Condition category
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status
Results overdue

Contact information



Primary contact

Mr Shriram Velamuri


Contact details

Centre for Experimental Cancer Medicine
LG floor
Old Anatomy Building Charterhouse Square
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title


Hyperthermia for Intermediate risk bladder cancer (HIVEC-II)

Study hypothesis

In the UK, 11000 new cases of bladder cancer are diagnosed per year; it is the fourth commonest non dermatological malignancy in males and tenth most common in females.
Non-Muscle invasive bladder cancer comprise (70-80%) of Transitional cell carcinoma at presentation and is defined as a disease confined to the mucosa (TCC) or lamina propria (T1) and carinoma in situ (CIS).
With in three years 15-70% of tumors recur following Trans urethral resection and 6-45% can complete despite adjuvant therapy.

Patients at intermediate risk for recurrence following TUR receive a single instillation of mitomycin followed by additional adjuvant therapy. Adjuvant MM reduces the recurrence rate, consists of six weekly consecutive weekly intravesical instillation.

Intravesical chemoprophylaxis following TUR results in a reduced risk of recurrence compared to TUR alone. Recurrence rates following adjuvant chemotherapy are reduced by 25-50%within two years.

The combat BRS system is a temperature controlled fluid recirculation system for the delivery of Hyperthermic intravesical chemotherapy. The chemotherapy fluid is circulated in a closed system and warmed by an external isolated dry system using a novel innovative laminated aluminium foil heat exchanger with a small priming volume.

Hypethermia in combination with chemotherapy has been widely used in cancer treatment. The effects of hyperthermia alter cell physiology, growth and survival and in combination with chemotherapy,hyperthermia increases the drug uptake, increases the drug reaction and enhances the inhibition of DNA repair in the damaged neoplastic cells.

The aim of the trial is to determine whether HIVEC is an effective therapy for patients with intermediate risk NMIBC. The trial include patients who have new disease and disease recurrence.

The primary objective of the study is to compare the treatments in terms of disease-free survival at 24months in all patients.

Ethics approval

13/LO/1434; First MREC approval date 07/11/2013

Study design

Randomised; Interventional; Design type: Treatment

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

GP practices

Trial type


Patient information sheet


Topic: Cancer; Subtopic: Bladder Cancer; Disease: Bladder (advanced), Bladder (superficial)


Mitomycin, Mitomycin will be given in either normal and hyperthermic state.; Follow Up Length: 24 month(s); Study Entry : Single Randomisation only

Intervention type



Phase II

Drug names


Primary outcome measure

Primary Objective; Timepoint(s): To determine if HIVEC increases disease-free survival at 24 months compared to the comparator arm of

Secondary outcome measures

Not provided at time of registration

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1.New or Recurrence of intermediate risk NMIBC following TURBT defined as;
1.1.Grade 2 or grade 1 stage Ta or T1 disease*.
1.2. Any grade G2 or G1 recurrent bladder cancer other than low risk and muscle invasive disease
2. Age = 18 yrs
3. WHO performance status 0, 1, 2, 3
4. Normal kidneys and ureters on imaging study within the past 12 months**
5. Pre-treatment haematology and biochemistry values within acceptable limits:
5.1. Haemoglobin (greater than or equal to)10 g/dl
5.2. Neutrophil count (Greater than or equal to)1.5 x 10^9/l
5.3. Platelets (Greater than or equal to) 100 x 10^9/l
5.4. WBC (Greater than or equal to) 3.0 X 10^9/l or ANC greater than or equal to 1.5 X 10^9/l
5.5. Serum creatinine < 1.5 X UNL
6. Negative pregnancy test for women of childbearing potential.
7. Available for longterm followup.
8. Females of childbearing potential and males must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) from the time consent is signed until 6 weeks after treatment discontinuation.
9. Written informed consent.

*T1 disease must have evidence of muscle in specimen. If muscularis propria is not present, a reresection should be performed (accordance with National best practice policy)

**Imaging of upper tracts by CT or US scan is routinely performed in some centres and is recommended as good practice in this study

Target Gender: Male & Female ; Lower Age Limit 18 years

Participant type


Age group




Target number of participants

Planned Sample Size: 191; UK Sample Size: 191

Participant exclusion criteria

1. Grade 3 TCC
2. Carcinoma in situ
3. New solitary Ta G1 (Small)<3cm
4. New solitary Ta G2 (Small)<3cm
5. Previous intravesical chemotherapy in the past 6 months, other than single instillation postTUR.
6. History of limited vesicle capacity (<200cc)
7. UCC involving the prostatic urethra or upper urinary tract.
8. Greater than or equal to T2 UCC
9. Known allergy to mitomycin
10. Pregnant or lactating women or women of childbearing potential unwilling or unable to use adequate nonhormonal contraception.
11. Other malignancy within the past five years, except: non-melanomatous skin cancer cured by excision, adequately treated carcinoma in situ of the cervix or DCIS/LCIS of the breast or prostate cancer with less than 5yrs life expectancy.
12. Concurrent chemotherapy.

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Centre for Experimental Cancer Medicine, LG floor
United Kingdom

Sponsor information


Queen Mary University of London (UK)

Sponsor details

Suite 3.1 Dominion House
59 Batholomew Close
SW18 1JG
United Kingdom

Sponsor type




Funder type


Funder name

Combat Medical Ltd.

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes