NCT03682068

Brief Summary

This is a randomized, open-label, controlled, multi-center, global Phase III study to determine the efficacy and safety of combining durvalumab ± tremelimumab with standard of care (SoC) chemotherapy (cisplatin + gemcitabine or carboplatin + gemcitabine doublet) followed by durvalumab monotherapy versus SoC alone as first-line chemotherapy in patients with histologically or cytologically documented, unresectable, locally advanced or metastatic transitional cell carcinoma of the urothelium (including renal pelvis, ureters, urinary bladder, and urethra).

Trial Health

67
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Strong global presence with extensive site network
Enrollment
1,246

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Sep 2018

Longer than P75 for phase_3

Geographic Reach
22 countries

222 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

First Submitted

Initial submission to the registry

September 6, 2018

Completed
18 days until next milestone

First Posted

Study publicly available on registry

September 24, 2018

Completed
3 days until next milestone

Study Start

First participant enrolled

September 27, 2018

Completed
7.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 29, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 29, 2026

Completed
Last Updated

February 3, 2026

Status Verified

January 1, 2026

Enrollment Period

7.6 years

First QC Date

September 6, 2018

Last Update Submit

January 30, 2026

Conditions

Keywords

renal pelvisuretersurinary bladderurethrabladder cancer

Outcome Measures

Primary Outcomes (1)

  • Overall Survival (OS)

    OS is defined as the time from the date of randomization until death due to any cause

    approximately 5 years

Secondary Outcomes (9)

  • Overall Survival (OS)

    approximately 5 years

  • Overall Survival at 24 months (OS24)

    24 months

  • Progression Free Survival (PFS)

    approximately 5 years

  • Alive and Progression Free Survival at 12 months (APF12)

    12 months

  • Objective Response Rate (ORR)

    approximately 5 years

  • +4 more secondary outcomes

Other Outcomes (3)

  • To assess safety using a summary of adverse events.

    approximately 5 years

  • To assess pharmacokinetics of Durvalumab and Tremelimumab

    approximately 5 years

  • To assess immunogenicity of Durvalumab and Tremelimumab

    approximately 5 years

Study Arms (3)

Durvalumab in Combination with SoC Chemotherapy

EXPERIMENTAL

Durvalumab every 3 weeks in concurrence with chemotherapy, followed by durvalumab monotherapy every 4 weeks. All patients will receive one of the following standard of care chemotherapy regimens every 3 weeks for 6 cycles: * cisplatin+ gemcitabine * If the patient is cisplatin-ineligible, carboplatin + gemcitabine

Drug: DurvalumabDrug: Cisplatin + GemcitabineDrug: Carboplatin + Gemcitabine

Durvalumab in Combination with Tremelimumab+SoC Chemotherapy

EXPERIMENTAL

Durvalumab and Tremelimumab every 3 weeks in concurrence with chemotherapy, followed by durvalumab monotherapy every 4 weeks Tremelimumab will be provided for 4 cycles. All patients will receive one of the following standard of care chemotherapy regimens every 3 weeks for 6 cycles: * cisplatin+ gemcitabine * If the patient is cisplatin-ineligible, carboplatin + gemcitabine

Drug: DurvalumabDrug: TremelimumabDrug: Cisplatin + GemcitabineDrug: Carboplatin + Gemcitabine

SoC Chemotherapy

ACTIVE COMPARATOR

Patients will receive one of the following standard of care chemotherapy regimens every 3 weeks for 6 cycles: * cisplatin+ gemcitabine * If the patient is cisplatin-ineligible, carboplatin + gemcitabine

Drug: Cisplatin + GemcitabineDrug: Carboplatin + Gemcitabine

Interventions

Carboplatin IV (intravenous)+ Gemcitabine IV(intravenous), as standard of care.

