Purpose

This phase IV trial studies whether there is a relationship between how a patient is positioned while receiving bacillus Calmette Guerin (BCG) within the bladder (intravesical) and how long BCG stays in the bladder (dwell time) to improve the treatment of non-muscle invasive bladder cancer. For the past 40 years, intravesical BCG has been used for the treatment of non-muscle invasive bladder cancer. An important factor for BCG treatment is the dwell time, which is the period of time a patient can hold the BCG medication in the bladder after it has been given. Normally, patients are instructed during intravesical BCG treatment to avoid emptying the bladder for 2 hours after the BCG is given. However, this may be difficult for some patients who may have limited bladder capacity, restricted movement, or severe urinary symptoms. There have been studies outlining the relationship with increased dwell time and how well the treatment works, but studies on the potential impact of patient positioning or activity on the patient's ability to retain the drug are limited. Researchers hope by studying whether there is a relationship between patient positioning during intravesical BCG treatment and dwell time, they may be able to improve how BCG treatment for non-muscle invasive bladder cancer is given, especially for patients with limited bladder capacity, restricted movement, or severe urinary symptoms.

Condition

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Patient with intermediate or high risk NMIBC opting for intravesical induction BCG - Has not initiated induction therapy - Able to remain in supine position for two hours. (Head may be raised on up to two pillows) - Able to remain in a sitting position for two hours - Willingness to utilize a wearable fitness tracker for at least five days during the study - Able to perform a remote video or telephone encounter - Able to provide informed consent

Exclusion Criteria

  • Receipt of intravesical BCG within the past 1 year - Known inability to retain BCG - History of urinary incontinence with a score of 3 or more on the Overactive Bladder Survey (OAB) urgency, urgency incontinence, or incontinence questions - Refusal to wear a fitness tracker during a 24-hour baseline, during treatment, and/or for 2 hours post treatment

Study Design

Phase
Phase 4
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Treatment (BCG no restrictions, BCG lying down, BCG sitting)
Patients receive SOC BCG therapy QW and post-treatment activity guidance for the first three weekly BCG installations in the absence of disease progression or unacceptable toxicity. FIRST TREATMENT: Patients receive SOC BCG intravesically and instructions to avoid urination for two hours with no activity restrictions and immediate clinic discharge. SECOND TREATMENT: Patients receive SOC BCG intravesically and remain in a lying down position for as long as able to hold treatment in for up to 2 hours. THIRD TREATMENT: Patients receive SOC BCG intravesically and remain in a sitting position for as long as able to hold treatment in for up to 2 hours. Additionally, patients receive and wear a Fitbit activity tracker throughout the study.
  • Procedure: Accelerometry
    Receive and wear Fitbit
  • Biological: BCG Solution
    Given intravesically with no activity restrictions
    Other names:
    • Bacillus Calmette Guerin Solution
    • Bacillus Calmette-Guerin Solution
    • TICE BCG Solution
  • Biological: BCG Solution
    Given intravesically in lying down position
    Other names:
    • Bacillus Calmette Guerin Solution
    • Bacillus Calmette-Guerin Solution
    • TICE BCG Solution
  • Biological: BCG Solution
    Given intravesically in sitting position
    Other names:
    • Bacillus Calmette Guerin Solution
    • Bacillus Calmette-Guerin Solution
    • TICE BCG Solution
  • Other: Electronic Health Record Review
    Ancillary studies
  • Behavioral: Patient Discharge
    Receive immediate clinic discharge
    Other names:
    • Discharge
    • Discharge from Healthcare Facility
    • Release
  • Other: Survey Administration
    Ancillary studies

Recruiting Locations

Ohio State University Comprehensive Cancer Center
Columbus, Ohio 43210
Contact:
Cheryl T. Lee, MD
614-685-4713
cheryl.lee@osumc.edu

More Details

Status
Recruiting
Sponsor
Ohio State University Comprehensive Cancer Center

Study Contact

The Ohio State University Comprehensive Cancer Center
800-293-5066
OSUCCCClinicaltrials@osumc.edu

Detailed Description

PRIMARY OBJECTIVES: I. To assess the relationship between bacillus Calmette Guerin (BCG) dwell time and patient position in subjects with intermediate risk (IR) and high risk (HR) non-muscle-invasive bladder cancer (NMIBC). II. To assess the feasibility of a fitness tracker for remote capture of patient vitals and mobility during intravesical BCG treatment. OUTLINE: Patients receive standard of care (SOC) BCG therapy once a week (QW) and post-treatment activity guidance for the first three weekly BCG installations in the absence of disease progression or unacceptable toxicity. FIRST TREATMENT: Patients receive SOC BCG intravesically and instructions to avoid urination for two hours with no activity restrictions and immediate clinic discharge. SECOND TREATMENT: Patients receive SOC BCG intravesically and remain in a lying down position for as long as able to hold treatment in for up to 2 hours. THIRD TREATMENT: Patients receive SOC BCG intravesically and remain in a sitting position for as long as able to hold treatment in for up to 2 hours. Additionally, patients receive and wear a Fitbit activity tracker throughout the study.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.