Second Line Sorafenib After Pazopanib in Patients With RCC (SOAP)
Primary Purpose
Metastatic Renal Cell Carcinoma
Status
Terminated
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Sorafenib
Sponsored by
About this trial
This is an interventional treatment trial for Metastatic Renal Cell Carcinoma focused on measuring sorafenib, pazopanib, cross-resistance, TKI, mRCC
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years
- Patients with histological diagnosis of Renal Cell Carcinoma (RCC)
- Measurable disease
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
- Life expectancy of at least 12 weeks.
Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to screening:
- Hemoglobin >= 10.0 g/dl
- Absolute neutrophil count (ANC) >1,500/mm3
- Platelet count >= 100,000/ml
- Total bilirubin ≤ 1.5 times the upper limit of normal
- ALT and AST ≤ 2.5 x upper limit of normal
- Alkaline phosphatase ≤ 4 x upper limit of normal
- prothrombin time-international normalized ratio /partial thromboplastin time ≤ 1.5 x upper limit of normal [Patients who are being therapeutically anticoagulated with an agent such as coumadin or heparin will be allowed to participate provided that no prior evidence of underlying abnormality in these parameters exists.] For patients on warfarin, close monitoring of at least weekly evaluations will be performed, until international normalized ratio is stable based on a measurement at pre-dose, as defined by the local standard of care.
- Prognosis according to Heng: good or intermediate
- Previous treatment with pazopanib
- Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial and two weeks after the completion of trial.
- Signed informed consent must be obtained prior to any study specific procedures
Exclusion Criteria:
- First line treatment for metastatic RCC other than pazopanib.
- History of cardiac disease: congestive heart failure >New York Heart Association class 2; active CAD (MI more than 6 mo prior to study entry is allowed); cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted) or uncontrolled hypertension (>= 160 mmHg systolic and/or 90 mmHg diastolic).
- History of HIV infection
- Active clinically serious infections (> grade 2 NCI-CTC version 3.0)
- Brain or meningeal metastases
- Patients with seizure disorder requiring medication (such as steroids or anti-epileptics)
- History of organ allograft
- Patients with evidence or history of bleeding diathesis
- Patients undergoing renal dialysis
Sites / Locations
- Istituto Tumori
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
sorafenib
Arm Description
Sorafenib 400 mg bid
Outcomes
Primary Outcome Measures
Progression Free Survival (months) of patients treated with sorafenib after progression to pazopanib
Secondary Outcome Measures
Safety profile of sorafenib using Common Terminology Criteria for Adverse Events (CTCAE) criteria v.4.0 in patients previously treated with pazopanib
Overall Survival (months) of patients treated with sorafenib after pazopanib progression
Quality of Life of patients treated with sorafenib after pazopanib progression using the specific questionnaires FKSI-19 and European Organization for Research and Treatment of Cancer quality of life questionnaire -C30.
Full Information
NCT ID
NCT02122003
First Posted
April 6, 2014
Last Updated
November 21, 2017
Sponsor
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
1. Study Identification
Unique Protocol Identification Number
NCT02122003
Brief Title
Second Line Sorafenib After Pazopanib in Patients With RCC
Acronym
SOAP
Official Title
Activity and Safety of Second Line SOrafenib After Pazopanib in Patients With Metastatic Renal Cell Carcinoma (SOAP Study)
Study Type
Interventional
2. Study Status
Record Verification Date
November 2017
Overall Recruitment Status
Terminated
Why Stopped
availability of new and more promising therapeutic agents than expected in the experimentation in question
Study Start Date
September 2016 (undefined)
Primary Completion Date
November 8, 2017 (Actual)
Study Completion Date
November 8, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Retrospective studies showed Sorafenib's efficacy as second line treatment after a Tyrosine Kinase Inhibitor (TKI).
Currently there is no standard of treatment in 2nd line for patients treated in first line with pazopanib for metastatic Renal Cell Carcinoma (mRCC).
With this trial we evaluate the efficacy of sorafenib as second line of treatment in patients treated with pazopanib for mRCC.
Detailed Description
Retrospective studies showed Sorafenib's efficacy as second line treatment after a TKI: AXIS study showed sorafenib activity, in terms of Overall Response Rate (ORR), and the absence statistically significant difference in Overall Survival (OS) between the 2 arms, although there is a significant OS increase of 1.4 months in the Axitinib arm. The INTORSECT study (temsirolimus vs sorafenib in 2nd line after sunitinib) didn't demonstrate statistically significant difference for Progression Free Survival (PFS), but it showed an OS increase in patients treated with sorafenib.
