A Study of Cabozantinib (XL184) vs Everolimus in Subjects With Metastatic Renal Cell Carcinoma (METEOR)
Primary Purpose
Renal Cell Carcinoma
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Cabozantinib tablets
Everolimus (Afinitor) tablets
Sponsored by
About this trial
This is an interventional treatment trial for Renal Cell Carcinoma focused on measuring renal cell cancer, kidney, vascular endothelial growth factor receptor 2 (VEGFR2), tyrosine kinase inhibitor, hepatocyte growth factor receptor protein (MET), von Hippel-Lindau gene
Eligibility Criteria
Select Inclusion Criteria:
- Documented histological or cytological diagnosis of renal cell cancer with a clear-cell component.
- Measurable disease as determined by the investigator.
- Must have received at least one VEGFR-targeting TKI (eg, sorafenib, sunitinib, axitinib, pazopanib or tivozanib).
- Recovery from toxicities related to any prior treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive therapy.
- Adequate organ and marrow function.
- Sexually active fertile subjects(male and female)must agree to use medically accepted methods of contraception during the course of the study and for 4 months after the last dose of study treatment.
- Female subjects of childbearing potential must not be pregnant at screening.
Select Exclusion Criteria:
- Prior treatment with everolimus, or any other specific or selective TORC1/PI3K/AKT inhibitor (eg, temsirolimus), or cabozantinib.
- Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitor) within 2 weeks before randomization.
- Receipt of any type of anticancer antibody (including investigational antibody) within 4 weeks before randomization.
- Radiation therapy for bone metastasis within 2 weeks, any other external radiation therapy within 4 weeks before randomization. Systemic treatment with radionuclides within 6 weeks before randomization. Subjects with clinically relevant ongoing complications from prior radiation therapy are not eligible.
- Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery and stable for at least 3 months before randomization.
- Concomitant anticoagulation at therapeutic doses with oral anticoagulants or platelet inhibitors.
- Chronic treatment with corticosteroids or other immunosuppressive agents.
- Serious illness other than cancer.
- Major surgery within 3 months before randomization. Complete wound healing from major surgery must have occurred 1 month before randomization and from minor surgery at least 10 days before randomization.
- Pregnant or lactating females.
- Diagnosis of another malignancy within 2 years before randomization, except for superficial skin cancers, or localized, low grade tumors.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Cabozantinib (XL184)
Everolimus (Afinitor)
Arm Description
Cabozantinib (XL184) 60 mg tablet once daily.
Everolimus (Afinitor) 10 mg tablet once daily.
Outcomes
Primary Outcome Measures
Progression-free Survival (PFS)
The primary analysis of PFS is the time from randomization to date of first documented tumor progression as determined by investigator (per RECIST 1.1 criteria) or death due to any cause, whichever occurred first. A Kaplan-Meier analysis was performed to estimate the median duration.
Secondary Outcome Measures
Overall Survival (OS)
Overall Survival (OS) is defined as the time from randomization to the date of death. Participants that had not died were censored at last known date alive. Median OS was calculated using Kaplan-Meier estimates. Interim analyses for OS occurred after 320 deaths (78% of the total OS events needed for final analysis).
Objective Response Rate (ORR)
Objective Response Rate (ORR) is the number of participants with a best response of complete response (CR) or partial response (PR) divided by number of randomized participants. ORR was assessed by the Independent Radiology Committee (IRC) per RECIST 1.1 which was confirmed by a subsequent visit >= 28 days later, and was analyzed in the Intent to Treat (ITT) population at the time of the primary analysis of Progression Free Survival (PFS). The data cutoff date was 22 May 2015.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01865747
Brief Title
A Study of Cabozantinib (XL184) vs Everolimus in Subjects With Metastatic Renal Cell Carcinoma
Acronym
METEOR
Official Title
A Phase 3, Randomized, Controlled Study of Cabozantinib (XL184) vs Everolimus in Subjects With Metastatic Renal Cell Carcinoma That Has Progressed After Prior VEGFR Tyrosine Kinase Inhibitor Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
June 2013 (undefined)
Primary Completion Date
May 22, 2015 (Actual)
Study Completion Date
January 15, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Exelixis
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the effect of Cabozantinib (XL184) compared with Everolimus (Afinitor) on progression-free survival (PFS) and overall survival (OS) in subjects with advanced renal cell cancer that has progressed after prior VEGFR tyrosine kinase inhibitor therapy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Cell Carcinoma
Keywords
renal cell cancer, kidney, vascular endothelial growth factor receptor 2 (VEGFR2), tyrosine kinase inhibitor, hepatocyte growth factor receptor protein (MET), von Hippel-Lindau gene
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
658 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cabozantinib (XL184)
Arm Type
Experimental
Arm Description
Cabozantinib (XL184) 60 mg tablet once daily.
