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Pembrolizumab Plus Radiotherapy for Advanced Renal Cancer

Primary Purpose

Clear-cell Metastatic Renal Cell Carcinoma

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Drug: Pembrolizumab
Sponsored by
Nanfang Hospital, Southern Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Clear-cell Metastatic Renal Cell Carcinoma focused on measuring pembrolizumab, stereotactic radiotherapy

Eligibility Criteria

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

Inclusion Criteria:

  • Age> 18 years at the time of signing informed consent;
  • ECOG score of 0 or 1;
  • Histologically confirmed,advanced NSCLC of stage IV(AJCC 8);
  • Life expectancy of more than 12 weeks;
  • Evidence of measurable metastatic kidney cancer according to RECIST 1.1 criteria. Patients should have an adequate number of non-irradiated metastatic sites in order to adequately assess the activity of the pembrolizumab therapy;
  • If central nervous system (CNS) metastases are treated before inclusion and the patient's neurological system is present Return of symptoms to baseline levels (except for signs or symptoms associated with CNS therapy)At least 14 days, such patients may be included. In addition, patients must stop taking glucocorticoids or prednisone in a stable dose and ≤ 10 mg per day;
  • Main organ function meets the following criteria within 7 days before treatment:

    1. blood examination criteria (in the state without blood transfusion within 14 days): ① Hemoglobin(HB) ≥ 70 g/L; ② Absolute Neutrophil Count(ANC) ≥ 1.0×109/L; ③ Platelet (PLT) ≥ 60×109/L.
    2. Biochemical examination shall meet the following criteria: ① total bilirubin within 1.5×the upper limit of normal(ULN); ② serum transaminase≤2.5×the Upper Limit of Normal(ULN), If associated with liver metastasis, serum transaminase≤5.0×the Upper Limit of Normal(ULN);③ serum creatine ≤ 1.5 x Upper Limit of Normal(ULN),creatinine clearance rate ≥ 60ml/min;
  • Women of childbearing age should agree to use contraception (e. g. intrauterine device, contraceptive or condom) within 6 months after study completion, the pregnancy test results (serum or urine) within 7 days before enrolment must be negative;
  • Men should agree that contraception must be used during and within 6 months of the end of the study period;
  • With consent and have signed the informed consent, willing and able to comply with the planned visits, research treatment, laboratory tests, and other experimental procedures.

Exclusion Criteria:

  • Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2;
  • Any active or recently diagnosed clear or suspected autoimmune disorder disease, or symptoms requiring glucocorticoids (> 10 mg/day) or immunosuppressive drugs for systemic therapy;
  • Active brain metastases and/or cancerous meningitis;
  • Has had a prior monoclonal antibody within 4 weeks prior to the first dose of trial treatment or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier;
  • Has more than one previous chemotherapy,targeted small molecule therapy, or radiation therapy within 2 weeks prior to the first dose of trial treatment or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent;
  • Diagnosed with immunodeficiency within 2 weeks prior to study or being treated with systemic glucocorticoids or any other form of immunosuppressive therapy;
  • Have a positive history of human immunodeficiency virus (HIV) test or have acquired immunodeficiency syndrome (AIDS);
  • Has known active Hepatitis B or Hepatitis C;
  • Has a known additional malignancy that is progressing or requires active treatment;
  • Have interstitial lung disease, active pulmonary infectious pneumonia, or grade 3 or higher pneumonia;
  • Patients with mental or physical illnesses (such as infectious diseases) requiring compulsory isolation treatment;
  • Has received a live vaccine within 30 days prior to the first dose of trial treatment; · · According to the investigator, there may be increased risk associated with participation in the study, or other severe, acute or chronic medical or psychiatric disorders that may interfere with the interpretation of the findings.

Sites / Locations

  • Guozhu,Xie
  • Nanfang Hospital, Southern Medical University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pembrolizumab + RT (5 fractions, 8 Gy) + Pembrolizumab

Arm Description

Pembrolizumab will be started. Stereotactic Body Radiation Therapy will be given before the 2nd course of pembrolizumab and pembrolizumab will be continued. Pembrolizumab will continue until progression as per immune related response criteria (irRC).

Outcomes

Primary Outcome Measures

ORR
Objective response rate by immune related response criteria (irRC), and RECIST 1.1 criteria

Secondary Outcome Measures

Overall survival
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
The disease control rate

Full Information

First Posted
October 2, 2022
Last Updated
October 7, 2022
Sponsor
Nanfang Hospital, Southern Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT05567588
Brief Title
Pembrolizumab Plus Radiotherapy for Advanced Renal Cancer
Official Title
A Phase II,Single-arm Study to Evaluate the Safety and Efficacy of Pembrolizumab and Stereotactic Radiotherapy (SBRT) in Patients Advanced Metastatic Renal Clear Cell Carcinoma.
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 31, 2022 (Anticipated)
Primary Completion Date
October 31, 2024 (Anticipated)
Study Completion Date
October 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Nanfang Hospital, Southern Medical University

