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Phase 3 Trial of Autologous Dendritic Cell Immunotherapy Plus Standard Treatment of Advanced Renal Cell Carcinoma (ADAPT)

Primary Purpose

Advanced Renal Cell Carcinoma, Renal Cell Carcinoma, Metastatic Renal Cell Carcinoma

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Standard Treatment
AGS-003
Sponsored by
Argos Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Renal Cell Carcinoma focused on measuring RCC, Kidney Cancer

Eligibility Criteria

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

Key Inclusion Criteria for Tumor Collection:

  1. Diagnosis or clinical signs of advanced RCC
  2. Scheduled for cytoreductive or partial nephrectomy

Key Exclusion Criteria for Tumor Collection:

  1. Known inability to undergo sunitinib treatment as currently labeled, due to pre-existing medical conditions
  2. Requirement for systemic chronic immunosuppressive drugs or corticosteroids
  3. Evidence of brain metastases prior to nephrectomy

Key Inclusion Criteria for Treatment Study:

  1. Advanced disease, histologically assessed as RCC, with predominantly clear cell histology
  2. Metastatic disease (measurable or non-measurable) that can be monitored throughout the course of the study participation per RECIST 1.1
  3. Subjects who are candidates for standard first-line therapy initiating with sunitinib
  4. Time from diagnosis to treatment < 1 year
  5. Karnofsky performance status (KPS) ≥ 70%
  6. Life expectancy of 6 months or greater
  7. Resolution of all acute toxic effects of prior radiotherapy or surgical procedures to Grade ≤ 1 according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
  8. Adequate hematologic, renal, hepatic, and coagulation function
  9. Negative serum pregnancy test for female subjects with reproductive potential, and agreement of all male and female subjects of reproductive potential to use a reliable form of contraception during the study and for 12 weeks after the last dose of study drug
  10. Normal ECG or clinically non-significant finding(s) at Screening
  11. Able to abstain from taking prohibited drugs, either prescription or non-prescription, during the treatment phase of the study
  12. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures

Key Exclusion Criteria for Treatment Study:

  1. Prior systemic therapy (including adjuvant or neoadjuvant) of any kind for RCC, including immunotherapy, chemotherapy, hormonal, or investigational therapy
  2. Prior history of malignancy within the preceding 3 years, except for adequately treated in situ carcinomas or non-melanoma skin cancer, adequately treated early stage breast cancer, superficial bladder cancer, and non-metastatic prostate cancer with a normal PSA
  3. History of or known brain metastases, spinal cord compression, or carcinomatous meningitis, or evidence of brain or leptomeningeal disease
  4. Patients with 4 or more of the following risk factors:

    1. Hgb < LLN
    2. Corrected calcium > 10.0 mg/dL
    3. KPS < 80%
    4. Neutrophils > ULN
    5. Platelets > ULN
  5. Planned or elective surgical treatment post-nephrectomy for the direct management of RCC, within 28 days before Visit 1 (Week 0)
  6. NCI CTCAE Grade 3 hemorrhage < 28 days before Visit 1 (Day 0)
  7. Clinically significant cardiovascular conditions within 3 months prior to Randomization
  8. Significant gastrointestinal abnormalities
  9. Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication
  10. Active autoimmune disease or condition requiring chronic immunosuppressive therapy
  11. Clinically significant infections, including human immunodeficiency virus, syphilis, and active hepatitis B or C
  12. Current treatment with an investigational therapy on another clinical trial
  13. Pregnancy or breastfeeding
  14. Any serious medical condition or illness considered by the investigator to constitute an unwarranted high risk for investigational treatment

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

AGS-003 + Standard Treatment

Standard Treatment

Arm Description

Subjects on this arm will receive standard treatment for Renal Cell Carcinoma. In addition, subjects will receive AGS-003.

Subjects on this arm will receive standard treatment for Renal Cell Carcinoma.

Outcomes

Primary Outcome Measures

Overall Survival
Duration from randomization to death

Secondary Outcome Measures

Progression Free Survival
Tumor Response
Monitor for evidence of the following tumor responses: Objective response rate, Duration of overall response, and Disease control rate.
Monitor treatment emergent adverse events between both arms
Compare adverse events between both arms.