Arm Title
Everolimus (Afinitor)
Arm Type
Active Comparator
Arm Description
Everolimus (Afinitor) 10 mg tablet once daily.
Intervention Type
Drug
Intervention Name(s)
Cabozantinib tablets
Other Intervention Name(s)
XL184
Intervention Type
Drug
Intervention Name(s)
Everolimus (Afinitor) tablets
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
The primary analysis of PFS is the time from randomization to date of first documented tumor progression as determined by investigator (per RECIST 1.1 criteria) or death due to any cause, whichever occurred first. A Kaplan-Meier analysis was performed to estimate the median duration.
Time Frame
PFS is measured from the date of randomization until the date of first documented disease progression or date of death from any cause as determined by the Independent Radiology Committee (IRC) per RECIST 1.1, assessed for up to 17 months.
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
Overall Survival (OS) is defined as the time from randomization to the date of death. Participants that had not died were censored at last known date alive. Median OS was calculated using Kaplan-Meier estimates. Interim analyses for OS occurred after 320 deaths (78% of the total OS events needed for final analysis).
Time Frame
OS was measured from the time of randomization until 320 deaths, approximately 28 months
Title
Objective Response Rate (ORR)
Description
Objective Response Rate (ORR) is the number of participants with a best response of complete response (CR) or partial response (PR) divided by number of randomized participants. ORR was assessed by the Independent Radiology Committee (IRC) per RECIST 1.1 which was confirmed by a subsequent visit >= 28 days later, and was analyzed in the Intent to Treat (ITT) population at the time of the primary analysis of Progression Free Survival (PFS). The data cutoff date was 22 May 2015.
Time Frame
ORR was assessed at 8 weeks post-randomization, every 8 weeks for 12 months, and every 12 weeks until date of disease progression or death, up to May 2015 (approximately 21 months)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Select Inclusion Criteria:
Documented histological or cytological diagnosis of renal cell cancer with a clear-cell component.
Measurable disease as determined by the investigator.
Must have received at least one VEGFR-targeting TKI (eg, sorafenib, sunitinib, axitinib, pazopanib or tivozanib).
Recovery from toxicities related to any prior treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive therapy.
Adequate organ and marrow function.
Sexually active fertile subjects(male and female)must agree to use medically accepted methods of contraception during the course of the study and for 4 months after the last dose of study treatment.
Female subjects of childbearing potential must not be pregnant at screening.
Select Exclusion Criteria:
Prior treatment with everolimus, or any other specific or selective TORC1/PI3K/AKT inhibitor (eg, temsirolimus), or cabozantinib.
Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitor) within 2 weeks before randomization.
Receipt of any type of anticancer antibody (including investigational antibody) within 4 weeks before randomization.
Radiation therapy for bone metastasis within 2 weeks, any other external radiation therapy within 4 weeks before randomization. Systemic treatment with radionuclides within 6 weeks before randomization. Subjects with clinically relevant ongoing complications from prior radiation therapy are not eligible.
Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery and stable for at least 3 months before randomization.
Concomitant anticoagulation at therapeutic doses with oral anticoagulants or platelet inhibitors.
Chronic treatment with corticosteroids or other immunosuppressive agents.
Serious illness other than cancer.
Major surgery within 3 months before randomization. Complete wound healing from major surgery must have occurred 1 month before randomization and from minor surgery at least 10 days before randomization.
Pregnant or lactating females.
