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Efficacy and Safety of Bevacizumab/Temsirolimus Combination to Treat Advanced Renal Cell Carcinoma

Primary Purpose

Kidney Cancer

Status
Terminated
Phase
Phase 2
Locations
Greece
Study Type
Interventional
Intervention
Bevacizumab
Temsirolimus
Sponsored by
Hellenic Cooperative Oncology Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Kidney Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult patients (18th year of age completed)
  • Signed and dated written informed consent form prior to any procedures related to this protocol.
  • Histologically confirmed advanced clear cell renal cancer.
  • Measurable disease.
  • Failure of first line anti-VEGF treatment.
  • Performance status 0-2, according to Eastern Cooperative Oncology Group (ECOG) .
  • Satisfactory hematological parameters:

    • White blood cell count > 4000 mm3.
    • Platelet count 100000/mm3.
    • Neutrophil blood cell count > 1200/ mm3 .
    • Hemoglobin > 9,0 g/dL (can be achieved with red blood cell transfusion).
  • Satisfactory biochemical parameters:

    • Serum creatinine < 2 x Upper Limit of Normal(ULN)
    • Aspartate Aminotransferase (AST)<2,5 x ULN
    • Alanine Transaminase (ALT)< 2,5 x ULN.
    • Bilirubin <2 x ULN
  • (For female patients) Absence of pregnancy (negative pregnancy test for women of reproductive age before enrollment).
  • (For female patients) Non-lactating women.
  • Use of efficient contraceptive measures (women and men) to prevent possible pregnancy of female patient or female partner of a male patient during treatment and until 6 months after the end of treatment.

Exclusion Criteria:

  • Prior treatment with mTOR inhibitor.
  • Major surgery (including open biopsy) or insufficient recovery or existence of major trauma within 4 weeks before enrollment.
  • Uncontrolled hypertension.
  • Active infection requiring systemic treatment within 4 weeks prior to enrollment.
  • Minor surgery (for instance, catheter placement) within 2 days before enrollment.
  • Scheduled major surgery within the treatment period.
  • Medical history in the last 6 months prior to enrollment of significant cardiovascular disease, diabetes, cardiac infarction, unstable angina, uncontrolled arrhythmia or significant heart failure.
  • Indications of uncontrolled metastases or disease progression in CNS lesions (the suspicion of uncontrolled metastases or disease progression should be eliminated by imaging techniques within 14 days prior to enrollment).
  • Medical history in the last 5 years prior to enrollment of any other malignancies (excluding the basal or squamous skin cell carcinoma or in situ carcinoma of the cervix).
  • History of non-healing wound including active gastric ulcer.
  • History of fistula in the last 6 months prior to enrollment.
  • History of gastrointestinal perforations.
  • Patient incapacity (for psychiatric or social reasons) to conform with the protocol.
  • History of hemorrhagic predisposition.
  • History of hypersensitivity to the medications under investigation.
  • Significant proteinurea.
  • Prior immunotherapy within 4 weeks prior to enrollment.
  • Prior radiation treatment within 2 weeks prior to enrollment.
  • Concomitant medication with inducers or strong inhibitors of the coenzyme CYP3A4 (see Appendix 5 for an indicative list of active compounds).
  • Concurrent participation in other interventional clinical trials with investigational medicinal products.
  • History of chronic interstitial lung disease.

Sites / Locations

  • General Hospital of Athens "Hippokratio"
  • General Peripheral Hospital of Athens "Alexandra"
  • Agii Anargiri Cancer Hospital, 2nd Dept of Medical Oncology
  • Agii Anargiri Cancer Hospital, 3rd Dept of Medical Oncology
  • Metropolitan Hospital, 1st Dept of Medical Oncology
  • Metropolitan Hospital, 2nd Dept of Medical Oncology
  • University Hospital of Patras
  • Papageorgiou General Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bevacizumab combined with temsirolimus

Arm Description

Bevacizumab 10mg/kg intravenous every 2 weeks Temsirolimus 25mg intravenous once weekly

Outcomes

Primary Outcome Measures

6-month Progression Free Survival (PFS)
Proportion of patients who are progression-free at 6month evaluation from treatment initiation

