RecruitingPhase 2NCT06290687

Partial Cystectomy & Extended Pelvic Lymph Node Dissection With SOC Perioperative Systemic Therapy

Phase II Trial on the Safety and Efficacy of Partial Cystectomy and Extended Pelvic Lymph Node Dissection With Standard of Care Perioperative Systemic Therapy in the Management of Muscle-Invasive Bladder Cancer (PRESERVE Trial)


Sponsor

Case Comprehensive Cancer Center

Enrollment

40 participants

Start Date

Jun 1, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to determine if a partial cystectomy with extended pelvic lymph node removal will be effective at treating Muscle-Invasive Bladder Cancer instead of a complete cystectomy with extended pelvic lymph node removal. This clinical trial aims to determine the safety and oncologic efficacy of the intervention, and to examine patient-reported quality of life outcomes in participants. Participants will receive the standard pre-surgery treatment for approximately 4 to 6 weeks. After the pre-surgery treatment is completed, participants will undergo a partial cystectomy with extended pelvic lymph node dissection. After surgery, participants will receive adjuvant systemic therapy.


Eligibility

Min Age: 19 Years

Plain Language Summary

Simplified for easier understanding

This study is evaluating a bladder-sparing surgical option for people with muscle-invasive bladder cancer. Instead of removing the entire bladder, surgeons remove only the cancerous portion (partial cystectomy) along with nearby lymph nodes, combined with standard chemotherapy or immunotherapy. **You may be eligible if...** - You have confirmed bladder cancer (urothelial carcinoma) at stage T2–T3 with no spread to lymph nodes or distant sites - Your tumor is in a location where partial bladder removal can completely remove the cancer - You are over 18 with good performance status (Karnofsky ≥70 or ECOG 0–1) - Your organ function (blood, liver, kidneys) is within normal limits **You may NOT be eligible if...** - Your cancer has spread to lymph nodes or other organs - Your tumor involves too much of the bladder to allow partial removal - You have significant organ dysfunction - You are under 18 Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGNeoadjuvant Chemotherapy

Standard of care neoadjuvant systemic therapy is currently cisplatin-based chemotherapy in cisplatin-eligible participants. Participants will start treatment within 60 days of Transurethral Resection of Bladder Tumor. Regimens may include: * Cisplatin - Gemcitabine (Gem/Cis) * Dose Dense Methotrexate - Vinblastine - Adriamycin - Cisplatin (MVAC)

PROCEDUREPartial cystectomy with Extended pelvic lymph node dissection

Partial cystectomy will then be performed using the surgical technique at the discretion of the treating Urologic Oncologist. Extended pelvic lymphadenectomy will then be performed at the discretion of the treating Urologic Oncologist. Surgery will be performed within 60 days of Transurethral Resection of Bladder Tumor for Cisplatin-ineligible participants. Surgery will be performed within 60 days of completing neoadjuvant chemotherapy for Cisplatin-eligible participants.

DRUGAdjuvant systemic therapy

Standard of care adjuvant systemic therapy in eligible participants. The choice of adjuvant systemic therapy will be left to the discretion of the treating Medical Oncologist but must fall within the SOC as outlined in NCCN guidelines.


Locations(1)

Glickman Urological and Kidney Institute, Cleveland Clinic, Case Comprehensive Cancer Center

Cleveland, Ohio, United States

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NCT06290687


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