Diagnosis of another malignancy within 2 years before randomization, except for superficial skin cancers, or localized, low grade tumors.
Facility Information:
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Ontario
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Toronto
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Montreal
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Canada
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Saskatoon
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Canada
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Santiago
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Chile
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Olomouc
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775 20
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Czechia
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Brno
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656 91
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Czechia
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Prague
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128 08
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Czechia
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Herlev
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Hovedstaden
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Denmark
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Aarhus
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Midtjylland
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DK-8000
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Denmark
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Denmark
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Turku
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Helsinki
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Finland
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France
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Besancon
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Doubs
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25030
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France
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Bordeaux
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Gironde
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33075
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France
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Toulouse
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31052
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France
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Rennes
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Ille-et-Vilaine
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35042
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France
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Nantes
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Loire-Atlantique
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44805
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France
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Lyon
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Rhône
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96008
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France
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Le Mans
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Sarthe
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France
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Villejuif
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Val-de-Marne
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94805
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France
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Marseille
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13273
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France
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Paris
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France
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Freiburg
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Germany
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Tubingen
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Baden-Württemberg
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Germany
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Ulm
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Baden-Württemberg
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Germany
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Bayern
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Germany
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Aachen
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52074
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Germany
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Essen
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Nordrhein-Westfalen
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45122
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Germany
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Mainz
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Rheinland-Pfalz
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55131
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Germany
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Jena
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Thuringen
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99089
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Germany
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Erfurt
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Thüringen
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99089
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Germany
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Berlin
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12200
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Germany
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Dresden
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01307
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Germany
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Frankfurt am Main
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60590
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Germany
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Guetersloh
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33332
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Germany
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Hamburg
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20246
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Germany
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Hannover
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30605
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Germany
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Heidelberg
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69120
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Germany
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Munchen
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81675
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Germany
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Munich
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81377
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Germany
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Budapest
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1122
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Hungary
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Szolnok
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5004
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Hungary
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Dublin
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24
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Ireland