Secondary Outcome Measures

Progression Free Survival (PFS)
PFS will be calculated from date of treatment initiation until disease progression or death (whichever occurs first)
Overall Survival (OS)
OS will be calculated from the date of treatment initiation to the date of death or last contact
Response Rate (RR)
RR is defined as the overall percentage of patients with partial (PR) or complete response (CR). The evaluation of responses will be performed according to RECIST criteria
Tumor Shrinkage
Tumor shrinkage will be computed using waterfall plots
Adverse Events (AEs) of all participants will be recorded and assessed upon signature of the informed consent form, until 30 days after the last administration of study treatment.
Adverse Events will be graded according to the NCI CTCAE v3.0 criteria and will be reported in a frequency table according to the highest severity grade observed per patient
Quality of Life (QoL) assessment
QoL will be assessed using the EORTC QLQ C-30 questionnaire. The change in the QoL during treatment will be estimated using the Wilcoxon paired t-test
Investigation of antiangiogenic factors (FGF, VEGF, VEGFRR)
Changes in serum levels of antiangiogenic factors during treatment and correlation to the outcome of study treatment.

Full Information

First Posted
December 20, 2010
Last Updated
February 13, 2017
Sponsor
Hellenic Cooperative Oncology Group
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1. Study Identification

Unique Protocol Identification Number
NCT01264341
Brief Title
Efficacy and Safety of Bevacizumab/Temsirolimus Combination to Treat Advanced Renal Cell Carcinoma
Official Title
Phase II Study of Efficacy and Safety of Bevacizumab in Combination With Temsirolimus, After 1st Line Anti-VEGF Treatment in Patients With Advanced Renal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Terminated
Why Stopped
Based on the developments in the treatment of recurrent metastatic renal cancer, the study treatment is no longer considered to be the best treatment option
Study Start Date
December 2010 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
July 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hellenic Cooperative Oncology Group

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether the combination of bevacizumab/temsirolimus is effective in patients with advanced renal carcinoma progressing after anti-VEGF treatment

