Spectrum Pharmaceuticals, Inc. An International Commercial-Stage Biotechnology Company
Spectrum Pharmaceuticals, Inc. An International Commercial-Stage Biotechnology Company
Home > Product Portfolio > Late Stage > Qapzola (apaziquone)

Qapzola® (apaziquone) for Intravesical Instillation

Being investigated as intravesical instillation in non-muscle invasive bladder cancer.

Target Indications

Non-Muscle Invasive Bladder Cancer (NMIBC)

Qapzola bladder cancer

Cystoscopic appearance of tumors in the bladder.

Route of Administration

Intravesical Instillation (instilled directly into the bladder)

Mode of Action

Qapzola is a bio-reductive agent activated by reductase enzymes, such as DT-diaphorase, expressed by bladder tumor cells, to form cytotoxic alkylating agents.

Qapzola bladder cancer

A) Bladder tumor before intravesical therapy.
B) In a Phase 2 study, after 6 weekly intravesical instillations of Qapzola, tumor is no longer present.


  • The Company received a new SPA from the FDA for a new Phase 3 study incorporating learnings from the previous studies, as well as recommendations from the FDA.
  • Compared to the previous program, this new Phase 3 study will include fewer evaluable patients (n=425 versus 1,557 patients), use a higher dosage of QAPZOLA (8 mg versus 4 mg), and will evaluate time-to-recurrence as the primary endpoint.
  • The Phase 3 trial is expected to start enrolling patients in the third quarter of 2017.

Previous Phase 3 Clinical Trial Information

Click here to view trial details on Clinical Trials.gov

  • Spectrum conducted two multi-center, randomized, double-blind, placebo controlled, Phase 3 pivotal trials of single dose intravesical Qapzola to be instilled into the bladder in the immediate post-operative period after surgical resection of low-risk, non-muscle invasive bladder tumors. The primary endpoints were the rate of tumor recurrence at 2 years between Qapzola and placebo.
  • These two trials were analyzed individually and did not meet their primary endpoint of a statistically significant difference in the rate of tumor recurrence at 2 years between the two arms.

Back to top

Spectrum Pharmaceuticals, Inc. An International Commercial-Stage Biotechnology Company

Market Opportunities

qapzola bladder cancer staging

Bladder Cancer

According to the National Cancer Institute, bladder cancer is the fifth most common malignancy in the US with 74,000 new cases of bladder cancer expected in 2015, and currently over 500,000 patients living with the disease.

Approximately 70% of all patients newly diagnosed with bladder cancer have NMIBC. Urologists treat the disease predominantly by TURBT. In the U.S., there are approximately 300,000 TURBT procedures every year to treat bladder cancer. Because of the high recurrence rate, both professional urology associations and NCCN Guidelines recommend the instillation of a cytotoxic agent following TURBT for NMIBC, although in the U.S., there are no FDA-approved agents for this indication.

The global prevalence of bladder cancer is estimated at 2.7 million.

Risk factors for bladder cancer include smoking and exposure to certain industrial chemicals. Symptoms may include hematuria, painful or burning urination without evidence of a urinary tract infection, or abdominal pain. If detected early, bladder cancer is a managable disease.

qapzola bladder cancer staging

The initial treatment of this cancer is complete surgical removal of the tumor (TURBT). However, bladder cancer is a highly recurrent disease with approximately 80% of patients recurring within 5 years, and a majority of these patients recur within 2 years.

Because bladder cancer patients have a high risk of recurrence, bladder cancer is the most expensive cancer to treat on a per patient lifetime basis. (Botteman et al., Pharmacoeconomics, 2003).

For additional information on bladder cancer, please refer to the following links:

The American Urological Association (AUA)

The Bladder Cancer Advisory Network (BCAN)

American Bladder Cancer Society (ABLCS) www.bladdercancersupport.org

National Cancer Institute www.cancer.gov/cancertopics/types/bladder
The U.S. National Cancer Institute's website (http://www.cancer.gov) provides accurate, up-to-date information about many types of cancer, information about clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.

The links provided by Spectrum are for informational purposes only and are not meant to replace your physician's medical advice. Spectrum Pharmaceuticals, Inc. accepts no responsibility for the content of these sites. Spectrum does not control these sites, and the opinions, claims, or comments expressed on these sites should not be attributed to Spectrum. We recommend that you consult with your physician or other healthcare provider to obtain more information.