Pembrolizumab and Axitinib as Neoadjuvant Therapy for Locally Advanced Non-metastatic Clear Cell Renal Cell Carcinoma (PANDORA)
Primary Purpose
Renal Cell Carcinoma, Clear Cell Renal Cell Carcinoma
Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Pembrolizumab
Axitinib
Sponsored by
About this trial
This is an interventional treatment trial for Renal Cell Carcinoma focused on measuring Pembrolizumab, Axitinib, Neoadjuvant
Eligibility Criteria
Inclusion Criteria:
- Patients with a renal mass consistent with a clinical stage >= T3Nx or TanyN+ or deemed unresectable by surgeon
- Renal cell carcinoma with clear cell component on pre-treatment biopsy of the primary tumor
- The participant (or legally acceptable representative if applicable) provides written informed consent and the willingness and ability to comply with all aspects of the protocol
- Have an Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Agree to collect tumor tissue, blood and other specimens required by this study and apply them to relevant studies
- Important organs and bone marrow functions meet the following requirements: absolute neutrophil count (ANC) ≥1.5×10^9/L, platelet (PLT) ≥100×10^9/L, hemoglobin (HGB) ≥9g/dL;Liver function: serum total bilirubin (TBIL) ≤1.5 times normal upper limit (ULN), alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤2.5 times ULN, serum albumin (ALB) ≥ 2.8g /dL. Renal function: serum creatinine (Cr) ≤1.5×ULN, or creatinine clearance ≥40 mL/min
- Cardiac function met the following conditions: baseline electrocardiogram (ECG) had no evidence of PR prolongation or AV block
- All females must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of beta-human chorionic gonadotropin [beta-hCG]) at the screening visit and the baseline visit. A pregnancy test needs to be performed within 72 hours of the first dose of study drug. Women of childbearing potential (WOCBP) must agree to use a highly effective method of contraception for the entire study period and for 120 days after study discontinuation
- Male subjects who are partners of women of childbearing potential must use a condom and their female partners of childbearing potential must use a highly effective method of contraception beginning at least 1 menstrual cycle prior to starting study drugs, throughout the entire study period, and for 120 days after the last dose of study drug, unless the male subjects are totally sexually abstinent or have undergone a successful vasectomy with confirmed azoospermia or unless the female partners have been sterilized surgically or are otherwise proven sterile
Exclusion Criteria:
- Subject has an active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents
- Subject is currently participating or has participated in a study of an investigational agent or using an investigational device within 30 days of the first dose of study treatment
- Subject is expected to require any other form of systemic or localized antineoplastic therapy while on study
- Subject is on any systemic steroid therapy, within one week before the planned date for first dose of study treatment.
- Subject is on any other form of immunosuppressive medication
- Unable to swallow and retain orally administered medication
- Active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis, or other -Gastrointestinal conditions with increased risk of perforation; history of abdominal fistula, GI perforation, or intra-abdominal abscess within 4 weeks before beginning study treatment
- Known history of HIV infection or a known history of or is positive for Hepatitis B or Hepatitis C
- Presence of active infection requiring systemic therapy
- Corrected QT interval duration prolongation
- History of any one or more of the following cardiac conditions within the past 6 months: Cardiac angioplasty or stenting; Myocardial infarction; Unstable angina; --History of Class III or IV congestive heart failure according to New York Heart Association classification
- History of cerebrovascular accident within the past 6 months
- Poorly controlled hypertension
- History of untreated deep venous thrombosis
- Presence of any non-healing wound, fracture, or ulcer, or presence of symptomatic peripheral vascular disease
- Evidence of bleeding diathesis or coagulopathy
- Any serious and/or unstable pre-existing medical, psychiatric, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures
- Has taken any prohibited medications that are listed in the protocol within 14 days of the first dose of study treatment
- Subject has received or will receive a live vaccine within 30 days before the first administration of study treatment
Sites / Locations
- Tianjin Medical Unversity Second Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Locally Advanced Non-metastatic Clear Cell Renal Cell Carcinoma
