NCT07097142ClinicalTrials.gov

Testing Shorter Duration Radiation Therapy Versus the Usual Radiation Therapy in Patients Receiving the Usual Chemotherapy Treatment for Bladder Cancer, ARCHER Study

The Phase III Adaptive Radiation and Chemotherapy for Muscle Invasive Bladder Cancer Trial (ARCHER)

RecruitingTaking participants now, according to the registry record.

Contact this study

In brief

Phase 3486 participants sought211 sites1 country

Registered in 1 registry

ClinicalTrials.govNCT07097142Open this record at ClinicalTrials.govSynced last month

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Trial information is shown as published by the registry, in its original language.

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How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

Present: Registered before enrolment beganFirst posted 2025-07-31; recorded start 2025-10-07
Present: Has a defined primary outcomeA primary outcome measure is listed in the record
Present: The primary outcome states a time frameThe primary outcome measure records a time frame
Present: Participants are randomly assignedAllocation is recorded as randomised
Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
Not stated: Open label (no blinding)Masking is recorded as none (open label)
Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
Present: Sponsor has 49 other studies in this databaseCounted from the lead sponsor named in the record (NRG Oncology)
Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database

The record lists 3 conditions.
Lead sponsor type recorded as: other.
Intervention regulatory context: investigational, within a phased regulatory pathway.

These are facts from the public registry record, not a judgement about the study. Discuss any trial with your own doctor before taking part.

What these facts mean, and what to ask · ruleset v1

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourSTRONG

A strong methodological design for a phase 3 study, judged from its ClinicalTrials.gov record.

How this score is built

Randomised allocation20/20
Participants are randomly allocated between arms
Blinding0/20
Open-label
Control arm15/15
Active-comparator control arm
Primary-outcome specificity10/10
Named primary outcome with a defined time frame
Endpoint type10/10
Mortality / MACE endpoint (hard clinical outcome)
Multi-centre8/8
Multi-centre: 211 sites
Data monitoring committee0/7
No data monitoring committee stated
Prospective registration5/5
Registered before the study start date
Protocol / SAP posted0/5
No protocol or SAP posted to the registry

ScaleMEDIUM

A medium-sized study: 486 participants (target), run at 211 sites.

How this score is built

Enrolment26/40
486 participants (target)
Site count25/25
211 sites
Country count0/15
Single country
Planned duration10/10
Planned over about 57 months
Sponsor scale6/10
NRG Oncology has led 49 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built

Investigator standing0/100
No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

Summary

This phase III trial compares the effect of decreased number of radiation (ultra-hypofractionated) treatments to the usual radiation number of treatments (hypofractionation) with standard of care chemotherapy, with cisplatin, gemcitabine or mitomycin and 5-fluorouracil for the treatment of patients with muscle invasive bladder cancer. Hypofractionated radiation therapy delivers higher doses of radiation therapy over a short period of time. Ultra-hypofractionated radiation therapy delivers radiation over an even shorter period of time than hypofractionated radiation therapy. Cisplatin is in a class of medications known as platinum-containing compounds. It works by killing, stopping or slowing the growth of tumor cells. Gemcitabine is a chemotherapy drug that blocks the cells from making DNA and may kill tumor cells. Chemotherapy drugs, such as mitomycin-C and 5-fluorouracil (5-FU), work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving ultra-hypofractionated radiation may be equally effective as hypofractionated therapy for patients with muscle invasive bladder cancer.