The COMPARZ study demonstrated the non-inferiority of pazopanib vs sunitinib in 1st line of treatment for mRCC.
Currently there is no standard of treatment in 2nd line for patients treated in first line with pazopanib for mRCC.
Primary objective:to evaluate the efficacy of sorafenib (PFS) as second line of treatment in patients treated with pazopanib for mRCC.
Secondary objectives: To evaluate the safety of sorafenib in patients previously treated with pazopanib. To evaluate the Overall Survival. To evaluate the Quality of Life through specific questionnaires (FKSI-19; European Organization for Research and Treatment of Cancer quality of life questionnaire -C30).To assess the predictive role for PFS and OS of arterial blood pressure increase from baseline to week 4 and 8 after start of treatment with sorafenib. To assess the predictive role for PFS and OS of hand-foot syndrome before week 4 and 8 after start of treatment with sorafenib.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Renal Cell Carcinoma
Keywords
sorafenib, pazopanib, cross-resistance, TKI, mRCC
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)
8. Arms, Groups, and Interventions
Arm Title
sorafenib
Arm Type
Experimental
Arm Description
Sorafenib 400 mg bid
Intervention Type
Drug
Intervention Name(s)
Sorafenib
Other Intervention Name(s)
Nexavar
Intervention Description
Sorafenib 400 mg bid
Primary Outcome Measure Information:
Title
Progression Free Survival (months) of patients treated with sorafenib after progression to pazopanib
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Safety profile of sorafenib using Common Terminology Criteria for Adverse Events (CTCAE) criteria v.4.0 in patients previously treated with pazopanib
Time Frame
24 months
Title
Overall Survival (months) of patients treated with sorafenib after pazopanib progression
Time Frame
24 months
Title
Quality of Life of patients treated with sorafenib after pazopanib progression using the specific questionnaires FKSI-19 and European Organization for Research and Treatment of Cancer quality of life questionnaire -C30.
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18 years
Patients with histological diagnosis of Renal Cell Carcinoma (RCC)
Measurable disease
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
Life expectancy of at least 12 weeks.
Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to screening:
Hemoglobin >= 10.0 g/dl
Absolute neutrophil count (ANC) >1,500/mm3
Platelet count >= 100,000/ml
Total bilirubin ≤ 1.5 times the upper limit of normal
ALT and AST ≤ 2.5 x upper limit of normal
Alkaline phosphatase ≤ 4 x upper limit of normal
prothrombin time-international normalized ratio /partial thromboplastin time ≤ 1.5 x upper limit of normal [Patients who are being therapeutically anticoagulated with an agent such as coumadin or heparin will be allowed to participate provided that no prior evidence of underlying abnormality in these parameters exists.] For patients on warfarin, close monitoring of at least weekly evaluations will be performed, until international normalized ratio is stable based on a measurement at pre-dose, as defined by the local standard of care.
Prognosis according to Heng: good or intermediate
Previous treatment with pazopanib
Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial and two weeks after the completion of trial.
Signed informed consent must be obtained prior to any study specific procedures
Exclusion Criteria:
First line treatment for metastatic RCC other than pazopanib.
History of cardiac disease: congestive heart failure >New York Heart Association class 2; active CAD (MI more than 6 mo prior to study entry is allowed); cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted) or uncontrolled hypertension (>= 160 mmHg systolic and/or 90 mmHg diastolic).
History of HIV infection
Active clinically serious infections (> grade 2 NCI-CTC version 3.0)
Brain or meningeal metastases
Patients with seizure disorder requiring medication (such as steroids or anti-epileptics)
History of organ allograft
Patients with evidence or history of bleeding diathesis
Patients undergoing renal dialysis
Facility Information:
Facility Name
Istituto Tumori
City
Milan
State/Province
Mi
ZIP/Postal Code
20156
Country
Italy
12. IPD Sharing Statement
Citations:
PubMed Identifier
25688511
Citation
Iacovelli R, Verzoni E, Grassi P, Farcomeni A, de Braud F, Procopio G. Rationale and protocol of SOAP: a phase II study to evaluate the efficacy of sorafenib as second-line treatment after pazopanib in patients with advanced renal cell carcinoma. Tumori. 2014 Nov-Dec;100(6):e282-5. doi: 10.1700/1778.19296.
Results Reference
derived
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Second Line Sorafenib After Pazopanib in Patients With RCC
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