NCT02447549

Brief Summary

Bladder cancer is the seventh most common cancer in the UK, with 10,399 new cases diagnosed in 2011. In a quarter of these cases the cancer has infiltrated the muscular wall of the bladder (muscle invasive) and is life threatening. This type of bladder cancer is usually treated either with surgical removal of the bladder, or daily radiotherapy treatment (high strength xrays which kill cells), given every day for 4 or 7 weeks. RAIDER will investigate methods which have the potential to improve how well this radiotherapy works. RAIDER is based on a study of novel radiotherapy techniques which was conducted at a single UK NHS Trust. Bladder radiotherapy is normally delivered using a single plan throughout treatment and treats the whole bladder with the same radiotherapy dose. In adaptive radiotherapy the delivery plan is chosen from 3 possible plans. In cancer (tumour) focused radiotherapy, the highest dose of the radiotherapy is aimed at the tumour within the bladder. In RAIDER, at least 240 participants with muscle invasive bladder cancer will be in one of 3 treatment groups:

  1. 1.standard whole bladder radiotherapy
  2. 2.standard dose tumour focused adaptive radiotherapy
  3. 3.dose escalated tumour boost adaptive radiotherapy

Trial Health

78
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
345

participants targeted

Target at P75+ for phase_2

Timeline
35mo left

Started Oct 2015

Longer than P75 for phase_2

Geographic Reach
3 countries

49 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress79%
Oct 2015Mar 2029

First Submitted

Initial submission to the registry

May 11, 2015

Completed
8 days until next milestone

First Posted

Study publicly available on registry

May 19, 2015

Completed
5 months until next milestone

Study Start

First participant enrolled

October 21, 2015

Completed
6.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2021

Completed
7.3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2029

Expected
Last Updated

June 9, 2020

Status Verified

June 1, 2020

Enrollment Period

6.1 years

First QC Date

May 11, 2015

Last Update Submit

June 5, 2020

Conditions

Keywords

IMRTIGRTMuscle invasiveAdaptive Radiotherapy

Outcome Measures

Primary Outcomes (2)

  • Proportion of participants meeting predefined radiotherapy dose constraints in DART group

    Primary outcome of stage 1 of study, predefined radiotherapy dose constraints for bladder, bowel and rectum met for medium plan in DART group.

    4-6 weeks from randomisation

  • Proportion of patients experiencing severe late side effects following radiotherapy.

    Primary outcome of stage 2 of study, late CTC toxicity grade 3 or higher.

    6-18 months post radiotherapy

Secondary Outcomes (9)

  • Clinician reported acute toxicity

    0-6 months post radiotherapy

  • Patient reported outcomes- symptomatic toxicity

    0-24 months post radiotherapy

  • Patient reported outcomes- urinary side effects

    0-24 months post radiotherapy

  • Patient reported outcomes- sexual function

    0-24 months post radiotherapy

  • Patient reported outcomes- chronic gastrointestinal symptoms

    0-24 months post radiotherapy

  • +4 more secondary outcomes

Study Arms (3)

WBRT

ACTIVE COMPARATOR

Standard dose whole bladder radiotherapy

Radiation: WBRT

SART

EXPERIMENTAL

Standard dose Adaptive tumour focused radiotherapy (SART)

Radiation: SART

DART

EXPERIMENTAL

Dose escalated Adaptive tumour boost radiotherapy (DART)

Radiation: DART

Interventions

WBRTRADIATION

One RT plan with whole bladder treated to standard dose.

WBRT
SARTRADIATION

Three plans (small, medium \& large) generated with the standard dose of RT focused on the tumour, sparing the normal bladder from full dose radiation. Pretreatment cone beam CTs will be used to select the best fitting of the three plans prior to treatment.

SART
DARTRADIATION

Three plans (small, medium \& large) generated with a higher dose than standard focused on the tumour and the remainder of the bladder treated to the same dose as in the SART group. Pretreatment cone beam CTs will be used to select the best fitting of the three plans prior to treatment.

