Intravesical Mistletoe Extract in Superficial Bladder Cancer: A Phase III Efficacy Study

Condition: Superficial Bladder Cancer


  • Drug: abnobaVISCUM 900
  • Drug: Mitomycin C

Purpose: The aim of this phase III study is to assess the efficacy of abnobaVISCUM® 900 compared with Mitomycin C (MMC) monotherapy in patients with superficial bladder carcinoma by evaluation of the time to tumor recurrence. Secondary objective is to evaluate the safety of abnobaVISCUM® 900, in particular, to compare the toxicity of the two treatments. Another secondary objective is the treatment efficacy as measured by calculated prognosis for recurrence and progression after 1 year, the tumor grading in case of a recurrence and by measurement of Quality of Life.

Study Type: Interventional

Clinical Trials Identifier NCT 8-digits: NCT02106572

Sponsor: Abnoba Gmbh

Primary Outcome Measures:

  • Measure: Time to tumor recurrence
  • Time Frame: up to two years
  • Safety Issue:

Secondary Outcome Measures:

  • Measure: Toxicity and tolerability of the study medication
  • Time Frame: up to two years
  • Safety Issue:
  • Measure: Prognosis after 1 year for recurrence and progression
  • Time Frame: 1 year
  • Safety Issue:
  • Measure: Quality of Life with the EORTC QLQ-C30 and BLS24 Quality of Life Questionnaires
  • Time Frame: up to two years
  • Safety Issue:
  • Measure: Tumor grading
  • Time Frame: up to two years
  • Safety Issue:

Estimated Enrollment: 546

Study Start Date: February 2015

Phase: Phase 3


  • Age: minimum 18 Years maximum 85 Years
  • Gender: All

Inclusion Criteria:

  • Signed and dated written informed consent for data protection and willingness to participate and comply with the study protocol prior to any study-related procedures
  • Completely resected (detrusor muscle in the TUR specimen according to need) superficial bladder carcinoma (Stage Ta) with classification as intermediate-risk according to the EAU (update 2013) and one immediately post operative intravesical MMC instillation of 40 mg, completed re-resection if indicated
  • Karnofsky Performance Status of 50% to 100% (corresponding to Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2)
  • Life expectancy of ≥ 2 years at the time point of study inclusion
  • Normal renal and liver function, normal cardiac and hematology profiles (patients with laboratory values slightly outside the reference range may be included, unless the investigator considers the abnormality as clinically significant)
  • Female patients of childbearing potential must have a negative pregnancy test (β-human chorionic gonadotropin test) at Screening. Pregnancy during the treatment period including 12 weeks after the last instillation has to be excluded

Exclusion Criteria:

  • Locally infiltrative or metastatic bladder tumor (Stage T2 or greater), low-risk Ta tumor (primary, solitary, LG/G1, <3 cm, no CIS) or high-risk tumors according to EAU classification, update 2013 (T1; HG/G3; CIS; multiple and recurrent and large [>3 cm] Ta G1/G2 tumors [all conditions must be present at this point], presence of upper urinary tract tumors or lesions which were not completely removed by TURB
  • Urinary tract infection, benign prostatic obstruction grade II or III, neurogenic bladder, stress incontinence, bladder or urethral diverticula, fistulas or urethral stenosis
  • Patients with acute systemic illness, such as inflammatory infections with fever > 38°C
  • Patients with previous recurrence of a superficial bladder cancer or radiotherapy of the bladder or other intravesical treatment within the last 6 months, or patients with previous mistletoe therapy
  • Patients with other previous or co-existing malignancies or CIS
  • Patients having any previous or concurrent therapy with a systemic chemo- / immunotherapeutical treatment regimen, in particular vinca alkaloids, bleomycine and doxorubicine, or patients who are treated with pyroxidine hydrochloride (vitamin B6)
  • Untreated coagulation disorders or inadequate anticoagulation therapy
  • Leukocyte count < 4,000/mm3 or platelet count < 100,000/mm3
  • Serum creatinine > 1.7 mg/dL
  • Patients with known hypersensitivity to the excipients of the study medication (monosodium phosphate, disodium phosphate, ascorbic acid)
  • Patients with a known hypersensitivity to mistletoe products and MMC
  • Patients who were administered within a 4-week period before Visit 1 any other experimental drug under investigation
  • Male patients planning to father a child or sperm donation from the first administration of study medication until 3 months after the last administration of the study medication
  • Male patients unwilling to use barrier contraception ie, condoms and spermicide, from the day of first administration of the study medication until 12 weeks after administration of the study medication. In case the sexual relation is restricted to women fulfilling one of the criteria listed under inclusion criteria for female patients the barrier contraception is not necessary.
  • Patients with a history of alcohol and / or drug abuse
  • Patients who are unable to be regularly observed, not permitting adequate follow-up and compliance to the protocol


