Ignite Creation Date:
2025-12-25 @ 2:04 AM
Ignite Modification Date:
2025-12-30 @ 12:46 PM
Study NCT ID:
NCT04574960
Status:
RECRUITING
Last Update Posted:
2025-07-20
First Post:
2020-09-18
Is Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Neoadjuvant Upper Tract Invasive Cancer Trial (NAUTICAL)
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D001749', 'term': 'Urinary Bladder Neoplasms'}], 'ancestors': [{'id': 'D014571', 'term': 'Urologic Neoplasms'}, {'id': 'D014565', 'term': 'Urogenital Neoplasms'}, {'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D052776', 'term': 'Female Urogenital Diseases'}, {'id': 'D005261', 'term': 'Female Urogenital Diseases and Pregnancy Complications'}, {'id': 'D000091642', 'term': 'Urogenital Diseases'}, {'id': 'D001745', 'term': 'Urinary Bladder Diseases'}, {'id': 'D014570', 'term': 'Urologic Diseases'}, {'id': 'D052801', 'term': 'Male Urogenital Diseases'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'D000093542', 'term': 'Gemcitabine'}, {'id': 'D002945', 'term': 'Cisplatin'}, {'id': 'D016190', 'term': 'Carboplatin'}], 'ancestors': [{'id': 'D006571', 'term': 'Heterocyclic Compounds'}, {'id': 'D003841', 'term': 'Deoxycytidine'}, {'id': 'D003562', 'term': 'Cytidine'}, {'id': 'D011741', 'term': 'Pyrimidine Nucleosides'}, {'id': 'D011743', 'term': 'Pyrimidines'}, {'id': 'D006573', 'term': 'Heterocyclic Compounds, 1-Ring'}, {'id': 'D017606', 'term': 'Chlorine Compounds'}, {'id': 'D007287', 'term': 'Inorganic Chemicals'}, {'id': 'D017672', 'term': 'Nitrogen Compounds'}, {'id': 'D017671', 'term': 'Platinum Compounds'}, {'id': 'D056831', 'term': 'Coordination Complexes'}, {'id': 'D009930', 'term': 'Organic Chemicals'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ESTIMATED', 'count': 14}}, 'statusModule': {'overallStatus': 'RECRUITING', 'startDateStruct': {'date': '2021-02-08', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-07', 'completionDateStruct': {'date': '2027-12', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-07-16', 'studyFirstSubmitDate': '2020-09-18', 'studyFirstSubmitQcDate': '2020-10-02', 'lastUpdatePostDateStruct': {'date': '2025-07-20', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2020-10-05', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2026-12', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Feasibility of enrolling cT1-4N0 M0 UTUC patients in a randomized trial of neoadjuvant chemotherapy versus standard of care by assessing pilot trial recruitment rates', 'timeFrame': '24 months'}, {'measure': 'Disease-free survival (DFS)', 'timeFrame': '36 months', 'description': 'DFS is defined as the time from randomization to development of intravesical recurrence, contralateral upper tract recurrence or distant metastasis'}, {'measure': 'Rate of complete pathologic response', 'timeFrame': '36 months', 'description': 'Complete pathologic response is defined as pT0 N0'}], 'secondaryOutcomes': [{'measure': 'Site-specific enrolment rate', 'timeFrame': '24 months'}, {'measure': 'Number of patients approached per site per month', 'timeFrame': '24 months'}, {'measure': 'Number of patients randomized per site per month', 'timeFrame': '24 months'}]}, 'oversightModule': {'isUsExport': False, 'oversightHasDmc': True, 'isFdaRegulatedDrug': False, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Upper tract urothelial carcinoma', 'UTUC'], 'conditions': ['Bladder Cancer', 'Bladder Urothelial Carcinoma']}, 'descriptionModule': {'briefSummary': 'Upper tract urothelial cancer (UTUC) is cancer in the lining of the kidney or ureter (the tube that drains the kidney). This type of cancer is rare and as a result, there are only a few studies that have looked at it.\n\nStandard of care for UTUC would be surgery followed by chemotherapy (adjuvant chemotherapy). However, we know from studies that have looked at cancer of the lining of the bladder, which is a similar cancer in many ways, that treating people with chemotherapy before surgery (neoadjuvant chemotherapy) can lead to longer survival compared to the standard of care. There are no studies to show this in UTUC. Neoadjuvant chemotherapy is thought to help improve survival by treating any cancer that may have spread from the original tumour but that is not visible yet on scans. This study would be the first clinical trial in Canada to evaluate the use of chemotherapy before surgery in this disease setting.\n\nSince UTUC is rare, the purpose of this study is to determine if it is possible to enrol enough patients to a trial looking at the use of chemotherapy before surgery.