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Investigator-Initiated Trial of Combined Ipilimumab, Nivolumab and Stereotactic Radiation in Patients With Metastatic Clear-Cell RCC (ccRCC) Who Have Failed Treatment With Single-Agent Nivolumab

Primary Purpose

Clear Cell Renal Cell Carcinoma, Metastatic Renal Cell Carcinoma

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Nivolumab
Ipilimumab
Steriotactic radiation therapy
Sponsored by
Medical University of South Carolina
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Clear Cell Renal Cell Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of metastatic ccRCC.
  • Age 18 years and older
  • ECOG 0-1
  • Progressive disease after treatment with single-agent nivolumab
  • Life expectancy at least 3 months
  • Presence of measurable disease per RECIST 1.1 criteria
  • Presence of a metastatic lesion greater than 1 cm in size that is amenable to radiation treatment
  • Adequate organ system function
  • WOCBP and men who are sexually active with WOCBP must agree to use appropriate method(s) of contraception.

Exclusion Criteria:

  • Patients are excluded if they have active brain metastases or leptomeningeal metastases (exceptions outlined in the protocol).
  • Active, known or suspected autoimmune disease, such as systemic lupus erythematosus, that require treatment with immune suppressing drugs.

Note: Subjects are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger

  • Presence of a condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone or equivalents) or other immunosuppressive medications within 14 days of study drug administration.

Note: Inhaled or topical steroids and adrenal replacement doses > 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.

  • Unstable angina or uncontrolled congestive heart failure
  • Uncontrolled hypercalcemia
  • Positive test for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection
  • Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
  • Presence of other malignant diseases, except non-melanoma skin care
  • History of allergy to study drug components.
  • History of severe hypersensitivity reaction to any monoclonal antibody.
  • Anti-cancer treatment including surgery, radiotherapy, chemotherapy, other immunotherapy, or investigational therapy within 14 days of registration.
  • Women must not be pregnant or breastfeeding. WOCBP must have a negative serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 7 days prior to registration.
  • Any other medical condition for which treatment with ipilimumab or nivolumab would be medically contraindicated

Sites / Locations

  • Medical University of South Carolina

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Nivolumab + Ipilimumab + SRT

Arm Description

Outcomes

Primary Outcome Measures

Number of patients with a partial or complete response
The response rate of combined ipilimumab and nivolumab plus STR will be determined using irRECIST criteria.

Secondary Outcome Measures

Progression free survival (PFS)
PFS will be determined from the onset of treatment to the time of documented disease progression.

Full Information

First Posted
May 4, 2017
Last Updated
June 14, 2018
Sponsor
Medical University of South Carolina
Collaborators
Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT03149159
Brief Title
Investigator-Initiated Trial of Combined Ipilimumab, Nivolumab and Stereotactic Radiation in Patients With Metastatic Clear-Cell RCC (ccRCC) Who Have Failed Treatment With Single-Agent Nivolumab
Official Title
An Investigator-Initiated Trial of Combined Ipilimumab, Nivolumab and Stereotactic Radiation in Patients With Metastatic Clear-Cell RCC (ccRCC) Who Have Failed Treatment With Single-Agent Nivolumab
Study Type
Interventional

2. Study Status

Record Verification Date
June 2018
Overall Recruitment Status
Withdrawn
Why Stopped
This study is withdrawn due to feasibility issues.
Study Start Date
April 1, 2018 (Actual)
Primary Completion Date
April 1, 2018 (Actual)
Study Completion Date
April 1, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medical University of South Carolina
Collaborators
Bristol-Myers Squibb

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to see if continued nivolumab with the addition of ipilimumab plus hypo-fractionated stereotactic radiation (sTR) of a single lesions results in partial or complete responses in patients with metastatic ccRCC who fail initial treatment with single agent nivolumab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clear Cell Renal Cell Carcinoma, Metastatic Renal Cell Carcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Nivolumab + Ipilimumab + SRT
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Nivolumab
Other Intervention Name(s)
opdivo
Intervention Description
Nivolumab will be given every 21 days for the first 12 weeks at a dose of 3mg/kg. After 12 weeks, the dose will be 240mg and will be given every 14 days.
Intervention Type
Drug
Intervention Name(s)
Ipilimumab
Intervention Description
Ipilimumab will be given at a dose of 1mg/kg every 21 days for up to 12 weeks.
Intervention Type
Radiation
Intervention Name(s)
Steriotactic radiation therapy
Intervention Description
The dose of radiation will be 6 Gy daily x 5 days. Radiation will be given between the first and second doses of ipilimumab plus nivolumab.
Primary Outcome Measure Information:
Title
Number of patients with a partial or complete response
Description
The response rate of combined ipilimumab and nivolumab plus STR will be determined using irRECIST criteria.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
PFS will be determined from the onset of treatment to the time of documented disease progression.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed diagnosis of metastatic ccRCC. Age 18 years and older ECOG 0-1 Progressive disease after treatment with single-agent nivolumab Life expectancy at least 3 months Presence of measurable disease per RECIST 1.1 criteria Presence of a metastatic lesion greater than 1 cm in size that is amenable to radiation treatment Adequate organ system function WOCBP and men who are sexually active with WOCBP must agree to use appropriate method(s) of contraception. Exclusion Criteria: Patients are excluded if they have active brain metastases or leptomeningeal metastases (exceptions outlined in the protocol). Active, known or suspected autoimmune disease, such as systemic lupus erythematosus, that require treatment with immune suppressing drugs. Note: Subjects are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger Presence of a condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone or equivalents) or other immunosuppressive medications within 14 days of study drug administration. Note: Inhaled or topical steroids and adrenal replacement doses > 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease. Unstable angina or uncontrolled congestive heart failure Uncontrolled hypercalcemia Positive test for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) Presence of other malignant diseases, except non-melanoma skin care History of allergy to study drug components. History of severe hypersensitivity reaction to any monoclonal antibody. Anti-cancer treatment including surgery, radiotherapy, chemotherapy, other immunotherapy, or investigational therapy within 14 days of registration. Women must not be pregnant or breastfeeding. WOCBP must have a negative serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 7 days prior to registration. Any other medical condition for which treatment with ipilimumab or nivolumab would be medically contraindicated
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Lilly, MD
Organizational Affiliation
Medical University of South Carolina
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Investigator-Initiated Trial of Combined Ipilimumab, Nivolumab and Stereotactic Radiation in Patients With Metastatic Clear-Cell RCC (ccRCC) Who Have Failed Treatment With Single-Agent Nivolumab

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