Arm Description
Neoadjuvant pembrolizumab plus axitinib
Outcomes
Primary Outcome Measures
Major Pathologic Response (MPR)
The residual tumor cells (% RVT) were calculated according to immune related pathologic response criteria (irPRC), MPR is defined as %RVT<10%
Secondary Outcome Measures
Pathologic Complete Response (pCR)
The residual tumor cells (% RVT) were calculated according to immune related pathologic response criteria (irPRC), pCR is defined as %RVT<0%
Objective response rate (ORR)
Rate of patients achieving a complete response (CR) or partial response (PR) by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) and immune-related response criteria (IRC)
Disease-free survival(DFS)
DFS is defined as the time from treatment to recurrence of tumor or death
Overall survival(OS)
OS is defined as the time from treatment to death
Incidence of treatment-related adverse events(AEs)
To be assessed by CTCAE v5.0
Full Information
NCT ID
NCT04995016
First Posted
July 30, 2021
Last Updated
July 30, 2021
Sponsor
Tianjin Medical University Second Hospital
1. Study Identification
Unique Protocol Identification Number
NCT04995016
Brief Title
Pembrolizumab and Axitinib as Neoadjuvant Therapy for Locally Advanced Non-metastatic Clear Cell Renal Cell Carcinoma
Acronym
PANDORA
Official Title
A Single-center, Non-randomized Controlled, Single-arm, Phase II Clinical Trial of Pembrolizumab and Axitinib as Neoadjuvant Therapy for Locally Advanced Non-metastatic Clear Cell Renal Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
July 2021
Overall Recruitment Status
Unknown status
Study Start Date
August 20, 2021 (Anticipated)
Primary Completion Date
August 20, 2022 (Anticipated)
Study Completion Date
August 20, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tianjin Medical University Second Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a single-arm phase II clinical trial to evaluate the initial efficacy and safety of pembrolizumab combined with axitinib as neoadjuvant therapy for locally advanced non-metastatic clear cell renal cell carcinoma.
Detailed Description
This study is design to prospectively investigate the safety and efficacy of pembrolizumab combined with axitinib in downsizing tumors in patients with nonmetastatic biopsy-proven clear cell renal cell carcinoma. This is a single-institution, single-arm phase 2 clinical trial. Patients will receive axitinib 5 mg bid on days 1-21 combined with pembrolizumab intravenously (IV) over 30 minutes on day 1. Treatments repeat every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.Patients then will receive partial or radical nephrectomy after neoadjuvant therapy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Cell Carcinoma, Clear Cell Renal Cell Carcinoma
Keywords
Pembrolizumab, Axitinib, Neoadjuvant
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
simon's two stage design
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Locally Advanced Non-metastatic Clear Cell Renal Cell Carcinoma
Arm Type
Experimental
Arm Description
Neoadjuvant pembrolizumab plus axitinib
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
Keytruda
Intervention Description
PD-1 inhibitor,Pembrolizumab 200mg IV, every 3 weeks.
Intervention Type
Drug
Intervention Name(s)
Axitinib
Other Intervention Name(s)
Inlyta
Intervention Description
Tyrosine kinase inhibitor,licensed for use in treatment of renal cell carcinoma. Oral treatment Axitinib given 5 mg PO BID.
Primary Outcome Measure Information:
Title
Major Pathologic Response (MPR)
Description
The residual tumor cells (% RVT) were calculated according to immune related pathologic response criteria (irPRC), MPR is defined as %RVT<10%
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Pathologic Complete Response (pCR)
Description
The residual tumor cells (% RVT) were calculated according to immune related pathologic response criteria (irPRC), pCR is defined as %RVT<0%
Time Frame
12 weeks
Title
Objective response rate (ORR)
Description
Rate of patients achieving a complete response (CR) or partial response (PR) by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) and immune-related response criteria (IRC)
Time Frame
12 weeks
Title
Disease-free survival(DFS)
Description
DFS is defined as the time from treatment to recurrence of tumor or death
Time Frame
Up to 24 months
Title
Overall survival(OS)
Description
OS is defined as the time from treatment to death
Time Frame
Up to 24 months
Title
Incidence of treatment-related adverse events(AEs)
Description
To be assessed by CTCAE v5.0
Time Frame
Up to 24 months
Other Pre-specified Outcome Measures:
Title
Biomarker analysis
Description
Paired t-test or Wilcoxon singed-rank test will be used to compare the biomarkers change before, during, and after treatment.