PRIMARY OBJECTIVE: I. Demonstrate non-inferiority of ultra-hypofractionated (stereotactic body radiation therapy \[SBRT\]) compared to hypofractionated radiation therapy (RT) with a 10% non-inferiority margin (from 50% to 40%) in the rate of bladder-intact event-free survival (BI-EFS) at 3 years (corresponding to a hazard ratio \< 1.32). SECONDARY OBJECTIVES: I. Compare the rates of urinary and bowel toxicity, patient-reported outcomes (PRO), event-free survival (EFS), metastasis-free survival (MFS), and overall survival (OS) between the two treatment arms. II. Compare and evaluate symptomatic adverse events and quality of life measures that are most meaningful to patients. III. Evaluate circulating tumor deoxyribonucleic acid (ctDNA) as a biomarker to determine whether it is predictive of disease recurrence and as a secondary outcome variable. EXPLORATORY OBJECTIVES: I. Evaluate ctDNA, tissue-free minimal residual disease (tfMRD) and urine tumor DNA (utDNA) as biomarkers for predicting recurrence. II. Evaluate tfMRD, obtained at the time of progression, to determine if it captures the presence of disease. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive hypofractionated radiation therapy (RT) once daily (QD), Monday to Friday, for 20 treatments in the absence of disease progression or unacceptable toxicity. Patients also receive one of 3 systemic chemotherapy regimens per treating physician's choice: 1) cisplatin intravenously (IV) weekly for 4 weeks; 2) gemcitabine IV on days 1, 4, 8, 11, 15, 18, 22 and 25 or weekly for 4 weeks; or 3) mitomycin-C IV on day 1 and fluorouracil (5 FU), over 120 hours on days 1-5 and 22-26. Treatment is given in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT) scan and/or magnetic resonance imaging (MRI) or fluorodeoxyglucose (FDG) positron emission tomography (PET) throughout the study. In addition, patients may undergo optional blood and urine sample collection throughout the study, as well as an optional biopsy during cystoscopy during follow up. ARM II: Patients receive ultra-hypofractionated RT QD, no more than twice weekly, for 5 treatments in the absence of disease progression or unacceptable toxicity. Patients also receive one of 3 systemic chemotherapy regimens per treating physician's choice: 1) cisplatin IV weekly for 4 weeks; 2) gemcitabine IV on days 1, 4, 8, 11, 15, 18, 22 and 25 or weekly for 4 weeks; or 3) mitomycin-C IV on day 1 and 5 FU, over 120 hours on days 1-5 and 22-26. Treatment given in the absence of disease progression or unacceptable toxicity. Patients also undergo CT scan and/or MRI or FDG PET throughout the study. In addition, patients may undergo optional blood and urine sample collection throughout the study, as well as an optional biopsy during cystoscopy during follow up. After completion of study treatment, patients are followed up at week 16, every 3 months for 3 years then every 6 months to year 5.

Conditions

Muscle Invasive Bladder Urothelial Carcinoma
Stage II Bladder Cancer AJCC v8
Stage IIIA Bladder Cancer AJCC v8

Eligibility

Eligibility
Sex	All
Ages	18 Years – No maximum
Healthy volunteers	No

Eligibility as written in the registry

Inclusion Criteria: * Histologically proven, cT2-T3,N0M0 urothelial carcinoma of the bladder prior to randomization. * Note: Patients with mixed urothelial carcinoma will be eligible for the trial, but the presence of small cell carcinoma will make a patient ineligible * Must undergo a transurethral resection of bladder tumor (TURBT) prior to randomization. Patients may have either completely or partially resected tumors as long as the treating urologist attempted maximal resection * Must undergo radiological staging prior to randomization. Imaging of chest, abdomen, and pelvis must be performed using CT or MRI (with or without contrast is acceptable). Patients must not have evidence of T4 or node positive disease. Fluorodeoxyglucose (FDG) PET imaging is acceptable for radiological staging * If any lymph nodes ≥ 1.0 cm in shortest cross-sectional diameter are noted on imaging (CT / MRI of abdomen and pelvis), then the patient must have had a biopsy of the enlarged lymph node showing no tumor involvement prior to randomization * No diffuse carcinoma in situ (CIS) based on cystoscopy and biopsy * No definitive clinical or radiologic evidence of metastatic disease * Must not have had urothelial carcinoma or histological variant at any site outside of the urinary bladder within 24 months prior to registration except Ta/T1/Carcinoma in situ (CIS) of the upper urinary tract including renal pelvis and ureter if the patient had undergone complete nephroureterectomy * Age ≥ 18 * Zubrod performance status of ≤ 2 * Not pregnant and not nursing * Negative urine or serum pregnancy test (in persons of childbearing potential) within 14 days prior to registration. Childbearing potential is defined as any person who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal * Absolute neutrophil count (ANC) ≥ 1,500 cells/mm\^3 * Platelets ≥ 100,000 cells/mm\^3 * Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin \[Hgb\]) ≥ 8.0 g/dl is acceptable) * Creatinine clearance (CrCL) of ≥ 30 mL/min by the Cockcroft-Gault formula * Total bilirubin ≤ 2 x institutional upper limit of normal (ULN) * Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase \[SGPT\]) ≤ 3 x institutional ULN * All adverse events associated with any prior therapy must have resolved to Common Terminology Criteria for Adverse Events (CTCAE) grade ≤ 3 prior to randomization * For patients who have completed neoadjuvant therapy, they are eligible if the pre-neoadjuvant therapy diagnosis (TURBT path) is within 180 days before randomization * Must not have had prior pelvic radiation * New York Heart Association Functional Classification II or better (NYHA Functional Classification III/IV are not eligible) (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification.) * No active infection requiring IV antibiotics * Patients with hydronephrosis are eligible if they have unilateral hydronephrosis and kidney function meet criteria specified

