[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100641890":3},{"organization":4,"armGroups":7,"interventions":29,"overallOfficials":136,"centralContacts":141,"locations":146,"responsibleParty":162,"collaborators":164,"id":168,"slug":169,"hasResults":170,"nctId":171,"briefTitle":172,"officialTitle":173,"acronym":57,"eligibilityCriteria":174,"healthyVolunteers":170,"sex":175,"minAge":176,"maxAge":57,"enrollmentInfo":177,"targetDuration":57,"studyType":180,"phases":181,"briefSummary":184,"conditions":185,"keywords":57,"overallStatus":189,"whyStopped":57,"lastUpdateSubmitDate":190,"lastUpdatePostDateStruct":191,"startDateStruct":194,"completionDateStruct":196,"leadSponsor":198,"locationsCount":199},{"fullName":5,"class":6},"University of Washington","OTHER",[8],{"label":9,"type":10,"description":11,"interventionNames":12},"Local consolidative therapy","EXPERIMENTAL","Following a complete re-TURBT, participants with residual bladder disease will receive either concurrent chemoradiation (IMRT\u002FVMAT, 55 Gy in 20 fractions) to bladder +\u002F- pelvic nodes or cystectomy, based on shared decision-making. For patients with a clinical complete response, bladder-directed consolidation is encouraged but optional. Patients with disease outside the true pelvis will receive metastasis-directed therapy (preferably SBRT) following primary chemoradiation to all site of metastasis. Participants then proceed to observation or maintenance pembrolizumab until progression, unacceptable toxicity, or clinical discretion. The study includes longitudinal imaging, cystoscopy, biospecimen collection, and quality-of-life assessments.",[13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28],"Radiation: Intensity-Modulated Radiation Therapy","Radiation: Volume Modulated Arc Therapy","Drug: Cisplatin","Drug: Gemcitabine","Drug: Fluorouracil","Drug: Mitomycin","Procedure: Radical Cystectomy","Procedure: Pelvic Lymphadenectomy","Radiation: Stereotactic Body Radiation Therapy","Procedure: Computed Tomography","Procedure: Positron Emission Tomography","Procedure: Magnetic Resonance Imaging","Procedure: Transurethral Resection of Bladder Tumor","Procedure: Cystoscopy","Procedure: Biospecimen Collection","Other: Questionnaire Administration",[30,39,46,54,58,66,73,78,85,93,101,108,114,120,126,132],{"type":31,"name":32,"description":33,"armGroupLabels":34,"otherNames":35},"RADIATION","Intensity-Modulated Radiation Therapy","Undergo IMRT",[9],[36,37,38],"IMRT","Intensity modulated radiation therapy (procedure)","Intensity Modulated RT",{"type":31,"name":40,"description":41,"armGroupLabels":42,"otherNames":43},"Volume Modulated Arc Therapy","Undergo VMAT",[9],[44,45],"VMAT","Volumetric Modulated Arc Therapy (procedure)",{"type":47,"name":48,"description":49,"armGroupLabels":50,"otherNames":51},"DRUG","Cisplatin","Given IV",[9],[52,53],"Platinol","Cisplatinum",{"type":47,"name":55,"description":49,"armGroupLabels":56,"otherNames":57},"Gemcitabine",[9],null,{"type":47,"name":59,"description":60,"armGroupLabels":61,"otherNames":62},"Fluorouracil","Given fluorouracil",[9],[63,64,65],"5-Fluorouracil","5-Fu","Ribofluor",{"type":47,"name":67,"description":68,"armGroupLabels":69,"otherNames":70},"Mitomycin","Given mitomycin",[9],[71,72],"MITO","MITO-C",{"type":74,"name":75,"description":76,"armGroupLabels":77,"otherNames":57},"PROCEDURE","Radical Cystectomy","Undergo radical cystectomy",[9],{"type":74,"name":79,"description":80,"armGroupLabels":81,"otherNames":82},"Pelvic Lymphadenectomy","Undergo pelvic lymph node dissection",[9],[83,84],"Excision Pelvic Lymph Nodes","Pelvic Lymph Node Dissection",{"type":31,"name":86,"description":87,"armGroupLabels":88,"otherNames":89},"Stereotactic Body Radiation Therapy","Undergo SBRT",[9],[90,91,92],"SBRT","SABR","Stereotactic Ablative Body Radiation Therapy",{"type":74,"name":94,"description":95,"armGroupLabels":96,"otherNames":97},"Computed Tomography","Undergo CT and\u002For PET\u002FCT",[9],[98,99,100],"CT","CT Scan","CAT Scan",{"type":74,"name":102,"description":103,"armGroupLabels":104,"otherNames":105},"Positron Emission Tomography","Undergo PET\u002FCT",[9],[106,107],"PET","PET scan",{"type":74,"name":109,"description":110,"armGroupLabels":111,"otherNames":112},"Magnetic