DART

Eligibility Criteria

Age16 Years+
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Written informed consent
  • Age ≥16 years
  • Histologically or cytologically confirmed transitional cell carcinoma (TCC) of the bladder
  • Unifocal bladder TCC staged T2-T4a N0 M0\*
  • Fit to receive a radical course of radiotherapy
  • WHO performance status 0-2
  • Willing and able to comply with study procedures and follow up schedule \*Tumour location must be clearly visible on imagine or recorded on a surgical bladder map

You may not qualify if:

  • Nodal or metastatic disease
  • Multifocal invasive disease
  • Simultaneous TCC in upper tract or urethra
  • Pregnancy
  • Active malignancy within 2 years of randomisation (not including non melanomatous skin carcinoma, previous non muscle invasive bladder tumours, NCCN low risk prostate cancer (T1/T2a, Gleason 6 PSA \<10), in situ carcinoma of any site)
  • Bilateral hip replacements
  • Any other conditions that in the Principal Investigator's opinion would be a contra-indication to radiotherapy (e.g. previous pelvic radiotherapy / inflammatory bowel disease)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (49)

Riverina Cancer Care Centre

Wagga Wagga, New South Wales, Australia

Location

Princess Alexandra Hospital

Brisbane, Queensland, Australia

Location

Townsville General Hospital

Douglas, Queensland, Australia

Location

Radiation Oncology Mater Centre QLD

South Brisbane, Queensland, Australia

Location

Royal Hobart Hospital

Hobart, Tasmania, Australia

Location

Austin Hospital

Melbourne, Victoria, Australia

Location

Sir Charles Gairdner Hospital

Nedlands, Western Australia, Australia

Location

Auckland Hospital

Auckland, New Zealand

Location

Christchurch Hospital

Christchurch, New Zealand

Location

Waikato

Hamilton, New Zealand

Location

Torbay District General Hospital

Torquay, Devon, United Kingdom

Location

Barts Health NHS Trust

London, England, EC1M 6BQ, United Kingdom

Location

The Christie NHS Foundation Trust

Manchester, England, M20 4BX, United Kingdom

Location

Nottingham University Hospital NHS Trust

Nottingham, England, NG5 1PB, United Kingdom

Location

Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust

Romford, Essex, United Kingdom

Location

Mount Vernon Cancer Centre

Northwood, Middlesex, United Kingdom

Location

Ayr Hospital

Ayr, Scotland, KA6 6DX, United Kingdom

Location

Maidstone Hospital, Kent Oncology Centre

Adstone, United Kingdom

Location

Belfast City Hospital

Belfast, United Kingdom

Location

Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust

Birmingham, United Kingdom

Location

Queen Elizabeth Hospital, University Hospitals Birmingham NHS Trust

Birmingham, United Kingdom

Location

Bradford Teaching Hospitals NHS Foundation Trust

Bradford, United Kingdom

Location

Royal Sussex County Hospital

Brighton, United Kingdom

Location

Bristol Haematology & Oncology Centre

Brixton, United Kingdom

Location

West Suffolk Hospital

Bury St Edmunds, United Kingdom

Location

Addenbrooke's Hospital

Cambridge, United Kingdom

Location

Velindre Hospital, Cardiff and Vale NHS Trust

Cardiff, United Kingdom

Location

Cheltenham General Hospital

Cheltenham, United Kingdom

Location

University Hospital Coventry

Coventry, United Kingdom

Location

Western General Hospital

Edinburgh, United Kingdom

Location

Royal Devon and Exeter Hospital

Exeter, United Kingdom

Location

Beatson West of Scotland Cancer Centre

Glasgow, United Kingdom

Location

St Luke's Cancer Centre

Guildford, United Kingdom

Location

Leeds Teaching Hospitals NHS Trust

Leeds, United Kingdom

Location

Guy's and St Thomas' Hospital

London, United Kingdom

Location

Royal Marsden NHSFT

London, United Kingdom

Location

Royal Oldham Hospital