Eligibility in plain statements

This record's criteria have not been broken into separate statements yet. The registry text above is complete and is the authoritative version.

Study design

Study design
Study type	Interventional
Phase	Phase 3
Allocation	Randomised
Intervention model	PARALLEL
Primary purpose	TREATMENT
Masking	NONE (0)
Enrolment	486 participants sought

Sponsor and collaborators

NRG Oncology Sponsor

Arms and interventions

Arm I (hypofractionated radiation therapy)ACTIVE_COMPARATOR
Patients receive hypofractionated RT QD, Monday to Friday, for 20 treatments in the absence of disease progression or unacceptable toxicity. Patients also receive one of 3 systemic chemotherapy regimens per treating physician's choice: 1) cisplatin IV weekly for 4 weeks; 2) gemcitabine IV on days 1, 4, 8, 11, 15, 18, 22 and 25 or weekly for 4 weeks; or 3) mitomycin-C IV on day 1 and 5 FU, over 120 hours on days 1-5 and 22-26. Treatment is given in the absence of disease progression or unacceptable toxicity. Patients also undergo CT scan and/or MRI or FDG PET throughout the study. In addition, patients may undergo optional blood and urine sample collection throughout the study, as well as an optional biopsy during cystoscopy during follow up.
Arm II (Ultrahypofractionated radiation therapy)EXPERIMENTAL
Patients receive ultra-hypofractionated RT QD, no more than twice weekly, for 5 treatments in the absence of disease progression or unacceptable toxicity. Patients also receive one of 3 systemic chemotherapy regimens per treating physician's choice: 1) cisplatin IV weekly for 4 weeks; 2) gemcitabine IV on days 1, 4, 8, 11, 15, 18, 22 and 25 or weekly for 4 weeks; or 3) mitomycin-C IV on day 1 and 5 FU, over 120 hours on days 1-5 and 22-26. Treatment given in the absence of disease progression or unacceptable toxicity. Patients also undergo CT scan and/or MRI or FDG PET throughout the study. In addition, patients may undergo optional blood and urine sample collection throughout the study, as well as an optional biopsy during cystoscopy during follow up.

Interventions

Procedure Biospecimen Collection
Undergo blood, tissue, and urine sample collection
Drug Cisplatin
Given IV
Procedure Computed Tomography
Undergo CT scan
Drug Fluorouracil
Given IV
Drug Gemcitabine
Given IV
Radiation Hypofractionated Radiation Therapy
Undergo hypofractionated radiation therapy
Procedure Magnetic Resonance Imaging
Undergo MRI
Drug Mitomycin
Given IV
Procedure Positron Emission Tomography
Undergo PET scan
Other Survey Administration
Ancillary studies
Radiation Ultrahypofractionated Radiation Therapy
Undergo ultrahypofractionated radiation therapy.