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Newly diagnosed radiographically visible (CT or MRI) cT1-4 N0 M0 with positive selective urinary cytology, positive bladder urinary cytology, or endoscopic biopsy for high grade urothelial cell carcinoma\n* Age ≥18 years of age\n* Eastern Cooperative Oncology Group (ECOG) score 0-1\n* Medically appropriate candidate for radical nephroureterectomy or ureterectomy as per participating site attending urologic oncologist\n* Medically appropriate candidate for cisplatin-based chemotherapy as per participating site attending medical oncologist\n* Adequate organ system function defined as follows: absolute neutrophil count ≥ 1500/mm3, platelets ≥ 100,00/mm3, hemoglobin ≥ 90 g/L, ALT and AST \\< 2.5 x upper limit of normal, electrolytes (Na, K, Mg, Ca): within normal limits, GFR ≥ 60 mL/min\n\nPatients who are randomized to the adjuvant chemotherapy will be reassessed for suitability to receive adjuvant chemotherapy after definitive surgery (nephroureterectomy or ureterectomy) based on the following criteria:\n\n* pT2-4 N0-3 M0 or pT any N1-3 M0 with predominant urothelial component\n* ECOG score 0-2\n* Medically appropriate candidate for platin-based chemotherapy as per participating site attending medical oncologist\n* Adequate organ system function defined as follows: absolute neutrophil count ≥ 1500/mm3, platelets ≥ 100,00/mm3, hemoglobin ≥ 90 g/L, ALT and AST \\< 2.5 x upper limit of normal, electrolytes (Na, K, Mg, Ca): within normal limits, GFR ≥ 30 mL/min\n\nExclusion Criteria:\n\n* Metastatic disease\n* Radiographically visible nodal disease\n* Concurrent muscle-invasive bladder cancer (non-muscle invasive bladder cancer is acceptable)\n* Solitary kidney\n* Other cancer diagnosis or systemic chemotherapy use within 2 years of study enrollment (prior bladder cancer and intravesical therapy allowed)\n* Concomitant diseases that are a formal exclusion to cisplatin chemotherapy (deafness, ≥ grade II neuropathy, serious active infection)\n* Concomitant use of any other investigational drugs\n* Pregnancy or breast feeding (you must remain on contraception, not father a child or donate sperm while receiving gemcitabine/cisplatin and for 6 months following the last dose)'}, 'identificationModule': {'nctId': 'NCT04574960', 'acronym': 'NAUTICAL', 'briefTitle': 'Neoadjuvant Upper Tract Invasive Cancer Trial (NAUTICAL)', 'organization': {'class': 'OTHER', 'fullName': 'University Health Network, Toronto'}, 'officialTitle': 'Neoadjuvant Chemotherapy in Upper Tract Urothelial Cancer: A Multicentre, Feasibility Pilot Trial', 'orgStudyIdInfo': {'id': '20-5149'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Neoadjuvant Chemotherapy Arm', 'description': 'Gemcitabine/Cisplatin will be administered on a 3-week cycle for up to 4 cycles. This will be followed by surgical intervention (nephroureterectomy or ureterectomy).', 'interventionNames': ['Drug: Gemcitabine', 'Drug: Cisplatin']}, {'type': 'ACTIVE_COMPARATOR', 'label': 'Adjuvant Chemotherapy Arm (Standard of Care)', 'description': 'Patients will undergo surgical intervention (nephroureterectomy or ureterectomy) followed by adjuvant chemotherapy.\n\nPatients with a GFR greater or equal to 60 mL/min will receive Gemcitabine/Cisplatin while those with a GFR greater or equal to 30 mL/min but less than 60 mL/min will receive Gemcitabine/Carboplatin.\n\nGemcitabine/Cisplatin will be administered on a 3-week cycle for up to 4 cycles.\n\nGemcitabine/Carboplatin will be administered on a 3-week cycle for up to 4 cycles.', 'interventionNames': ['Drug: Gemcitabine', 'Drug: Cisplatin', 'Drug: Carboplatin']}], 'interventions': [{'name': 'Gemcitabine', 'type': 'DRUG', 'otherNames': ['Gemzar'], 'description': 'Gemcitabine 1000 mg/m\\^2, IV infusion on days 1 and 8 of each 3-week cycle', 'armGroupLabels': ['Adjuvant Chemotherapy Arm (Standard of Care)', 'Neoadjuvant Chemotherapy Arm']}, {'name': 'Cisplatin', 'type': 'DRUG', 'otherNames': ['Platinol'], 'description': 'Cisplatin 70 mg/m\\^2, IV infusion on day 1 of each 3-week cycle', 'armGroupLabels': ['Adjuvant Chemotherapy Arm (Standard of Care)', 'Neoadjuvant Chemotherapy Arm']}, {'name': 'Carboplatin', 'type': 'DRUG', 'otherNames': ['Paraplatin'], 'description': 'Carboplatin AUC 5-6 calculated using the Calvert formula on day 1 of each cycle', 'armGroupLabels': ['Adjuvant Chemotherapy Arm (Standard of Care)']}]}, 'contactsLocationsModule': {'locations': [{'zip': 'K1H8L6', 'city': 'Ottawa', 'state': 'Ontario', 'status': 'RECRUITING', 'country': 'Canada', 'contacts': [{'name': 'Pascale Juneau', 'role': 'CONTACT', 'email': 'pjuneau@ohri.ca', 'phone': '613-737-8899', 'phoneExt': '73852'}, {'name': 'Rodney Breau, MD', 'role': 'PRINCIPAL_INVESTIGATOR'}], 'facility': 'The Ottawa Hospital', 'geoPoint': {'lat': 45.41117, 'lon': -75.69812}}, {'zip': 'M5G2M9', 'city': 'Toronto', 'state': 'Ontario', 'status': 'RECRUITING', 'country': 'Canada', 'contacts': [{'name': 'Sarah Cheung', 'role': 'CONTACT', 'email': 'sarah.cheung@uhn.ca', 'phone': '(437) 335-2949'}, {'name': 'Girish Kulkarni, MD', 'role': 'PRINCIPAL_INVESTIGATOR'}], 'facility': 'University Health Network', 'geoPoint': {'lat': 43.70643, 'lon': -79.39864}}], 'centralContacts': [{'name': 'Emily Hickey', 'role': 'CONTACT', 'email': 'emily.hickey@uhn.ca', 'phone': '(416) 270-5395'}], 'overallOfficials': [{'name': 'Girish Kulkarni, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'University Health Network - Princess Margaret Hospital'}]}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'University Health Network, Toronto', 'class': 'OTHER'}, 'collaborators': [{'name': 'Bladder Cancer Canada', 'class': 'UNKNOWN'}], 'responsibleParty': {'type': 'SPONSOR'}}}}