Durvalumab in Combination with SoC ChemotherapyDurvalumab in Combination with Tremelimumab+SoC ChemotherapySoC Chemotherapy

Durvalumab IV (intravenous infusion)

Also known as: MEDI4736
Durvalumab in Combination with SoC ChemotherapyDurvalumab in Combination with Tremelimumab+SoC Chemotherapy

Tremelimumab IV (intravenous infusion)

Durvalumab in Combination with Tremelimumab+SoC Chemotherapy

Cisplatin IV (intravenous)+ Gemcitabine IV(intravenous), as standard of care.

Durvalumab in Combination with SoC ChemotherapyDurvalumab in Combination with Tremelimumab+SoC ChemotherapySoC Chemotherapy

Eligibility Criteria

Age18 Years - 130 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with histologically or cytologically documented, unresectable, locally advanced or metastatic transitional cell carcinoma (transitional cell and mixed transitional/non-transitional cell histologies) of the urothelium (including renal pelvis, ureters, urinary bladder, and urethra)
  • Patients who have not been previously treated with first-line chemotherapy. Patients who have received prior definitive chemoradiation, adjuvant or neoadjuvant treatment for locally advanced disease are eligible provided that progression to locally advanced or metastatic disease has occurred \>12 months from the last therapy \[for chemoradiation and adjuvant treatment\] or \>12 months from the last surgery \[for neoadjuvant treatment\].
  • At least 1 lesion, not previously irradiated, that qualifies as a RECIST 1.1 target lesion at baseline.
  • World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 at enrolment
  • Adequate organ and marrow function as defined in the protocol
  • Life expectancy ≥12 weeks in the opinion of the investigator
  • Evidence of post-menopausal status, or negative urinary or serum pregnancy test for female pre-menopausal patients.

You may not qualify if:

  • No severe concomitant condition that requires immunosuppression medication
  • Untreated central nervous system (CNS) metastases and/or carcinomatous meningitis
  • Patients who may be eligible for or are being considered for radical resection during the course of the study.
  • Any medical contraindications to platinum (cisplatin or carboplatin) based doublet chemotherapy and/or known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (222)

Research Site

Birmingham, Alabama, 35294, United States

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Bakersfield, California, 93309, United States

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Fullerton, California, 92835, United States

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Los Angeles, California, 90095, United States

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Salinas, California, 93901, United States

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Santa Barbara, California, 93105, United States

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Truckee, California, 96161, United States

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New Haven, Connecticut, 06520, United States

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Washington D.C., District of Columbia, 20007, United States

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Orlando, Florida, 32806, United States

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Chicago, Illinois, 60611, United States

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Fort Wayne, Indiana, 46804, United States

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Kansas City, Kansas, 66160, United States

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Louisville, Kentucky, 40202, United States

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New Orleans, Louisiana, 70112, United States

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Grand Rapids, Michigan, 49503, United States

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Bozeman, Montana, 59715, United States

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New Hyde Park, New York, 11042, United States

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New York, New York, 10029, United States

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New York, New York, 10065, United States

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Rochester, New York, 14642, United States

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Germantown, Tennessee, 38138, United States

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Fort Worth, Texas, 76104, United States

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Ciudad de Buenos Aires, 1280, Argentina

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Ciudad de Buenos Aires, C1120AAT, Argentina

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Ciudad de Buenos Aires, C1419AHL, Argentina

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Ciudad de Buenos Aires, C1426ANZ, Argentina

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Rosario, S2000DEJ, Argentina

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Box Hill, 3128, Australia

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Elizabeth Vale, 5112, Australia

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Kogarah, 2217, Australia

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Macquarie University, 2109, Australia

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Murdoch, 6150, Australia

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Orange, 2800, Australia

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South Brisbane, 4101, Australia

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St Albans, 3021, Australia

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Curitiba, 80810-050, Brazil

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Fortaleza, 60336-232, Brazil

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Porto Alegre, 90020-090, Brazil

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Porto Alegre, 90610-000, Brazil

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Porto Alegre, 91350-200, Brazil

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Ribeirão Preto, 14048-900, Brazil

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Rio de Janeiro, 20231-050, Brazil