Outcome measures

Primary outcome
Bladder-intact event-free survival (BI-EFS)
Defined as histologically proven presence of muscle invasive bladder cancer (MIBC), radiographic evidence of nodal or metastatic disease, performance of radical cystectomy, or death from any cause. Time to event will be calculated from the date of randomization. BI-EFS will be estimated in the two treatment groups using the Kaplan-Meier method and the hazard ratio between ultra-hypofractionation and hypofractionation estimated by fitting a Cox proportional hazards regression model, including a treatment arm indicator variable and adjusting for the three stratification factors employed in the randomization.
Time frame Up to 3 years
Secondary outcome
Incidence of urinary adverse events
Will be graded per Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v 5.0). The proportion of patients experiencing grade 3 or higher urinary/bowel toxicity within two years of initiation of treatment will be compared between the two treatment groups using a chi-square test. The 95% confidence interval (CI) width for the true difference will be at most ± 8.9%.
Time frame Up to year 2
Secondary outcome
Incidence of bowel adverse events
Will be graded per CTCAE v 5.0. The proportion of patients experiencing grade 3 or higher urinary/bowel toxicity within two years of initiation of treatment will be compared between the two treatment groups using a chi-square test. The 95% CI width for the true difference will be at most ± 8.9%.
Time frame Up to year 2
Secondary outcome
Quality of life
As measured by the Functional Assessment of Cancer Therapy-Bladder instrument.
Time frame At baseline, 4 weeks, 16 weeks, 13 months, 25 months, and 37 months
Secondary outcome
Event free survival
Kaplan-Meier curves will be generated and the groups compared using a stratified logrank test (stratified by the randomization stratification factors). In addition, a Cox regression model will be fit, including treatment arm and the stratification factors.
Time frame From randomization to histologically proven presence of MIBC, radiographic evidence of nodal or metastatic disease, or death from any cause, up to 5 years
Secondary outcome
Metastasis-free survival
Kaplan-Meier curves will be generated and the groups compared using a stratified logrank test. A Cox regression model will also be fit, including treatment arm and the stratification factors.
Time frame From randomization to radiographic evidence of metastatic disease or death due to any cause, up to 5 years
Secondary outcome
Overall survival
Kaplan-Meier curves will be generated and the groups compared using a stratified logrank test. A Cox regression model will also be fit, including treatment arm and the stratification factors.
Time frame From randomization to death from any cause, up to 5 years
Secondary outcome
Incidence of adverse events (AE)
Will be graded using CTCAE v 5.0. AE rates between the two treatment groups will be compared using chi-square or Fisher exact tests.
Time frame Up to year 2
Secondary outcome
Circulating tumor deoxyribonucleic acid (ctDNA)
The association between the ctDNA results and imaging scans will be examined by generating 2x2 tables (presence/absence of minimal residual disease vs. positive/negative scan) at each time point and assessing the concordance between the results. For subjects who are ctDNA-positive at baseline, the proportion that clear ctDNA at the conclusion of RT treatment will be estimated in each arm. A point estimate of these proportions and their associated 95% Wilson score confidence interval will be reported. Clearance rates between the two arms will be compared using a chi-square or Fisher's exact test as appropriate.
Time frame At baseline, end of treatment (week 4), weeks 16, 28, 40, 56, and at disease progression or last follow-up visit
Other outcome
ctDNA
Will be analyzed as prognostic markers by fitting Cox regression models for BI-EFS.
Time frame At baseline, 4, 16, 28, 40, and 56 weeks from start of chemotherapy
Other outcome
Tissue free minimal residual disease
Will be obtained at the time of progression to determine if it captures the presence of disease. Will be analyzed as prognostic markers by fitting Cox regression models for BI-EFS.
Time frame At time of progression
Other outcome
Urine tumor deoxyribonucleic acid
Will be analyzed as prognostic markers by fitting Cox regression models for BI-EFS.
Time frame At baseline, 4, 16, 28, 40, and 56 weeks from start of chemotherapy
Other outcome
Primary outcome treatment effect by sex
The corresponding 95% CIs will be provided.
Time frame Up to 5 years
Other outcome
Primary outcome treatment effect by race
The corresponding 95% CIs will be provided.
Time frame Up to 5 years
Other outcome
Primary outcome treatment effect by ethnicity
The corresponding 95% CIs will be provided.
Time frame Up to 5 years

Dates

Dates
Start date	October 7, 2025 (actual)
Primary completion	May 31, 2030 (estimated)
Completion	May 31, 2035 (estimated)
First posted	July 31, 2025 (actual)
Last updated	August 18, 2026
Results posted	Not stated in the registry record
Status last verified	August 2026

Actual means the event happened. Estimated means the sponsor expects it. The two mean different things.

