308 Participants Needed

V940 + BCG for Bladder Cancer

Recruiting at 11 trial locations
TF
Overseen ByToll Free Number
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Merck Sharp & Dohme LLC
Must be taking: Antiretroviral therapy
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

What is the purpose of this trial?

Researchers are looking for new ways to treat people with high-risk non-muscle invasive bladder cancer (HR NMIBC). NMIBC is cancer in the tissue that lines the inside of the bladder but has not spread to the bladder muscle or outside of the bladder. High-risk means NMIBC may have a high chance of getting worse or coming back after treatment. HR NMIBC can also include carcinoma in situ (CIS). CIS is bladder cancer that appears flat and is only in the inner layer (surface) of the bladder. CIS is not raised and is not growing toward the center of the bladder. The standard treatment for HR NMIBC is a procedure to remove the tumor called transurethral resection of the bladder tumor (TURBT) followed by Bacillus Calmette-Guerin (BCG). Standard treatment is something that is considered the first line of treatment for a condition. BCG is an immunotherapy, which is a treatment that helps the immune system fight cancer. However, BCG may not work to treat HR NMIBC in some people. Researchers want to learn if adding intismeran autogene, the study treatment, to standard treatment can help treat HR NMIBC. Intismeran autogene is designed to help a person's immune system attack their specific cancer. The goals of this study are to learn: * If people who receive intismeran autogene with BCG live longer without the cancer growing, spreading, or coming back, or dying from any cause, compared to people who receive BCG alone * If more people who receive intismeran autogene with BCG have their cancer go away (complete response), compared to people who receive BCG alone * How many people who receive intismeran autogene without BCG have their cancer go away

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are on systemic anticancer therapy or chronic systemic steroid therapy, you may need to stop these before joining the trial.

What data supports the effectiveness of the treatment V940 + BCG for bladder cancer?

The research highlights the effectiveness of BCG (a type of bacteria used in treatment) in managing bladder cancer, especially in preventing tumor recurrence and progression. This suggests that combining BCG with V940 could potentially enhance treatment outcomes for bladder cancer.12345

Is the V940 + BCG treatment for bladder cancer safe?

The safety of Bacillus Calmette-Guerin (BCG) for bladder cancer has been studied, showing that while it is generally effective, it can cause side effects. These side effects are not fully understood, but research is ongoing to improve safety and reduce adverse reactions.46789

Research Team

MD

Medical Director

Principal Investigator

Merck Sharp & Dohme LLC

Eligibility Criteria

This trial is for individuals with high-risk non-muscle invasive bladder cancer (HR NMIBC), including carcinoma in situ (CIS). Participants must have had a recent tumor removal surgery and either never received BCG therapy or not within the last two years. People living with well-controlled HIV on treatment can join, but those who've had certain BCG treatments or refuse specific therapies cannot participate.

Inclusion Criteria

I am not eligible for or am refusing bladder instillation therapy.
I have HIV and it is well controlled with medication.
My bladder cancer is high-risk but has not invaded the muscle.
See 4 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either BCG monotherapy or intismeran autogene in combination with BCG. BCG is administered once weekly for 6 weeks, then once weekly on weeks 13-15, 25-27, 49-51, and 73-75. Intismeran autogene is administered every 3 weeks for 9 doses.

Approximately 18 months

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments for event-free survival and recurrence-free survival.

Up to approximately 5 years

Treatment Details

Interventions

  • V940
Trial Overview The study tests if adding V940 to standard BCG immunotherapy improves outcomes for HR NMIBC patients. It aims to see if this combination helps people live longer without cancer growth, spread, recurrence, or death compared to just receiving BCG. Researchers also want to know how many achieve complete cancer remission with V940 alone.
Participant Groups
3Treatment groups
Experimental Treatment
Active Control
Group I: Intismeran autogene + BCGExperimental Treatment2 Interventions
Participants receive 1 mg of intismeran autogene via intramuscular (IM) injection every 3 weeks (Q3W) for 9 doses. Participants also receive 50 mg of TICE® BCG once weekly for 6 weeks, then once weekly on weeks 13-15, 25-27, 49-51, and 73-75.
Group II: Intismeran autogeneExperimental Treatment1 Intervention
Participants receive 1 mg of intismeran autogene via intramuscular (IM) injection every 3 weeks (Q3W) for 9 doses.
Group III: BCGActive Control1 Intervention
Participants receive 50 mg of TICE® BCG once weekly for 6 weeks, then once weekly on weeks 13-15, 25-27, 49-51, and 73-75.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Merck Sharp & Dohme LLC

Lead Sponsor

Trials
4,096
Recruited
5,232,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

ModernaTX, Inc.