Time Frame
Up to 24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with a renal mass consistent with a clinical stage >= T3Nx or TanyN+ or deemed unresectable by surgeon
Renal cell carcinoma with clear cell component on pre-treatment biopsy of the primary tumor
The participant (or legally acceptable representative if applicable) provides written informed consent and the willingness and ability to comply with all aspects of the protocol
Have an Eastern Cooperative Oncology Group (ECOG) performance status =< 2
Agree to collect tumor tissue, blood and other specimens required by this study and apply them to relevant studies
Important organs and bone marrow functions meet the following requirements: absolute neutrophil count (ANC) ≥1.5×10^9/L, platelet (PLT) ≥100×10^9/L, hemoglobin (HGB) ≥9g/dL;Liver function: serum total bilirubin (TBIL) ≤1.5 times normal upper limit (ULN), alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤2.5 times ULN, serum albumin (ALB) ≥ 2.8g /dL. Renal function: serum creatinine (Cr) ≤1.5×ULN, or creatinine clearance ≥40 mL/min
Cardiac function met the following conditions: baseline electrocardiogram (ECG) had no evidence of PR prolongation or AV block
All females must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of beta-human chorionic gonadotropin [beta-hCG]) at the screening visit and the baseline visit. A pregnancy test needs to be performed within 72 hours of the first dose of study drug. Women of childbearing potential (WOCBP) must agree to use a highly effective method of contraception for the entire study period and for 120 days after study discontinuation
Male subjects who are partners of women of childbearing potential must use a condom and their female partners of childbearing potential must use a highly effective method of contraception beginning at least 1 menstrual cycle prior to starting study drugs, throughout the entire study period, and for 120 days after the last dose of study drug, unless the male subjects are totally sexually abstinent or have undergone a successful vasectomy with confirmed azoospermia or unless the female partners have been sterilized surgically or are otherwise proven sterile
Exclusion Criteria:
Subject has an active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents
Subject is currently participating or has participated in a study of an investigational agent or using an investigational device within 30 days of the first dose of study treatment
Subject is expected to require any other form of systemic or localized antineoplastic therapy while on study
Subject is on any systemic steroid therapy, within one week before the planned date for first dose of study treatment.
Subject is on any other form of immunosuppressive medication
Unable to swallow and retain orally administered medication
Active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis, or other -Gastrointestinal conditions with increased risk of perforation; history of abdominal fistula, GI perforation, or intra-abdominal abscess within 4 weeks before beginning study treatment
Known history of HIV infection or a known history of or is positive for Hepatitis B or Hepatitis C
Presence of active infection requiring systemic therapy
Corrected QT interval duration prolongation
History of any one or more of the following cardiac conditions within the past 6 months: Cardiac angioplasty or stenting; Myocardial infarction; Unstable angina; --History of Class III or IV congestive heart failure according to New York Heart Association classification
History of cerebrovascular accident within the past 6 months
Poorly controlled hypertension
History of untreated deep venous thrombosis
Presence of any non-healing wound, fracture, or ulcer, or presence of symptomatic peripheral vascular disease
Evidence of bleeding diathesis or coagulopathy
Any serious and/or unstable pre-existing medical, psychiatric, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures
Has taken any prohibited medications that are listed in the protocol within 14 days of the first dose of study treatment
Subject has received or will receive a live vaccine within 30 days before the first administration of study treatment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Bin HUO
Phone
+860228832
Ext
6610
Email
huobin_doctor@icloud.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bin HUO, MD
Organizational Affiliation
Tianjin Medical University Second Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gang LI, MD
Organizational Affiliation
Tianjin Medical University Second Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Haitao WANG, Professor
Organizational Affiliation
Tianjin Medical University Second Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Tianjin Medical Unversity Second Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300211
Country
China
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Pembrolizumab and Axitinib as Neoadjuvant Therapy for Locally Advanced Non-metastatic Clear Cell Renal Cell Carcinoma
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