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Dublin
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7
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Ireland
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Meldola
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Emilia-Romagna
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47014
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Italy
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Modena
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Emilia-Romagna
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41124
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Italy
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Ravenna
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Emilia-Romagna
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48100
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Italy
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Rome
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Lazio
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00128
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Italy
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Rome
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Lazio
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00152
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Italy
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Genova
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Liguria
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16132
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Italy
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Cremona
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Lombardia
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Lombardia
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Italy
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Bari
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Puglia
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70124
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Italy
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Arezzo
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Toscana
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52100
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Italy
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Terni
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Umbria
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05100
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Italy
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Seoul
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110-744
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Korea, Republic of
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Seoul
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120-752
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Korea, Republic of
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Seoul
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Korea, Republic of
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Maastricht
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Limburg
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6229 HX
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Netherlands
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Amsterdam
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Noord-Holland
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1066 CX
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Netherlands
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Leiden
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Zuid-Holland
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2333 ZA
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Netherlands
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Rotterdam
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Zuid-Holland
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3045 PM
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Netherlands
City
Bialystok
State/Province
Podlaskie
ZIP/Postal Code
15-027
Country
Poland
City
Gdansk
State/Province
Pomorskie
ZIP/Postal Code
80-210
Country
Poland
City
Poznan
State/Province
Wielkopolskie
ZIP/Postal Code
60-569
Country
Poland
City
Warsaw
ZIP/Postal Code
04-909
Country
Poland
City
Lisbon
ZIP/Postal Code
1500-650
Country
Portugal
City
Lisbon
ZIP/Postal Code
1649-035
Country
Portugal
City
Porto
ZIP/Postal Code
200-072
Country
Portugal
City
Moscow
ZIP/Postal Code
115478
Country
Russian Federation
City
Omsk
ZIP/Postal Code
644013
Country
Russian Federation
City
St. Petersburg
ZIP/Postal Code
196247
Country
Russian Federation
City
Yaroslavl
ZIP/Postal Code
150040
Country
Russian Federation
City
Presov
ZIP/Postal Code
08001
Country
Slovakia
City
Zilina
ZIP/Postal Code
01207
Country
Slovakia
City
Oviedo
State/Province
Asturias
ZIP/Postal Code
33006
Country
Spain
City
Barcelona
State/Province
Cataluna
ZIP/Postal Code
08025
Country
Spain
City
Badalona
State/Province
Cataluña
ZIP/Postal Code
08003
Country
Spain
City
L'Hospitalet de Llobregat
State/Province
Cataluña
ZIP/Postal Code
08907
Country
Spain
City
Pamplona
State/Province
Navarra
ZIP/Postal Code
31008
Country
Spain
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
City
Madrid
ZIP/Postal Code
28034
Country
Spain
City
Madrid
ZIP/Postal Code
28041
Country
Spain
City
Madrid
ZIP/Postal Code
28922
Country
Spain
City
Málaga
ZIP/Postal Code
Málaga
Country
Spain
City
Santiago de Compostela
ZIP/Postal Code
15706
Country
Spain
City
Seville
ZIP/Postal Code
28050
Country
Spain
City
Valencia
ZIP/Postal Code
46010
Country
Spain
City
Lund
State/Province
Skane Lan
ZIP/Postal Code
SE-22185
Country
Sweden
City
Stockholm
State/Province
Sodermanlands Lan
Country
Sweden
City
Umea
Country
Sweden
City
Taichung
Country
Taiwan
City
Taipei
Country
Taiwan
City
Ankara
ZIP/Postal Code
6500
Country
Turkey
City
Gaziantep
ZIP/Postal Code
27100
Country
Turkey
City
Istanbul
ZIP/Postal Code
34365
Country
Turkey
City
Izmir
ZIP/Postal Code
35100
Country
Turkey
City
Birmingham
State/Province
England
ZIP/Postal Code
B15 2TH
Country
United Kingdom
City
Derby
State/Province
England
ZIP/Postal Code
DE22 3NE
Country
United Kingdom
City
Guildford
State/Province
England
ZIP/Postal Code
GU2 7XX
Country
United Kingdom
City
London
State/Province
England
ZIP/Postal Code
EC1A 7BE
Country
United Kingdom
City
London
State/Province
England
ZIP/Postal Code
SE1 9ER
Country
United Kingdom
City
London
State/Province
England
Country
United Kingdom
City
Manchester
State/Province
England
ZIP/Postal Code
M20 4BX
Country
United Kingdom
City
Northwood
State/Province
England
ZIP/Postal Code
HA6 2RN
Country
United Kingdom
City
Wirral
State/Province
England
ZIP/Postal Code
CH63 4JY
Country
United Kingdom
City
Aberdeen
State/Province
Scotland
ZIP/Postal Code
AB25 2ZN
Country
United Kingdom
City
Edinburgh
State/Province
Scotland
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
City
Glasgow
State/Province
Scotland
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
34921022
Citation
Denize T, Farah S, Cimadamore A, Flaifel A, Walton E, Sticco-Ivins MA, Labaki C, Braun DA, Sun M, Wang E, Xie W, Choueiri TK, Signoretti S. Biomarkers of Angiogenesis and Clinical Outcomes to Cabozantinib and Everolimus in Patients with Metastatic Renal Cell Carcinoma from the Phase III METEOR Trial. Clin Cancer Res. 2022 Feb 15;28(4):748-755. doi: 10.1158/1078-0432.CCR-21-3088.
Results Reference
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PubMed Identifier
34364385
Citation
Powles T, Choueiri TK, Motzer RJ, Jonasch E, Pal S, Tannir NM, Signoretti S, Kaldate R, Scheffold C, Wang E, Aftab DT, Escudier B, George DJ. Outcomes based on plasma biomarkers in METEOR, a randomized phase 3 trial of cabozantinib vs everolimus in advanced renal cell carcinoma. BMC Cancer. 2021 Aug 7;21(1):904. doi: 10.1186/s12885-021-08630-w. Erratum In: BMC Cancer. 2021 Sep 15;21(1):1023.
