Clinical Trials

Clinical Trials

Clinical evidence fundamentally underpins commercial success in healthcare and consequently is one of the key pillars of our investment program. High-quality clinical evidence is needed by clinicians to make the decision to adopt Cxbladder in clinical practice and by healthcare payors to make decisions to cover and reimburse a Cxbladder test. The guidelines committees of professional medical societies, including the American Urological Association (AUA), the National Comprehensive Cancer Network (NCCN) and the European Association of Urology (EAU), also rely on this evidence to support embedding Cxbladder as a standard of care.

Status of Studies Within Our Clinical Trials Program

Last updated: 9th Oct, 2024 

 

Ongoing Study Program Goal Population and Use Status
STRATA
Safe Testing of Risk for AsymptomaTic MicrohematuriA
  • CU for Triage

  • CV/CU for Detect+ (retrospective)

  • Microhematuria (MH)

  • Risk stratification

  • Recruitment closed with 555 patients including 223 low risk patients (test and control) and interim analysis results published in Journal of Urology.

  • Data cleaning for final analysis was completed mid-Aug. A database lock is scheduled for mid-Dec 2024 and a final Clinical Study Report (CSR) in June 2025.

DRIVE

Detection and RIsk Stratification in VEterans Presenting with Hematuria

  • CV for Detect+, Detect & Triage within a Veterans’ cohort

  • Data for pooled analysis

  • MH and gross hematuria (GH)

  • Risk stratification

  • Enrolment closed with 710 patients enrolled including 46 tumour confirmed patients (target was 45) from across 10 US VA sites.

  • Projections are for database lock mid-Nov 24 and publication submitted Q1 25.

microDRIVE

Detection and RIsk Stratification in VEterans Presenting with MicroHematuria

  • CV of Detect+

  • Data for pooled analysis

  • MH

  • Detection

  • This is a network study across all VAMCs coordinated from a single US VA.

  • 358 patients have consented for the study with 152 samples received to date.

  • The target is 1,000 patients with 35-50 tumour confirmed patients.

  • Last patient in is now projected to be Q2 25.

AUSSIE
Australian Urologic Risk Stratification of PatientS wIth HEmaturia
  • CV of Detect+ (Australian cohort)

  • Data for pooled analysis

  • MH and GH

  • Risk stratification

  • Target enrolment: 600 patients across three Australian sites.

  • 264 subjects are enrolled to date, including 15 UC confirmed (target is 35).

  • Last patient in is projected for Q2 25.

Pooled Analysis

 

  • CV of Detect+

  • MH and GH

  • Risk stratification

  • MH and separately GH patient data from DRIVE, AUSSIE, and microDRIVE will be pooled and performance determined.

  • Paper submissions one quarter after publication of DRIVE, microDRIVE and AUSSIE.

LOBSTER

LOngitudinal Bladder Cancer Study for Tumor Recurrence

  • CV of Monitor/ Monitor+

  • Surveillance

  • Risk stratification

  • Enrolment will complete once 75 UC recurrences have been observed across 8-10 sites.

  • Enrolment is now 364 subjects providing 654 samples with 38 UC recurrences observed to date.

  • Expected completion is mid 2025.

CREDIBLE

Cystoscopic REDuction In BLadder Evaluations for microhematuria

  • CU of Detect+ 

  • MH

  • Risk stratification

  • Protocol approved by Specialty Networks central IRB and 3 of 15 sites contracted.

  • Target enrolment is 1,000 subjects with an interim analysis at 600 to determine if incidence is <5% tumours and if so, will continue to 1,000 are enrolled.

  • Enrolment due to commence Dec-2024.

* Dates are calendar years, not financial years
** Pacific Edge's IRB-approved clinical trials are listed at clinicaltrials.gov

The Strategic Rationale For Each Study

Our clinical studies are principally aimed at delivering two types of evidence: clinical validity (CV) evidence (evidence that Cxbladder accurately identifies a patient’s clinical status in an independent patient cohort) and clinical utility (CU) evidence (evidence that Cxbladder is clinically useful for patients and physicians in a defined population and indication). We are also undertaking studies to deliver analytical validity (AV) evidence (evidence that a test result is reproducible in laboratory conditions).

