study-end with a maximal follow-up of 62 weeks.

07

Results

Posted Apr 18, 2025
Limitations and caveats
In 2020, we started in 5 Italian centers. We expected that 30% of the screened patients (pts) had FGFR3 alterations (F3). Due to the Covid-19 crisis (recruitment delay) and the fact that we needed more pts to identify F3, recruitment prematurely stopped in Nov. 2021 with 42 pts screened and only 4/42 tested identified with F3 (9%). Two out of 4 pts were ineligible and only 2 started treatment and were followed until Study-End in Nov. 2022 resulting in a limited follow-up of maximal 62 weeks.

Participant flow

In 2020, the study was started in 5 Italian centers and recruitment commenced. The first patient was screened in July 2020.

Participant flow — Overall Study
MilestoneTreatment Arm
Started2
Completed0
Not completed2

Outcome measures

PrimaryMean Relapse-free Survival (RFS) After Start of Treatment With Pemigatinib.

In the protocol, RFS at Year 2 was defined as the time from the start of treatment until disease relapse by Investigator determination, study-end or lost to follow-up, or death due to any cause. Due to the Covid-19 crisis causing significant delay of recruitment and the fact that we needed much more patients to identify patients with FGFR3 alterations, the study recruitment was prematurely stopped in November 2021 when 46 patients were screened and only 4 among 42 tested (9.5%) patients were identified with FGFR3 alterations. Two of the FGFR3 positive patients started treatment and the others were ineligible for the study. Since patients withdrawing from the study before completing the study period of 2 years cannot be included in the calculation of the 2-year RFS rate, the outcome results through premature study-end are presented.

Time frame:
Mean Relapse-free survival rate from start of treatment through premature study-end with a maximal follow-up of 62 weeks.
Reported as:
Mean · weeks
Mean Relapse-free Survival (RFS) After Start of Treatment With Pemigatinib.
weeksMean RFS for Patients Treated With Pemigatinib.
Mean Relapse-free Survival (RFS) After Start of Treatment With Pemigatinib.26.6 (6.9 to 46.4)
SecondaryMean Overall Survival After Start of Treatment With Pemigatinib.

Mean Overall Survival of patients who started treatment with Pemigatinib is defined as the time from the start of treatment until the last date known alive, or death due to any cause through premature study-end.

Time frame:
Mean Overall Sturvival from start of treatment through premature study-end with a maximal follow-up of 62 weeks.
Reported as:
Mean · weeks
Mean Overall Survival After Start of Treatment With Pemigatinib.
weeksMean Overall Survival of Patients Treated With Pemigatinib.
Mean Overall Survival After Start of Treatment With Pemigatinib.34.2 (6.9 to 61.6)

Adverse events

Collected over From start of treatment to premature study end with a maximal follow-up of 62 weeks.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Treatment Arm0/2 (0%)0/2 (0%)2/2 (100%)
Most frequent other events
Showing 10 of 14
Most frequent other events
EventTreatment Arm
high level of urea in bloodBlood and lymphatic system disorders1/2
worsening visual acuityEye disorders1/2
photophobiaEye disorders1/2
dygeusiaGeneral disorders1/2
weight lossGeneral disorders1/2
hypotensionGeneral disorders1/2
xerostomiaGeneral disorders1/2
mouth ulcersInfections and infestations1/2
aching sole of footMusculoskeletal and connective tissue disorders1/2
redness of basaliomaSkin and subcutaneous tissue disorders1/2

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Treatment Arm
<=18 years0
Between 18 and 65 years0
>=65 years2
Age, Continuous
Age, Continuous(years)Treatment Arm
Mean73.5 (71 to 76)
Sex: Female, Male
Sex: Female, Male(Participants)Treatment Arm
Female0
Male2
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Treatment Arm
Region of Enrollment
Region of Enrollment(participants)Treatment Arm
Italy2
08

Study locations

5 sites
  • ASST Papa Giovanni XXIII
    Bergamo, Italy
  • Policlinico Sant'Orsola-Malpighi - Azienda Ospedaliero-Univeristaria di Bologna
    Bologna, Italy
  • Fondazione IRCCS Istituto Nazionale dei Tumori
    Milano, Italy
  • IRCCS San Raffaele Hospital
    Milano, Italy
  • Fondazione Policlinico Universitario A. Gemelli, IRCCS
    Roma, Italy
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 18, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04294277
Lead sponsor
European Association of Urology Research Foundation
Collaborators
Incyte Biosciences International Sàrl, AMS Advanced Medical Services GmbH, High Research s.r.l.
Responsible party
Sponsor
First posted
Mar 4, 2020
Start date
Jul 13, 2020
Primary completion
Nov 15, 2021
Completion
Nov 15, 2022
Results posted
Apr 18, 2025
Last update
Apr 18, 2025

Study contacts

Andrea Necchi, Dr.
principal investigator · IRCCS San Raffaele Hospital

Oversight

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

Not currently enrolling

This study is terminated, as verified in Apr 2025. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Pemigatinib

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