Locations

204 sites are recruiting

United States

United States
Facility	City	State or region	Status
OSF Saint Anthony's Health Center	Alton	Illinois	Recruiting
UI Health Care Mission Cancer and Blood - Ankeny Clinic	Ankeny	Iowa	Recruiting
University of Michigan Rogel Cancer Center	Ann Arbor	Michigan	Recruiting
Langlade Hospital and Cancer Center	Antigo	Wisconsin	Recruiting
Emory Saint Joseph's Hospital	Atlanta	Georgia	Recruiting
Grady Health System	Atlanta	Georgia	Recruiting
Emory University Hospital Midtown	Atlanta	Georgia	Recruiting
Emory University Hospital/Winship Cancer Institute	Atlanta	Georgia	Recruiting
UCHealth University of Colorado Hospital	Aurora	Colorado	Recruiting
UH Seidman Cancer Center at UH Avon Health Center	Avon	Ohio	Recruiting
Memorial Sloan Kettering Basking Ridge	Basking Ridge	New Jersey	Recruiting
Mary Bird Perkins Cancer Center	Baton Rouge	Louisiana	Recruiting
Louisiana Hematology Oncology Associates LLC	Baton Rouge	Louisiana	Recruiting
Bronson Battle Creek	Battle Creek	Michigan	Recruiting
UHHS-Chagrin Highlands Medical Center	Beachwood	Ohio	Recruiting
Billings Clinic Cancer Center	Billings	Montana	Recruiting
OSF Saint Joseph Medical Center	Bloomington	Illinois	Recruiting
Illinois CancerCare-Bloomington	Bloomington	Illinois	Recruiting
Central Care Cancer Center - Bolivar	Bolivar	Missouri	Recruiting
Massachusetts General Hospital Cancer Center	Boston	Massachusetts	Recruiting
Bozeman Health Deaconess Hospital	Bozeman	Montana	Recruiting
University of Michigan - Brighton Center for Specialty Care	Brighton	Michigan	Recruiting
Henry Ford Cancer Institute-Downriver	Brownstown	Michigan	Recruiting
Minnesota Oncology - Burnsville	Burnsville	Minnesota	Recruiting
Illinois CancerCare-Canton	Canton	Illinois	Recruiting
Mercy Cancer Center - Cape Girardeau	Cape Girardeau	Missouri	Recruiting
Saint Francis Medical Center	Cape Girardeau	Missouri	Recruiting
Memorial Hospital of Carbondale	Carbondale	Illinois	Recruiting
SIH Cancer Institute	Carterville	Illinois	Recruiting
Illinois CancerCare-Carthage	Carthage	Illinois	Recruiting
Centralia Oncology Clinic	Centralia	Illinois	Recruiting
Christiana Care Health System-Concord Health Center	Chadds Ford	Pennsylvania	Recruiting
UNC Lineberger Comprehensive Cancer Center	Chapel Hill	North Carolina	Recruiting
Medical University of South Carolina	Charleston	South Carolina	Recruiting
Memorial Hospital of Laramie County	Cheyenne	Wyoming	Recruiting
Rush MD Anderson Cancer Center	Chicago	Illinois	Recruiting
Northwestern University	Chicago	Illinois	Recruiting
University of Illinois	Chicago	Illinois	Recruiting
Case Western Reserve University	Cleveland	Ohio	Recruiting
Henry Ford Macomb Hospital-Clinton Township	Clinton Township	Michigan	Recruiting
Mercy Cancer Center-West Lakes	Clive	Iowa	Recruiting
UI Health Care Mission Cancer and Blood - West Des Moines Clinic	Clive	Iowa	Recruiting
Kootenai Health - Coeur d'Alene	Coeur d'Alene	Idaho	Recruiting
MU Health - University Hospital/Ellis Fischel Cancer Center	Columbia	Missouri	Recruiting
Ohio State University Comprehensive Cancer Center	Columbus	Ohio	Recruiting
Memorial Sloan Kettering Commack	Commack	New York	Recruiting
MD Anderson in The Woodlands	Conroe	Texas	Recruiting
Mercy Hospital	Coon Rapids	Minnesota	Recruiting
UM Sylvester Comprehensive Cancer Center at Coral Gables	Coral Gables	Florida	Recruiting
Greater Regional Medical Center	Creston	Iowa	Recruiting

161 further sites are listed in the registry record.

Study documents

No documents are linked in this registry record.

Changes over time

No changes have been recorded since we first ingested this record.

A change is recorded each time the sponsor updates the registry record. Status, dates, enrolment and sites appear here as they move.

Registry: ClinicalTrials.gov · NCT########

https://xmedica.io/trials/ctgov/NCT07097142

Categories

Registered in 1 registry

Interested in this study?

How this study is set up

Summary

Conditions

Eligibility

Eligibility as written in the registry

Eligibility in plain statements

Study design

Sponsor and collaborators

Arms and interventions

Interventions

Outcome measures

Dates

Locations

United States

Study documents

Changes over time