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
39 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bevacizumab combined with temsirolimus
Arm Type
Experimental
Arm Description
Bevacizumab 10mg/kg intravenous every 2 weeks Temsirolimus 25mg intravenous once weekly
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Intervention Description
Bevacizumab 10mg/kg intravenous every 2 weeks until disease progression, unacceptable toxicity or consent withdrawal.
Intervention Type
Drug
Intervention Name(s)
Temsirolimus
Intervention Description
Temsirolimus 25mg intravenous once weekly until disease progression, unacceptable toxicity or consent withdrawal.
Primary Outcome Measure Information:
Title
6-month Progression Free Survival (PFS)
Description
Proportion of patients who are progression-free at 6month evaluation from treatment initiation
Time Frame
32 months
Secondary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
PFS will be calculated from date of treatment initiation until disease progression or death (whichever occurs first)
Time Frame
Tumor assessments will be performed every 8 weeks during treatment and at discontinuation, unless it was performed within the last 4 weeks
Title
Overall Survival (OS)
Description
OS will be calculated from the date of treatment initiation to the date of death or last contact
Time Frame
48 months
Title
Response Rate (RR)
Description
RR is defined as the overall percentage of patients with partial (PR) or complete response (CR). The evaluation of responses will be performed according to RECIST criteria
Time Frame
Tumor assessments will be performed every 8 weeks during treatment and at discontinuation, unless it was performed within the last 4 weeks
Title
Tumor Shrinkage
Description
Tumor shrinkage will be computed using waterfall plots
Time Frame
Tumor assessments will be performed every 8 weeks during treatment and at discontinuation, unless it was performed within the last 4 weeks
Title
Adverse Events (AEs) of all participants will be recorded and assessed upon signature of the informed consent form, until 30 days after the last administration of study treatment.
Description
Adverse Events will be graded according to the NCI CTCAE v3.0 criteria and will be reported in a frequency table according to the highest severity grade observed per patient
Time Frame
3 years
Title
Quality of Life (QoL) assessment
Description
QoL will be assessed using the EORTC QLQ C-30 questionnaire. The change in the QoL during treatment will be estimated using the Wilcoxon paired t-test
Time Frame
At baseline and every 8 weeks during treatment
Title
Investigation of antiangiogenic factors (FGF, VEGF, VEGFRR)
Description
Changes in serum levels of antiangiogenic factors during treatment and correlation to the outcome of study treatment.
Time Frame
36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult patients (18th year of age completed) Signed and dated written informed consent form prior to any procedures related to this protocol. Histologically confirmed advanced clear cell renal cancer. Measurable disease. Failure of first line anti-VEGF treatment. Performance status 0-2, according to Eastern Cooperative Oncology Group (ECOG) . Satisfactory hematological parameters: White blood cell count > 4000 mm3. Platelet count 100000/mm3. Neutrophil blood cell count > 1200/ mm3 . Hemoglobin > 9,0 g/dL (can be achieved with red blood cell transfusion). Satisfactory biochemical parameters: Serum creatinine < 2 x Upper Limit of Normal(ULN) Aspartate Aminotransferase (AST)<2,5 x ULN Alanine Transaminase (ALT)< 2,5 x ULN. Bilirubin <2 x ULN (For female patients) Absence of pregnancy (negative pregnancy test for women of reproductive age before enrollment). (For female patients) Non-lactating women. Use of efficient contraceptive measures (women and men) to prevent possible pregnancy of female patient or female partner of a male patient during treatment and until 6 months after the end of treatment. Exclusion Criteria: Prior treatment with mTOR inhibitor. Major surgery (including open biopsy) or insufficient recovery or existence of major trauma within 4 weeks before enrollment. Uncontrolled hypertension. Active infection requiring systemic treatment within 4 weeks prior to enrollment. Minor surgery (for instance, catheter placement) within 2 days before enrollment. Scheduled major surgery within the treatment period. Medical history in the last 6 months prior to enrollment of significant cardiovascular disease, diabetes, cardiac infarction, unstable angina, uncontrolled arrhythmia or significant heart failure. Indications of uncontrolled metastases or disease progression in CNS lesions (the suspicion of uncontrolled metastases or disease progression should be eliminated by imaging techniques within 14 days prior to enrollment). Medical history in the last 5 years prior to enrollment of any other malignancies (excluding the basal or squamous skin cell carcinoma or in situ carcinoma of the cervix). History of non-healing wound including active gastric ulcer. History of fistula in the last 6 months prior to enrollment. History of gastrointestinal perforations. Patient incapacity (for psychiatric or social reasons) to conform with the protocol. History of hemorrhagic predisposition. History of hypersensitivity to the medications under investigation. Significant proteinurea. Prior immunotherapy within 4 weeks prior to enrollment. Prior radiation treatment within 2 weeks prior to enrollment. Concomitant medication with inducers or strong inhibitors of the coenzyme CYP3A4 (see Appendix 5 for an indicative list of active compounds). Concurrent participation in other interventional clinical trials with investigational medicinal products. History of chronic interstitial lung disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aristotelis Bamias, MD, PhD
Organizational Affiliation
General Peripheral Hospital of Athens "Alexandra", Medical School, University of Athens
Official's Role
Study Chair
Facility Information:
Facility Name
General Hospital of Athens "Hippokratio"
City
Athens
ZIP/Postal Code
11527
Country
Greece
Facility Name
General Peripheral Hospital of Athens "Alexandra"
City
Athens
ZIP/Postal Code
11528
Country
Greece
Facility Name
Agii Anargiri Cancer Hospital, 2nd Dept of Medical Oncology
City
Athens
ZIP/Postal Code
14564
Country
Greece
Facility Name
Agii Anargiri Cancer Hospital, 3rd Dept of Medical Oncology
City
Athens
ZIP/Postal Code
14564
Country
Greece
Facility Name
Metropolitan Hospital, 1st Dept of Medical Oncology
City
Athens
ZIP/Postal Code
18547
Country
Greece
Facility Name
Metropolitan Hospital, 2nd Dept of Medical Oncology
City
Athens
ZIP/Postal Code
18547
Country
Greece
Facility Name
University Hospital of Patras
City
Rio, Patras
ZIP/Postal Code
26500
Country
Greece
Facility Name
Papageorgiou General Hospital
City
Thessaloniki
ZIP/Postal Code
56429
Country
Greece

12. IPD Sharing Statement

Citations:
PubMed Identifier
30374686
Citation
Bamias A, Karavasilis V, Gavalas N, Tzannis K, Samantas E, Aravantinos G, Koutras A, Gkerzelis I, Kostouros E, Koutsoukos K, Zagouri F, Fountzilas G, Dimopoulos MA. The combination of bevacizumab/temsirolimus after first-line anti-VEGF therapy in advanced renal-cell carcinoma: a clinical and biomarker study. Int J Clin Oncol. 2019 Apr;24(4):411-419. doi: 10.1007/s10147-018-1361-9. Epub 2018 Oct 29.
Results Reference
derived

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Efficacy and Safety of Bevacizumab/Temsirolimus Combination to Treat Advanced Renal Cell Carcinoma

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