 

STRATA: Demonstrate the clinical utility (CU) of Cxbladder Triage using a prospective, two-arm randomized design to risk-stratify patients and rule out from cystoscopy

  • Establish CU for Cxbladder Triage in microhematuria populations to identify patients at low risk of bladder cancer that can safely avoid cystoscopy.
  • Retrospective analysis with Cxbladder Detect+ to show theoretical CU for the second-generation test in microhematuria populations with the improved performance characteristics.
  • CU evidence supports AUA/NCCN guidelines inclusion using Cxbladder Triage and sets the stage for Cxbladder Detect+ to risk stratify microhematuria populations.

 

DRIVE: Prospective recruitment of patients to a single-arm observational study to demonstrate the CV of Cxbladder Detect and Detect+ test in risk stratifying Veterans presenting with hematuria

  • Demonstrate CV of Cxbladder Detect and Detect+ within a Veterans cohort supporting AUA/NCCN Guidelines inclusion in microhematuria & gross hematuria patients.
  • Contribute data to pooled-analysis to establish CV for Detect+ in microhematuria patients.
  • CV evidence for Cxbladder Triage in microhematuria & gross hematuria patients supplementing NZ studies.

 

microDRIVE: 

  • Demonstrate the clinical validity of Cxbladder Detect+ in detecting urothelial cancer in patients presenting with microhematuria.
  • MicroDRIVE will compare the performance of Detect+ against the current gold-standard for the detection of urothelial cancer, diagnostic cystoscopy and pathology.
  • Contribute data to pooled-analysis to establish CV for Detect+ in microhematuria patients.

 

AUSSIE: Prospective recruitment of patients to a single-arm observational study to demonstrate CV in an Australian healthcare setting for patients presenting with hematuria

  • Demonstrate CV of Cxbladder Detect+ with an Australian cohort.
  • Demonstrate accurate risk stratification of hematuria patients to intensify or de-intensify evaluation.
  • Contribute data to meta-analysis to establish CV for Detect+ in microhematuria patients.

 

Microhematuria Pooled Analysis: Pooled-analysis of Cxbladder Detect+ performance from multiple studies involving prospectively recruited patients from single-arm observational studies including eligible microhematuria patients

  • CV of Cxbladder Detect+ with microhematuria patients.
  • Combines data from DRIVE, AUSSIE, and MicroDRIVE. CV evidence supports AUA/NCCN guidelines inclusion using Cxbladder Detect+ to risk stratify microhematuria populations.

 

LOBSTER: Prospective recruitment of patients to a single-arm observational study to evaluate the clinical validity of Cxbladder Monitor/Monitor+.

  • To safely risk stratify patients under surveillance for recurrence of urothelial cancer (UC).
  • To demonstrate that it is safe to alternate Cxbladder Monitor with cystoscopy for intermediate and high-risk patients under surveillance for recurrence of UC.
  • Targeting AUA/NCCN guidelines inclusion for biomarkers as an alternative to cystoscopy in a surveillance setting.

 

CREDIBLE: Demonstrate the clinical utility (CU) of Detect+ using a randomized controlled study design prospectively enrolling microhematuria patients scheduled for evaluation of said hematuria

  • Will compare cystoscopy use for patients in the control arm risk stratified by AUA Standard of Care guidelines into high, intermediate and low risk with patients in the test arm risk stratified by Cxbladder Detect and managed as AUA high risk (Detectpositive) and AUA low risk (Detectnegative).

 

  • Analytical Validity (AV): Develop a test that is repeatable in the lab for a given indication and population.
  • Clinical Validity (CV): Make sure the test works in the same way on an independent eligible population for the given indication.
  • Clinical Utility (CU): Put the test in the hands of a physician to establish that it can usefully change patient management within the context of care for the defined population and indication.