Open Label Study to Evaluate the Safety and Efficacy of NDV01 KIT in High Grade NMIBC

High-grade NMIBC is more aggressive cancer that has a higher risk of progression and recurrence compared to low-grade NMIBC. NDV01 is a novel controlled release intravesical formulation designed for the treatment of non-muscle invasive bladder cancer (NMIBC).

NDV01 controlled release intravesical formulation for the treatment on refractory NMIBC. This formulation contains a combination of gemcitabine (1000 mg) and docetaxel (40 mg) and is administered directly into the bladder (intravesically). NDV01 is maximizing local drug concentration, allowing for continuous exposure of the bladder tissue to the therapeutic agents, while minimizing systemic exposure and associated side effects and , avoiding the peaks and troughs associated with conventional intravesical instillations. The combination and sustained release of the drugs improve the likelihood of eradicating cancer cells, potentially reducing the risk of recurrence. The formulation is developed as a controlled release system, allowing for the gradual release of gemcitabine and docetaxel simultaneously over 10 days period. This sustained release is critical in maintaining therapeutic drug concentrations in the bladder while reducing the frequency of administration.

Eligibility Criteria:
Subjects may participate in the study if they meet all the following criteria:

Inclusion criteria:

* Aged 18 years or older at the time of consent
* Able to give informed consent
* Histologically confirmed diagnosis of high grade non-muscle invasive bladder cancer (NMIBC) - patients having high-grade disease at first evaluation after induction BCG alone (at least 5 of 6 doses) may qualify in the absence of disease progression.
* Participants must be ineligible for or have elected not to undergo radical cystectomy.
* Available for the whole duration of the study.
* Life expectancy \>2 years, in the opinion of the investigator.
* Eastern Cooperative Oncology Group (ECOG) status 2 or less.
* Absence of concomitant upper tract urothelial carcinoma or urothelial carcinoma within the prostatic urethra. Freedom from upper tract disease (if clinically indicated) as indicated by no evidence of upper tract tumor by either intravenous pyelogram, retrograde pyelogram, computed tomography (CT) scan with or without urogram, or MRI with or without urogram performed within 6 months of enrolment.
* Patients with prostate cancer on active surveillance at low risk for progression, defined as Prostate-Specific Antigen (PSA) \< 10 ng/dL, Gleason score 6 and clinical stage tumor-1 (cT1) are permitted to be in the study at the discretion of the investigator (see exclusion criterion 10).
* Female patients of childbearing potential must use maximally effective birth control during the period of therapy, must be willing to use contraception for 1 month following the last study drug infusion and must have a negative urine or serum pregnancy test upon entry into this study. Otherwise, female patients must be postmenopausal (no menstrual period for a minimum of 12 months) or surgically sterile. 'Maximally effective birth control' means that the patient, if sexually active, should be using a combination of two methods of birth control that are approved and recognized to be effective by Regulatory Agencies.

Exclusion criteria:

* Current or previous evidence of muscle invasive (muscularis propria) or metastatic disease presented. Examples that increase the risk of metastatic disease are (but not limited to):
* Presence of lymphovascular invasion and/micropapillary disease as shown in the histology of the biopsy sample.
* Patients with T1 disease accompanied by the presence of hydronephrosis secondary to the primary tumor - Unless scheduled for treatment like nephrostomy or JJ stent insertion..
* Current systemic therapy for bladder cancer.
* Symptomatic urinary tract infection or bacterial cystitis (once satisfactorily treated, patients can enter the study).
* Clinically significant and unexplained elevated liver or renal function tests.
* Women who are pregnant or lactating or refuse to commit to using contraception anytime during the study.
* Any other significant disease or other clinical findings which in the investigator's opinion would prevent study entry.
* History of malignancy of other organ system within past 5 years, except treated basal cell carcinoma or squamous cell carcinoma of the skin and ≤ pathological tumor-2 (pT2) upper tract urothelial carcinoma at least 24 months after nephroureterectomy.