Industry Sponsor

Trials
127
Recruited
66,790,000+

Dr. Stephen Hoge

ModernaTX, Inc.

Chief Medical Officer

MD from Harvard Medical School

Stéphane Bancel profile image

Stéphane Bancel

ModernaTX, Inc.

Chief Executive Officer since 2011

MBA from Harvard Business School, MSc in Engineering from École Centrale Paris

Findings from Research

This study aims to systematically evaluate the efficacy and safety of Bacillus Calmette-Guerin (BCG) treatment for bladder cancer by reviewing high-quality trials from various databases, ensuring a comprehensive analysis.
The findings will provide crucial evidence to determine the effectiveness of BCG in treating bladder cancer, potentially influencing treatment decisions for patients.
Efficacy and safety of Bacillus Calmette-Guerin for bladder cancer: A protocol of systematic review.Zhang, ZH., Yin, L., Zhang, LL., et al.[2023]
In a study of 36 patients undergoing Mycobacterium bovis bacillus Calmette-Guérin (BCG) maintenance therapy for high-risk non-muscle-invasive bladder cancer, 86.7% of those who completed the therapy experienced local adverse reactions, indicating that while the therapy is common, side effects are prevalent.
The analysis suggested that severe adverse reactions, such as gross hematuria and systemic effects during the initial induction therapy, may contribute to a higher rate of discontinuation of the maintenance therapy, highlighting the importance of monitoring and managing these side effects.
Adverse reactions related to treatment compliance during BCG maintenance therapy for non-muscle-invasive bladder cancer.Miyazaki, J., Hinotsu, S., Ishizuka, N., et al.[2013]
In a study of 114 patients with non-muscle invasive bladder cancer, the BCG Danish 1331 strain showed a significantly lower incidence of moderate to severe adverse events compared to the BCG Moscow-I strain, indicating it may be a safer option for treatment.
Both strains demonstrated similar efficacy in terms of 3-year recurrence-free survival (80.0% for Danish 1331 vs. 72.9% for Moscow-I) and progression-free survival (96.5% for Danish 1331 vs. 97.8% for Moscow-I), suggesting that while safety profiles differ, their effectiveness in preventing cancer recurrence is comparable.
Intravesical bacillus Calmette-Guerin (BCG) in treating non-muscle invasive bladder cancer-analysis of adverse effects and effectiveness of two strains of BCG (Danish 1331 and Moscow-I).Thyavihally, YB., Dev, P., Waigankar, S., et al.[2022]

References

Efficacy of bacillus Calmette-Guérin in the treatment of superficial bladder cancer: the impact of previous intravesical treatment. [2009]
Long-term outcomes of high-grade T1 bladder cancer treated with intravesical bacillus Calmette-Guérin: experience of a single center. [2022]
Strategies for optimizing bacillus Calmette-Guérin. [2013]
Efficacy and safety of Bacillus Calmette-Guerin for bladder cancer: A protocol of systematic review. [2023]
Low dose Pasteur bacillus Calmette-Guerin regimen in stage T1, grade 3 bladder cancer therapy. [2020]
Adverse reactions related to treatment compliance during BCG maintenance therapy for non-muscle-invasive bladder cancer. [2013]
Bacillus Calmette-Guerin for the Treatment of Non-muscle Invasive Bladder Cancer: History and Current Status. [2022]
Intravesical bacillus Calmette-Guerin (BCG) in treating non-muscle invasive bladder cancer-analysis of adverse effects and effectiveness of two strains of BCG (Danish 1331 and Moscow-I). [2022]
9.Russia (Federation)pubmed.ncbi.nlm.nih.gov
IMMUNOTHERAPY OF BLADDER CANCER. BCG VACCINE: PRINCIPLES OF ACTION, EFFICACY AND SAFETY. [2018]
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