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
No

5. Study Description

Brief Summary
This study is designed as a phase-II proof of clinical trial to investigate if a treatment strategy where stereotactic body radiation therapy (SBRT) is given with pembrolizumab is sufficiently active to warrant further investigation in randomized phase II or III studies. Metastatic renal cell cancer (mRCC) patients with PD-1 expressing immune cells are more likely to have larger more aggressive tumours and reduced survival. Pembrolizumab is designed to directly block the interaction between PD-1 and its ligands, PD-L1 and PD-L2. SBRT will be given to the 1-5 most clinically significant lesions after the 1nd course of pembrolizumab treatment in an effort to improve the activity of pembrolizumab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clear-cell Metastatic Renal Cell Carcinoma
Keywords
pembrolizumab, stereotactic radiotherapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Pembrolizumab + RT (5 fractions, 8 Gy) + Pembrolizumab
Arm Type
Experimental
Arm Description
Pembrolizumab will be started. Stereotactic Body Radiation Therapy will be given before the 2nd course of pembrolizumab and pembrolizumab will be continued. Pembrolizumab will continue until progression as per immune related response criteria (irRC).
Intervention Type
Combination Product
Intervention Name(s)
Drug: Pembrolizumab
Other Intervention Name(s)
Keytruda
Intervention Description
200mg(body weight >75kg) or 100mg(body weight≤75kg) given intravenously over 30 minutes day 1 of every 3 week cycle until progression as per immune related response criteria.
Primary Outcome Measure Information:
Title
ORR
Description
Objective response rate by immune related response criteria (irRC), and RECIST 1.1 criteria
Time Frame
Approximately 2 months
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
up to 24 months
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time Frame
up to 24 months
Title
The disease control rate
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: Age> 18 years at the time of signing informed consent; ECOG score of 0 or 1; Histologically confirmed,advanced NSCLC of stage IV(AJCC 8); Life expectancy of more than 12 weeks; Evidence of measurable metastatic kidney cancer according to RECIST 1.1 criteria. Patients should have an adequate number of non-irradiated metastatic sites in order to adequately assess the activity of the pembrolizumab therapy; If central nervous system (CNS) metastases are treated before inclusion and the patient's neurological system is present Return of symptoms to baseline levels (except for signs or symptoms associated with CNS therapy)At least 14 days, such patients may be included. In addition, patients must stop taking glucocorticoids or prednisone in a stable dose and ≤ 10 mg per day; Main organ function meets the following criteria within 7 days before treatment: blood examination criteria (in the state without blood transfusion within 14 days): ① Hemoglobin(HB) ≥ 70 g/L; ② Absolute Neutrophil Count(ANC) ≥ 1.0×109/L; ③ Platelet (PLT) ≥ 60×109/L. Biochemical examination shall meet the following criteria: ① total bilirubin within 1.5×the upper limit of normal(ULN); ② serum transaminase≤2.5×the Upper Limit of Normal(ULN), If associated with liver metastasis, serum transaminase≤5.0×the Upper Limit of Normal(ULN);③ serum creatine ≤ 1.5 x Upper Limit of Normal(ULN),creatinine clearance rate ≥ 60ml/min; Women of childbearing age should agree to use contraception (e. g. intrauterine device, contraceptive or condom) within 6 months after study completion, the pregnancy test results (serum or urine) within 7 days before enrolment must be negative; Men should agree that contraception must be used during and within 6 months of the end of the study period; With consent and have signed the informed consent, willing and able to comply with the planned visits, research treatment, laboratory tests, and other experimental procedures. Exclusion Criteria: Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2; Any active or recently diagnosed clear or suspected autoimmune disorder disease, or symptoms requiring glucocorticoids (> 10 mg/day) or immunosuppressive drugs for systemic therapy; Active brain metastases and/or cancerous meningitis; Has had a prior monoclonal antibody within 4 weeks prior to the first dose of trial treatment or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier; Has more than one previous chemotherapy,targeted small molecule therapy, or radiation therapy within 2 weeks prior to the first dose of trial treatment or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent; Diagnosed with immunodeficiency within 2 weeks prior to study or being treated with systemic glucocorticoids or any other form of immunosuppressive therapy; Have a positive history of human immunodeficiency virus (HIV) test or have acquired immunodeficiency syndrome (AIDS); Has known active Hepatitis B or Hepatitis C; Has a known additional malignancy that is progressing or requires active treatment; Have interstitial lung disease, active pulmonary infectious pneumonia, or grade 3 or higher pneumonia; Patients with mental or physical illnesses (such as infectious diseases) requiring compulsory isolation treatment; Has received a live vaccine within 30 days prior to the first dose of trial treatment; · · According to the investigator, there may be increased risk associated with participation in the study, or other severe, acute or chronic medical or psychiatric disorders that may interfere with the interpretation of the findings.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Guozhu Xie
Phone
13242801662
Email
xieguozhu@126.com
Facility Information:
Facility Name
Guozhu,Xie
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Nanfang Hospital, Southern Medical University
City
Guangzhou
State/Province
Guangdong
Country
China

12. IPD Sharing Statement

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Pembrolizumab Plus Radiotherapy for Advanced Renal Cancer

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