Manchester, United Kingdom

Location

The Clatterbridge Cancer Centre NHS Foundation Trust

Metropolitan Borough of Wirral, United Kingdom

Location

Northern Centre for Cancer Care, Freeman Hospital,

Newcastle upon Tyne, United Kingdom

Location

Norfolk and Norwich University Hospital

Norwich, United Kingdom

Location

The Royal Oldham Hospital

Oldham, United Kingdom

Location

Peterborough City Hospital

Peterborough, United Kingdom

Location

Queen Alexandra Hospital

Portsmouth, United Kingdom

Location

Royal Preston Hospital

Preston, United Kingdom

Location

Weston Park Hospital, Sheffield Teaching Hospitals Trust

Sheffield, United Kingdom

Location

Kings Mill Hospital, Sherwood Forest Hospitals Foundation NHS Trust

Sutton in Ashfield, United Kingdom

Location

Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust

Taunton, United Kingdom

Location

Mid Yorkshire Hospitals

Wakefield, United Kingdom

Location

Pinderfields hospital, The Mid Yorkshire Hospitals NHS Trust

Wakefield, United Kingdom

Location

Related Publications (5)

  • Hafeez S, Warren-Oseni K, Jones K, Mohammed K, El-Ghzal A, Dearnaley D, Harris V, Khan A, Kumar P, Lalondrelle S, McDonald F, Tan M, Thomas K, Thompson A, McNair HA, Hansen VN, Huddart RA. Bladder Tumor-Focused Adaptive Radiation Therapy: Clinical Outcomes of a Phase I Dose Escalation Study. Int J Radiat Oncol Biol Phys. 2025 Jan 1;121(1):165-175. doi: 10.1016/j.ijrobp.2024.07.2317. Epub 2024 Jul 26.

  • Huddart R, Hafeez S, Omar A, Alonzi R, Birtle A, Cheung KC, Choudhury A, Foroudi F, Gribble H, Henry A, Hilman S, Hindson B, Lewis R, Muthukumar D, McLaren DB, McNair H, Nikapota A, Olorunfemi A, Parikh O, Philipps L, Rimmer Y, Syndikus I, Tolentino A, Varughese M, Vassallo-Bonner C, Webster A, Griffin C, Hall E. Acute Toxicity of Hypofractionated and Conventionally Fractionated (Chemo)Radiotherapy Regimens for Bladder Cancer: An Exploratory Analysis from the RAIDER Trial. Clin Oncol (R Coll Radiol). 2023 Sep;35(9):586-597. doi: 10.1016/j.clon.2023.05.002. Epub 2023 May 9.

  • Hafeez S, Lewis R, Hall E, Huddart R; RAIDER Trial Management Group. Advancing Radiotherapy for Bladder Cancer: Randomised Phase II Trial of Adaptive Image-guided Standard or Dose-escalated Tumour Boost Radiotherapy (RAIDER). Clin Oncol (R Coll Radiol). 2021 Jun;33(6):e251-e256. doi: 10.1016/j.clon.2021.02.012. Epub 2021 Mar 23. No abstract available.

  • Hafeez S, Webster A, Hansen VN, McNair HA, Warren-Oseni K, Patel E, Choudhury A, Creswell J, Foroudi F, Henry A, Kron T, McLaren DB, Mitra AV, Mostafid H, Saunders D, Miles E, Griffin C, Lewis R, Hall E, Huddart R. Protocol for tumour-focused dose-escalated adaptive radiotherapy for the radical treatment of bladder cancer in a multicentre phase II randomised controlled trial (RAIDER): radiotherapy planning and delivery guidance. BMJ Open. 2020 Dec 31;10(12):e041005. doi: 10.1136/bmjopen-2020-041005.

  • Hafeez S, Lewis R, Griffin C, Hall E, Huddart R. Failing to Close the Gap Between Evidence and Clinical Practice in Radical Bladder Cancer Radiotherapy. Clin Oncol (R Coll Radiol). 2021 Jan;33(1):46-49. doi: 10.1016/j.clon.2020.07.001. Epub 2020 Aug 3. No abstract available.

MeSH Terms

Conditions

Urinary Bladder Neoplasms

Condition Hierarchy (Ancestors)

Urologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteNeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesUrinary Bladder DiseasesUrologic DiseasesMale Urogenital Diseases

Study Officials

  • Robert Huddart

    Institute of Cancer Research/RMNHSFT

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 11, 2015

First Posted

May 19, 2015

Study Start

October 21, 2015

Primary Completion

December 1, 2021

Study Completion (Estimated)

March 1, 2029

Last Updated

June 9, 2020

Record last verified: 2020-06

Locations