Full Information

First Posted
April 19, 2012
Last Updated
June 13, 2018
Sponsor
Argos Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT01582672
Brief Title
Phase 3 Trial of Autologous Dendritic Cell Immunotherapy Plus Standard Treatment of Advanced Renal Cell Carcinoma
Acronym
ADAPT
Official Title
An International Phase 3 Randomized Trial of Autologous Dendritic Cell Immunotherapy (AGS-003) Plus Standard Treatment of Advanced Renal Cell Carcinoma (ADAPT)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy
Study Start Date
November 2012 (undefined)
Primary Completion Date
April 2018 (Actual)
Study Completion Date
April 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Argos Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a trial of AGS-003, which is being studied as a possible treatment for Advanced Renal Cell Carcinoma. The purpose of this study is to determine whether there is an overall survival (OS) benefit between subjects treated with AGS-003 in combination with standard treatment versus subjects treated with standard treatment alone.
Detailed Description
This study will investigate the combination of an autologous ribonucleic acid (RNA) electroporated dendritic cell (DC) based immunotherapy, AGS-003, plus standard treatment (initiating with sunitinib). The primary objective in this study is to determine the median OS achieved by this combination compared to the OS resulting from use of active control (standard treatment), in a population of adults with advanced renal cell carcinoma (RCC), with nephrectomy indicated, and with remaining metastatic disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Renal Cell Carcinoma, Renal Cell Carcinoma, Metastatic Renal Cell Carcinoma
Keywords
RCC, Kidney Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
462 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AGS-003 + Standard Treatment
Arm Type
Experimental
Arm Description
Subjects on this arm will receive standard treatment for Renal Cell Carcinoma. In addition, subjects will receive AGS-003.
Arm Title
Standard Treatment
Arm Type
Active Comparator
Arm Description
Subjects on this arm will receive standard treatment for Renal Cell Carcinoma.
Intervention Type
Drug
Intervention Name(s)
Standard Treatment
Other Intervention Name(s)
Sunitinib
Intervention Description
Standard treatment for Renal Cell Carcinoma
Intervention Type
Biological
Intervention Name(s)
AGS-003
Intervention Description
Autologous Dendritic Cell product. Intradermal injections; 8 injections in the 1st year followed by quarterly boosters.
Primary Outcome Measure Information:
Title
Overall Survival
Description
Duration from randomization to death
Time Frame
From date of subject randomization to date of death; assessed up to 42 months or until 290 deaths have been accrued on study
Secondary Outcome Measure Information:
Title
Progression Free Survival
Time Frame
From date of subject randomization to date of progression; assessed up to 42 months
Title
Tumor Response
Description
Monitor for evidence of the following tumor responses: Objective response rate, Duration of overall response, and Disease control rate.
Time Frame
From date of subject randomization to date of progression; assessed up to 42 months
Title
Monitor treatment emergent adverse events between both arms
Description
Compare adverse events between both arms.
Time Frame
From safety baseline until either meeting a discontinuation criterion or death; assessed up to 42 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria for Tumor Collection: Diagnosis or clinical signs of advanced RCC Scheduled for cytoreductive or partial nephrectomy Key Exclusion Criteria for Tumor Collection: Known inability to undergo sunitinib treatment as currently labeled, due to pre-existing medical conditions Requirement for systemic chronic immunosuppressive drugs or corticosteroids Evidence of brain metastases prior to nephrectomy Key Inclusion Criteria for Treatment Study: Advanced disease, histologically assessed as RCC, with predominantly clear cell histology Metastatic disease (measurable or non-measurable) that can be monitored throughout the course of the study participation per RECIST 1.1 Subjects who are candidates for standard first-line therapy initiating with sunitinib Time from diagnosis to treatment < 1 year Karnofsky performance status (KPS) ≥ 70% Life expectancy of 6 months or greater Resolution of all acute toxic effects of prior radiotherapy or surgical procedures to Grade ≤ 1 according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 Adequate hematologic, renal, hepatic, and coagulation function Negative serum pregnancy test for female subjects with reproductive potential, and agreement of all male and female subjects of reproductive potential to use a reliable form of contraception during the study and for 12 weeks after the last dose of study drug Normal ECG or clinically non-significant finding(s) at Screening Able to abstain from taking prohibited drugs, either prescription or non-prescription, during the treatment phase of the study Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures Key Exclusion Criteria for Treatment Study: Prior systemic therapy (including adjuvant or neoadjuvant) of any kind for RCC, including immunotherapy, chemotherapy, hormonal, or investigational therapy Prior history of malignancy within the preceding 3 years, except for adequately treated in situ carcinomas or non-melanoma skin cancer, adequately treated early stage breast cancer, superficial bladder cancer, and non-metastatic prostate cancer with a normal PSA History of or known brain metastases, spinal cord compression, or carcinomatous meningitis, or evidence of brain or leptomeningeal disease Patients with 4 or more of the following risk factors: Hgb < LLN Corrected calcium > 10.0 mg/dL KPS < 80% Neutrophils > ULN Platelets > ULN Planned or elective surgical treatment post-nephrectomy for the direct management of RCC, within 28 days before Visit 1 (Week 0) NCI CTCAE Grade 3 hemorrhage < 28 days before Visit 1 (Day 0) Clinically significant cardiovascular conditions within 3 months prior to Randomization Significant gastrointestinal abnormalities Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication Active autoimmune disease or condition requiring chronic immunosuppressive therapy Clinically significant infections, including human immunodeficiency virus, syphilis, and active hepatitis B or C Current treatment with an investigational therapy on another clinical trial Pregnancy or breastfeeding Any serious medical condition or illness considered by the investigator to constitute an unwarranted high risk for investigational treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Figlin, MD, FACP