Resonance Imaging","Undergo MRI",[9],[113],"MRI",{"type":74,"name":115,"description":116,"armGroupLabels":117,"otherNames":118},"Transurethral Resection of Bladder Tumor","Undergo TURBT",[9],[119],"TURBT",{"type":74,"name":121,"description":122,"armGroupLabels":123,"otherNames":124},"Cystoscopy","Undergo cystoscopy",[9],[125],"CS",{"type":74,"name":127,"description":128,"armGroupLabels":129,"otherNames":130},"Biospecimen Collection","Undergo collection of blood and urine samples",[9],[131],"Biological Sample Collection",{"type":6,"name":133,"description":134,"armGroupLabels":135,"otherNames":57},"Questionnaire Administration","Ancillary studies",[9],[137],{"name":138,"affiliation":139,"role":140},"T. Martin Ma, MD, PhD","Fred Hutch\u002FUniversity of Washington Cancer Consortium","PRINCIPAL_INVESTIGATOR",[142],{"name":138,"role":143,"phone":144,"phoneExt":57,"email":145},"CONTACT","206-606-7318","mma1@uw.edu",[147],{"facility":139,"status":57,"city":148,"state":149,"zip":150,"country":151,"countryCode":152,"cosmosGeoPoint":153,"geoPoint":158,"contacts":159},"Seattle","Washington","98109","United States","US",{"type":154,"coordinates":155},"Point",[156,157],-122.33207,47.60621,{"lat":157,"lon":156},[160,161],{"name":138,"role":143,"phone":144,"phoneExt":57,"email":145},{"name":138,"role":140,"phone":57,"phoneExt":57,"email":57},{"type":163,"investigatorFullName":57,"investigatorTitle":57,"investigatorAffiliation":57,"oldNameTitle":57,"oldOrganization":57},"SPONSOR",[165],{"name":166,"class":167},"Lopker Family Foundation","UNKNOWN","100641890","phase-1-consolidative-therapy-after-ev--pembrolizumab-in-muscle-invasive-bladder-cancer-reinforce-trial-100641890",false,"NCT07579195","Consolidative Therapy After EV + Pembrolizumab in Muscle Invasive Bladder Cancer, REINFORCE Trial","Consolidative Radiation Therapy or Cystectomy After Initial Favorable Response Succeeding Enfortumab Vedotin Plus Pembrolizumab (REINFORCE)--- A Phase I\u002FII Pilot Feasibility Trial","Inclusion Criteria:\n\n* Age \\>= 18 at the time of screening\n* Ability to understand and willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of potential study participants\n* Histopathologically confirmed cTxN1-3M0, cTxNxM1 or cT4bNxM0 muscle invasive bladder cancer at initial diagnosis\n* Achieved a radiographic complete response (CR) or partial response (PR), per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1 criteria and at the determination of treating physicians) after 3-9 cycles of induction EV + pembro\n* If M1 after completion of EV + pembro, patients need to have =\\\u003C 5 sites of metastasis and all sites of metastasis should be extracranial\n\n  * Note: when counting the number of oligometastatic lesions, each lymph node lesion, whether pelvic or extrapelvic, is counted (for example, 2 distinct lymph nodes in the right external iliac basin count as 2 oligometastatic lesions; one extrapelvic and one pelvic node count as 2 oligometastatic lesions, etc). Five or fewer sites of metastasis applies after the completion of EV + pembro, not at initial diagnosis\n* Be a candidate for consolidative radiation therapy (RT) to the pelvis (if indicated) or cystectomy (if indicated), and all sites of metastasis are amenable to RT\n* Life expectancy \\> 6 months\n* Eastern Cooperative Oncology Group (ECOG) performance 0-2\n* Absolute neutrophil count (ANC) \\>= 1500 \u002FmcL (within 180 days of trial registration)\n* Platelets \\>= 100,000\u002FmcL (within 180 days of trial registration)\n* Hemoglobin \\> 9 g\u002FdL (within 180 days of trial registration)\n* Creatinine =\\\u003C 1.5 x upper limit of normal (ULN) OR \\>= 60 mL\u002Fmin (within 180 days of trial registration)\n* Total bilirubin =\\\u003C 1.5 ULN OR direct bilirubin =\\\u003C ULN if total bilirubin \\> 1.5 x ULN (within 180 days of trial registration)\n* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\\\u003C 2.5 x ULN OR \\\u003C 5 x ULN if patient has live metastasis (within 180 days of trial registration)\n* Albumin \\>= 2.5 g\u002FdL (within 180 days of trial registration)\n* International normalized ratio (INR) or prothrombin time (PT) =\\\u003C 1.5 x ULN unless on