  • Juergen Eisenbraun, Dr.
  • +49 7231 315050


  • Theodor Bilharz Research Institute
  • Giza 12411 Egypt
  • Universitätsklinikum Freiburg
  • Freiburg Breisgau 79106 Germany
  • Kliniken Nordoberpfalz AG, Klinikum Weiden
  • Weiden Oberpfalz 92637 Germany
  • Urologisches Zentrum Euregio
  • Aachen 52064 Germany
  • Urologische Praxis
  • Berlin 10711 Germany
  • Urologische Gemeinschaftspraxis
  • Berlin 13187 Germany
  • Urologische Praxis Bonn-Rhein-Sieg
  • Bonn 53177 Germany
  • Urologicum Duisburg
  • Duisburg 47179 Germany
  • Urologische Praxis
  • Eisleben Lutherstadt 06295 Germany
  • Überörtliche urologische Gemeinschaftspraxis
  • Erkrath 40699 Germany
  • Clinic of Urology of the University Hospital of Essen
  • Essen 45122 Germany
  • Klinik für Urologie, Kinderurologie und Urologische Onkologie – St. Antonius Hospital Gronau
  • Gronau 48599 Germany
  • Urologische Praxis
  • Hagenow 19230 Germany
  • Urologikum Hamburg
  • Hamburg 22399 Germany
  • Urologische Gemeinschaftspraxis
  • Heinsberg 52525 Germany
  • Urologische Praxis
  • Herzberg 37412 Germany
  • Universitätsklinikum Jena
  • Jena 07747 Germany
  • Urologische Praxis
  • Karlsruhe 76133 Germany
  • Urologische Gemeinschaftspraxis
  • Kempen 47906 Germany
  • Urologische Gemeinschaftspraxis
  • Kirchheim unter Teck 73230 Germany
  • Urologische Facharztpraxis Cologne-Study-Group
  • Köln 50968 Germany
  • Urologische Praxis
  • Langenfeld 40764 Germany
  • Urologische Gemeinschaftspraxis
  • Leipzig 04229 Germany
  • Universitätsklinikum Gießen und Marburg GmbH Klinik für Urologie und Kinderurologie
  • Marburg/Lahn 35033 Germany
  • Urologische Praxis
  • Marburg 35039 Germany
  • Urologische Facharztpraxis
  • Markkleeberg 04416 Germany
  • Urologische Gemeinschaftspraxis
  • Michelstadt 64720 Germany
  • Urologische Gemeinschaftspraxis
  • Mühlacker 75417 Germany
  • Urologische Gemeinschaftspraxis
  • Mülheim 45468 Germany
  • Privatärztliche urologische Studienpraxis
  • Nürtingen 72622 Germany
  • Urologische Gemeinschaftspraxis – URONEUM
  • Reutlingen 72764 Germany
  • Urologische Gemeinschaftspraxis
  • Wesel 46483 Germany
  • Urologische Praxisgemeinschaft
  • Wolfsburg 38440 Germany
  • Urologische Facharztpraxis
  • Würselen 52146 Germany

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