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Rio de Janeiro, 22793-080, Brazil

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Salvador, 41.950-610, Brazil

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Santa Maria, 97015-450, Brazil

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São José do Rio Preto, 15090-000, Brazil

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São Paulo, 01246-000, Brazil

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São Paulo, 01327-001, Brazil

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Pleven, 5800, Bulgaria

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Plovdiv, 4000, Bulgaria

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Sofia, 1303, Bulgaria

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Sofia, 1431, Bulgaria

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Sofia, 1527, Bulgaria

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Sofia, 1797, Bulgaria

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Varna, 9010, Bulgaria

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Calgary, Alberta, T2N 5G2, Canada

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Edmonton, Alberta, T6G 1Z2, Canada

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Vancouver, British Columbia, V5Z 4E6, Canada

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Hamilton, Ontario, L8V 5C2, Canada

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Ottawa, Ontario, K1H 8L6, Canada

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Toronto, Ontario, M5G IX6, Canada

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Montreal, Quebec, H3T 1E2, Canada

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Beijing, 100034, China

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Beijing, 100191, China

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Beijing, 100730, China

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Changchun, 130021, China

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Changsha, 410008, China

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Changsha, 410013, China

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Chongqing, 400038, China

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Chongqing, 400042, China

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Dalian, 116027, China

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Guangzhou, 510000, China

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Guangzhou, 510060, China

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Hangzhou, 310003, China

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Hangzhou, 310009, China

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Hangzhou, 310014, China

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Hangzhou, 310022, China

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Jinan, 250012, China

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Nanchang, 330006, China

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Nanjing, 2100008, China

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Shanghai, 200032, China

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Shanghai, 200072, China

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Shenyang, 110001, China

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Suzhou, 215006, China

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Tianjin, 300211, China

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Tianjin, China

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Ürümqi, 830000, China

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Wuhan, 430022, China

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Xi'an, 710061, China

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Brno, 656 91, Czechia

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Hradec Králové, 500 05, Czechia

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Olomouc, 77900, Czechia

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Ostrava, 708 52, Czechia

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Prague, 128 08, Czechia

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Prague, 140 59, Czechia

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Prague, 180 81, Czechia

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Budapest, 1062, Hungary

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Budapest, 1122, Hungary

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Budapest, 1145, Hungary

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Debrecen, 4032, Hungary

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Győr, 9024, Hungary

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Kecskemét, 6000, Hungary

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Szolnok, 5000, Hungary

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Gūrgaon, 122001, India

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Hubli, 580025, India

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Kolkata, 700160, India

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Mysuru, 570017, India

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Nagpur, 440012, India

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Nashik, 422005, India

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New Delhi, 110085, India

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New Delhi, 11029, India

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Pune, 411004, India

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Haifa, 31096, Israel

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Jerusalem, 91120, Israel

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Kfar Saba, 95847, Israel

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Petah Tikva, 4941492, Israel

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Ramat Gan, 52621, Israel

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Arezzo, 52100, Italy

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Milan, 20132, Italy

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Milan, 20133, Italy

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Naples, 80131, Italy

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Orbassano, 10043, Italy

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Parma, 43126, Italy

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Pavia, 27100, Italy

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Roma, 00100, Italy

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Terni, 05100, Italy

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Verona, 37134, Italy

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Bunkyō City, 113-8603, Japan

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Chūōku, 104-0045, Japan

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Fukuoka, 811-1347, Japan

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Hirosaki-shi, 036-8563, Japan

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Kanazawa, 920-8641, Japan

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Kita-gun, 761-0793, Japan

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Koshigaya-shi, 343-8555, Japan

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Kōtoku, 135-8550, Japan

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Kumamoto, 860-0008, Japan

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Kumamoto, 860-8556, Japan

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Kyoto, 606-8507, Japan

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Miyazaki, 889-1692, Japan

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Nagasaki, 852-8501, Japan

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Nagoya, 466-8560, Japan

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Nagoya, 467-0001, Japan

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Niigata, 951-8520, Japan

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Osaka, 541-8567, Japan

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Osaka, 545-8586, Japan

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Osakasayama-shi, 589-8511, Japan