Results Reference
derived
PubMed Identifier
31887537
Citation
Donskov F, Motzer RJ, Voog E, Hovey E, Grullich C, Nott LM, Cuff K, Gil T, Jensen NV, Chevreau C, Negrier S, Depenbusch R, Bergmann L, Cornelio I, Champsaur A, Escudier B, Pal S, Powles T, Choueiri TK. Outcomes based on age in the phase III METEOR trial of cabozantinib versus everolimus in patients with advanced renal cell carcinoma. Eur J Cancer. 2020 Feb;126:1-10. doi: 10.1016/j.ejca.2019.10.032. Epub 2019 Dec 27.
Results Reference
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PubMed Identifier
31371341
Citation
Flaifel A, Xie W, Braun DA, Ficial M, Bakouny Z, Nassar AH, Jennings RB, Escudier B, George DJ, Motzer RJ, Morris MJ, Powles T, Wang E, Huang Y, Freeman GJ, Choueiri TK, Signoretti S. PD-L1 Expression and Clinical Outcomes to Cabozantinib, Everolimus, and Sunitinib in Patients with Metastatic Renal Cell Carcinoma: Analysis of the Randomized Clinical Trials METEOR and CABOSUN. Clin Cancer Res. 2019 Oct 15;25(20):6080-6088. doi: 10.1158/1078-0432.CCR-19-1135. Epub 2019 Aug 1.
Results Reference
derived
PubMed Identifier
29377755
Citation
Cella D, Escudier B, Tannir NM, Powles T, Donskov F, Peltola K, Schmidinger M, Heng DYC, Mainwaring PN, Hammers HJ, Lee JL, Roth BJ, Marteau F, Williams P, Baer J, Mangeshkar M, Scheffold C, Hutson TE, Pal S, Motzer RJ, Choueiri TK. Quality of Life Outcomes for Cabozantinib Versus Everolimus in Patients With Metastatic Renal Cell Carcinoma: METEOR Phase III Randomized Trial. J Clin Oncol. 2018 Mar 10;36(8):757-764. doi: 10.1200/JCO.2017.75.2170. Epub 2018 Jan 29.
Results Reference
derived
PubMed Identifier
29309249
Citation
Escudier B, Powles T, Motzer RJ, Olencki T, Aren Frontera O, Oudard S, Rolland F, Tomczak P, Castellano D, Appleman LJ, Drabkin H, Vaena D, Milwee S, Youkstetter J, Lougheed JC, Bracarda S, Choueiri TK. Cabozantinib, a New Standard of Care for Patients With Advanced Renal Cell Carcinoma and Bone Metastases? Subgroup Analysis of the METEOR Trial. J Clin Oncol. 2018 Mar 10;36(8):765-772. doi: 10.1200/JCO.2017.74.7352. Epub 2018 Jan 8.
Results Reference
derived
PubMed Identifier
27279544
Citation
Choueiri TK, Escudier B, Powles T, Tannir NM, Mainwaring PN, Rini BI, Hammers HJ, Donskov F, Roth BJ, Peltola K, Lee JL, Heng DYC, Schmidinger M, Agarwal N, Sternberg CN, McDermott DF, Aftab DT, Hessel C, Scheffold C, Schwab G, Hutson TE, Pal S, Motzer RJ; METEOR investigators. Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2016 Jul;17(7):917-927. doi: 10.1016/S1470-2045(16)30107-3. Epub 2016 Jun 5.
Results Reference
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PubMed Identifier
26406150
Citation
Choueiri TK, Escudier B, Powles T, Mainwaring PN, Rini BI, Donskov F, Hammers H, Hutson TE, Lee JL, Peltola K, Roth BJ, Bjarnason GA, Geczi L, Keam B, Maroto P, Heng DY, Schmidinger M, Kantoff PW, Borgman-Hagey A, Hessel C, Scheffold C, Schwab GM, Tannir NM, Motzer RJ; METEOR Investigators. Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma. N Engl J Med. 2015 Nov 5;373(19):1814-23. doi: 10.1056/NEJMoa1510016. Epub 2015 Sep 25.
Results Reference
derived
Learn more about this trial
A Study of Cabozantinib (XL184) vs Everolimus in Subjects With Metastatic Renal Cell Carcinoma
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