Organizational Affiliation
Cedars-Sinai Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Christopher G Wood, MD, FACP
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
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Scottsdale
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Little Rock
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Canada
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Canada
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Ontario
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Canada
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Canada
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Montreal
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Quebec
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Canada
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Montreal
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Quebec
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Canada
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Quebec
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Canada
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Hradec Kralove
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50005
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Czechia
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Liberec
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46063
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Czechia
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Olomouc
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77520
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Czechia
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Prague
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10034
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Czechia
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Praha 8
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18081
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Czechia
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Budapest
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H-1062
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Hungary
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Budapest
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H-1122
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Hungary
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Debrecen
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H-4032
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Hungary
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Haifa
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31096
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Israel
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Jerusalem
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91120
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Israel
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Kfar Saba
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44281
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Israel
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Rehovot
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76100
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Israel
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Tel Hashomer
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52621
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Israel
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Zerifin
ZIP/Postal Code
70300
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Israel
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Roma
ZIP/Postal Code
00152
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Italy
City
Rome
ZIP/Postal Code
00144
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Italy
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Badalona
ZIP/Postal Code
08916
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Spain
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
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Barcelona
ZIP/Postal Code
08035
Country
Spain
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Madrid
ZIP/Postal Code
28033
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Spain
City
Madrid
ZIP/Postal Code
28046
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Spain
City
Madrid
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28050
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Spain
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Sevilla
ZIP/Postal Code
41013
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Spain
City
Valencia
ZIP/Postal Code
46009
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Spain
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Vigo
ZIP/Postal Code
36204
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Spain
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Cambridge
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CB20QQ
Country
United Kingdom
City
Norwich
ZIP/Postal Code
NR47UY
Country
United Kingdom
City
Preston
ZIP/Postal Code
PR29HT
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32034074
Citation
Figlin RA, Tannir NM, Uzzo RG, Tykodi SS, Chen DYT, Master V, Kapoor A, Vaena D, Lowrance W, Bratslavsky G, DeBenedette M, Gamble A, Plachco A, Norris MS, Horvatinovich J, Tcherepanova IY, Nicolette CA, Wood CG; ADAPT study group. Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma. Clin Cancer Res. 2020 May 15;26(10):2327-2336. doi: 10.1158/1078-0432.CCR-19-2427. Epub 2020 Feb 7.
Results Reference
derived

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Phase 3 Trial of Autologous Dendritic Cell Immunotherapy Plus Standard Treatment of Advanced Renal Cell Carcinoma

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