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Shinjuku-ku, 160-8582, Japan

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Suita-shi, 565-0871, Japan

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Toyama, 930-0194, Japan

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Yokohama, 232-0024, Japan

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Yokohama, 241-8515, Japan

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Bacolod, 6100, Philippines

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Baguio City, 2600, Philippines

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Cebu, 6000, Philippines

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Davao City, 8000, Philippines

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Makati, 1229, Philippines

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Manila, 1015, Philippines

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Quezon City, 1101, Philippines

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Quezon City, 1104, Philippines

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Bialystok, 15-027, Poland

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Gdansk, 80-952, Poland

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Grudziądz, 86-300, Poland

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Koszalin, 75-581, Poland

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Krakow, 31-501, Poland

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Olsztyn, 10-228, Poland

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Poznan, 60-693, Poland

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Radom, 26-600, Poland

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Warsaw, 02-781, Poland

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Ivanovo, 153040, Russia

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Krasnoyarsk, 660133, Russia

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Moscow, 105077, Russia

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Moscow, 105229, Russia

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Moscow, 115280, Russia

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Moscow, 125284, Russia

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Nizhny Novgorod, 603074, Russia

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Nizhny Novgorod, 603137, Russia

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Omsk, 644013, Russia

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Rostov-on-Don, 344037, Russia

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Saint Petersburg, 195067, Russia

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Saint Petersburg, 197758, Russia

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Saint Petersburg, 199178, Russia

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Tyumen, 625041, Russia

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Vologda, 160012, Russia

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Goyang-si, 10408, South Korea

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Incheon, 21565, South Korea

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Seoul, 02841, South Korea

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Seoul, 03722, South Korea

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Seoul, 05505, South Korea

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Seoul, 06351, South Korea

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Suwon, 16247, South Korea

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Barcelona, 08908, Spain

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Barcelona, 8003, Spain

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Barcelona, 8035, Spain

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Lugo, 27003, Spain

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Madrid, 28007, Spain

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Madrid, 28034, Spain

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Madrid, 28040, Spain

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Málaga, 29010, Spain

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Santander, 39008, Spain

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Seville, 41013, Spain

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Taichung, 404, Taiwan

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Taichung, 40705, Taiwan

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Tainan, 704, Taiwan

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Taipei, 10050, Taiwan

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Taipei, 11217, Taiwan

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Taoyuan District, 333, Taiwan

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Bangkok, 10300, Thailand

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Bangkok, 10400, Thailand

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Khon Kaen, 40002, Thailand

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Mueang, 50200, Thailand

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Songkhla, 90110, Thailand

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Adana, 1260, Turkey (Türkiye)

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Adapazarı, 54290, Turkey (Türkiye)

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Ankara, 06590, Turkey (Türkiye)

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Edirne, 22030, Turkey (Türkiye)

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Istanbul, 34030, Turkey (Türkiye)

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Izmir, Turkey (Türkiye)

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Hanoi, 100000, Vietnam

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Hanoi, 10000, Vietnam

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Hà Nội, 100000, Vietnam

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Ho Chi Minh City, 70000, Vietnam

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MeSH Terms

Conditions

Urinary Bladder Neoplasms

Interventions

durvalumabtremelimumabCisplatinGemcitabineCarboplatin

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Chlorine CompoundsInorganic ChemicalsNitrogen CompoundsPlatinum CompoundsHeterocyclic CompoundsDeoxycytidineCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-RingCoordination ComplexesOrganic Chemicals

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 6, 2018

First Posted

September 24, 2018

Study Start

September 27, 2018

Primary Completion

April 29, 2026

Study Completion

April 29, 2026

Last Updated

February 3, 2026

Record last verified: 2026-01

Data Sharing

IPD Sharing
Will share

Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Access Criteria
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
More information

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