Clofarabine Therapy in Locally Advanced or Metastatic Urothelial Carcinoma

Launched by EKATERINA LAUKHTINA · Jun 13, 2025

Keywords

ClinConnect Summary

This clinical trial is testing a drug called clofarabine to see if it is safe and helpful for people with advanced or metastatic urothelial carcinoma, a type of bladder cancer that has spread or cannot be removed by surgery. The study aims to find the highest dose patients can tolerate without serious side effects and to understand how well the drug works in treating this cancer.

Adults who have urothelial cancer that has spread or cannot be removed and who have already tried standard treatments without success—or who chose not to have standard treatments—may be eligible to join. Participants need to be in generally good health, with specific blood counts and organ functions within certain limits, and able to give informed consent. During the study, patients will receive clofarabine and be closely monitored for side effects and any signs that the cancer is responding to treatment. It’s important to note that this study is currently recruiting and includes both men and women aged 18 and older. Women who could become pregnant must have a negative pregnancy test and use birth control during and after the study. This trial offers a potential option for patients who have limited treatment choices, but it also requires careful screening to ensure safety.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients with histologically or cytologically confirmed urothelial carcinoma, radiologically documented metastatic or unresectable locally advanced disease
• • Patients who have already received standard treatment and did not benefit from it, or patients who have refused standard therapy
• • Age ≥ 18 years
• • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• • Absolute neutrophil count (ANC) greater than or equal to 1500.
• • White blood cell (WBC) count greater than 3.0.
• • Platelets greater than or equal to 100.
• • Hemoglobin greater than 9.0 g/dL.
• • Adequate hepatobiliary function as indicated by the following laboratory values: Total bilirubin ≤ 1.5 x upper limit of normal (ULN); Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN
• • Adequate renal function as indicated by the following laboratory values: Serum creatinine ≤ 1.0 mg/dL; if serum creatinine \> 1.0 mg/dL, then the estimated glomerular filtration rate (GFR) must be \> 60 mL/min/1.73 m\^2 as calculated by the Modification of Diet in Renal Disease (MDRD) equation
• • Adequate cardiac function (NYHA cardiac III-IV excluded)
• • Male and female patients must use an effective contraceptive method during the study and for a minimum of 6 months after study treatment
• • Female patients of childbearing potential must have a negative serum pregnancy test within 2 weeks prior to enrollment
• • Willing and able to provide informed consent
• Exclusion Criteria:
• • Received previous treatment with clofarabine
• • Current concomitant chemotherapy, radiation therapy, or immunotherapy
• • Prior radiation therapy to the pelvis
• • Currently participation in other investigational drug studies or having received other investigational drugs within the previous 30 days
• • Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment. In particular: a) New York Heart Association classification stage II, III, or IV congestive heart failure; b) Coronary artery disease or arteriosclerotic cardiovascular disease (angina, myocardial infraction) within 3 months of first dose of study drug; c) Any other primary cardiac disease that, in the opinion of the investigator, increases the risk of ventricular arrhythmia.
• • Patients with a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment).
• • Any medical condition that requires chronic use of oral high-dose corticosteroids (in excess of 1 mg/kg/day) (low-dose corticosteroid for pre-medication purposes are allowed).
• • Any significant concurrent disease, illness, or psychiatric disorder that would compromise patient safety or compliance, interfere with consent, study participation, follow up, or interpretation of study results
• • Diagnosis of another malignancy, unless the patient has been disease-free for at least 5 years following the completion of curative intent therapy with the following exceptions: Patients with treated non-melanoma skin cancer, in-situ carcinoma or cervical intraepithelial neoplasia regardless of disease-free duration are eligible for this study if definitive treatment for the condition has been completed; Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on PSA value are eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed
• • Had currently active gastrointestinal disease, or prior surgery that might affect the ability of the participants to absorb oral Clofarabine.
• • Had prior treatment with a known nephrotoxic drug within 2 weeks of the first dose of study drug, unless the participants had a calculated GFR \>30 at 2 time points no \<7 days apart during the 2- week period prior to the first dose of study drug.
• • Positive human immunodeficiency virus (HIV) test.
• • Female patients who are pregnant/breastfeeding.