anticoagulation therapy, in which case PT or partial thromboplastin time (PTT) should be in the therapeutic range (within 180 days of trial registration)\n* PTT =\\\u003C 1.5 x ULN unless on anticoagulation therapy, in which case PT or PTT should be in the therapeutic range (within 180 days of trial registration)\n* Participants of child-bearing potential must be willing to employ two highly effective and acceptable forms of contraception during, and for at least 90 days after the end of radiation therapy. Women of childbearing potential (WOCBP) must have a negative serum pregnancy test within 72 hours of treatment initiation\n* HIV-infected patients who are healthy and have a low risk of AIDS-related outcomes are included in this trial\n\nExclusion Criteria:\n\n* Prior radiation therapy with field overlapping with current proposed radiation field, precluding delivery of meaningful dose of radiation\n* Intracranial metastasis\n* Any small cell component, or predominant (\\> 50%) sarcomatoid or plasmacytoid histology\n* Other active malignancy or clinically relevant malignancy within past 2 years, per discussion with the principal investigator\n* Genetic conditions that increase sensitivity to radiation, such as Fanconi syndrome, ataxia telangiectasia, and Nijmegen breakage syndrome\n* Active human immunodeficiency virus (HIV) not adequately controlled, active hepatitis B (e.g., hepatitis B virus surface antigen \\[HBsAg\\] reactive) or hepatitis C (e.g., hepatitis C virus \\[HCV\\] ribonucleic acid \\[RNA\\] \\[qualitative\\] is detected)\n* Known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial\n* Any other medical condition that may interfere with trial therapy delivery","ALL","18 Years",{"count":178,"type":179},12,"ESTIMATED","INTERVENTIONAL",[182,183],"PHASE1","PHASE2","This phase I\u002FII clinical trial is evaluating a novel treatment strategy for patients with advanced bladder cancer that is unresectable, has spread to nearby lymph nodes or a limited number of distant sites (oligometastatic disease), and has responded to initial treatment with enfortumab vedotin and pembrolizumab. Although this combination has significantly improved outcomes compared to traditional chemotherapy, many patients are left with residual cancer in the bladder or other sites, and there is currently no established standard approach for managing this remaining disease or determining the optimal duration of systemic therapy. Prolonged treatment can lead to cumulative side effects and negatively impact quality of life.\n\nThis study investigates whether adding consolidative treatment-such as radiation therapy to the bladder and metastatic sites or surgical removal of the bladder (radical cystectomy)-can safely eliminate residual disease and delay cancer progression. Radiation therapy uses high-energy x-rays to precisely target and destroy cancer cells while minimizing exposure to surrounding normal tissues. In selected patients, surgery may be used to remove remaining tumor in the bladder. Targeted radiation techniques, such as stereotactic body radiation therapy (SBRT), may also be used to treat small metastatic sites. This approach may allow for safe discontinuation of systemic therapy, potentially reducing long-term treatment-related side effects.\n\nA key component of this trial is the integration of biomarker testing using circulating tumor DNA (ctDNA) from blood and urine tumor DNA (utDNA). These tests detect small amounts of tumor-derived genetic material and may help identify patients most likely to benefit from consolidative treatment, as well as guide decisions about ongoing therapy. By combining response to systemic therapy with personalized local treatment and biomarker-driven monitoring, this study aims to improve cancer control, reduce complications from untreated local disease, and inform future treatment strategies for patients with advanced bladder cancer.",[186,187,188],"Muscle Invasive Bladder Carcinoma","Stage III Bladder Cancer AJCC v8","Stage IV Bladder Cancer AJCC v8","NOT_YET_RECRUITING","2026-06-17",{"date":192,"type":193},"2026-06-22","ACTUAL",{"date":195,"type":179},"2026-07-01",{"date":197,"type":179},"2029-12-31",{"name":5,"class":6},1]