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Anlotinib Plus Sintilimab as First-line Treatment for Advanced Non Clear Cell Renal Cell Carcinoma

Primary Purpose

Non Clear Cell Renal Carcinoma

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Anlotinib plus Sintilimab
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects voluntarily joined the study and signed informed consent;
  • Aged > 18 years;
  • ECOG body status score is 0 or 1,Expected survival time is greater than 3 months.
  • Locally advanced or metastatic, histological confirmed, non-clear cell RCC of all subtypes. Patients must have advanced non-clear cell of one of the following subtypes: papillary, chromophobe, collecting duct carcinoma (CDC), renal medullary carcinoma (RMC), or unclassified.
  • Patients must have measurable lesions as defined by the RECIST 1.1 standard;
  • Adequate hematologic and end-organ function as defined by the following laboratory results obtained within 28 days prior to the first study treatment:

    1. Absolute neutrophil count (ANC) ≥1.5x 109/L
    2. Lymphocyte count ≥ 500/uL.
    3. Platelet count ≥ 80x109/L.
    4. Hemoglobin ≥ 80 g/L (patients may be transfused to meet this criterion).
    5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x upper limit of normal (ULN) with the following exceptions: Patients with documented liver/bone metastases should have AST and ALT ≤ 5 x ULN.
    6. Serum bilirubin ≤ 1.5 x ULN.
    7. Creatinine clearance ≥ 60 mL/min.
    8. For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use highly effective forms of contraception and to continue its use 4 weeks after the last dose of anlotinib or sintilimab.
  • Signed informed consent form.
  • Ability and capacity to comply with study and follow-up procedures.

Exclusion Criteria:

  • Those who are known to be allergic to pharmaceutical ingredients.
  • Receive anti-tumor monoclonal antibody or other research drugs within 4 weeks before enrollment; have received other anti-PD-1 antibody therapy or other treatment for PD-1/PD-L1;
  • Previous use of anlotinib or other angiogenesis inhibitors
  • The patient has any active autoimmune disease or a history of autoimmune disease;
  • There are uncontrolled heart clinical symptoms or diseases;
  • Patients with congenital or acquired immune deficiency;
  • Receive chemotherapy, targeted therapy, radiotherapy within 2 weeks before enrollment;
  • A history of gastrointestinal perforation or major surgery within 4 weeks before enrollment;
  • Overactive/venous thrombosis occurred within 6 months prior to enrollment, such as cardiovascular-cerebral vascular (including transient ischemic attack),deep vein thrombosis (except for patients who have recovered from venous catheterization due to previous chemotherapy)and pulmonary embolism;
  • Those with active bleeding or bleeding tendency;
  • Presence of a drug uncontrolled hypertension;
  • Urine routine indicates more than urinary protein 2+;
  • Correct QT interval > 470msec; if the patient has a prolonged QT interval, but the investigator's study evaluates that the prolongation is due to a cardiac pacemaker (and no other abnormalities in the heart), it is necessary to discuss with the sponsor's researcher to determine if the patient is Suitable for group study;
  • Patients suspected of having other primary cancers;
  • Those who are known to be allergic to pharmaceutical ingredients.
  • Patients with active or chronic hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening). Patients with past/resolved HBV infection (defined as having negative HBsAg test and a positive antibody to hepatitis B core antigen [anti-HBc] antibody test) are eligible. A negative HBA DNA test must be obtained in patients with positive hepatitis B core antibody prior to Cycle 1 Day 1.
  • Active hepatitis C infection. Patients positive hepatitis C antibody test are eligible if PCR is negative for hepatitis C viral DNA.
  • Pregnant or lactating women.

Sites / Locations

  • Cancer Center, Sun Yat-sen University

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Anlotinib plus Sintilimab

Arm Description

Anlotinib was taken orally (10mg mg qd, d1-14, 21 days per cycle) .Sintilimab was administered intravenously (200mg once every 3weeks).

Outcomes

Primary Outcome Measures

progression-free survival (PFS)
Time from treatment until disease progression or death

Secondary Outcome Measures

objective response rate (ORR)
objective response rate (ORR) by RECIST1.1, the total proportion of patients with complete response (CR), partial response (PR)
disease control rate (DCR)
disease control rate (DCR)by RECIST1.1, the total proportion of patients with complete response (CR), partial response (PR) and Stable Disease(SD).
overall survival (OS)
Time from treatment until death from any cause
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0

Full Information

First Posted
December 24, 2021
Last Updated
February 1, 2022
Sponsor
Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT05220267
Brief Title
Anlotinib Plus Sintilimab as First-line Treatment for Advanced Non Clear Cell Renal Cell Carcinoma
Official Title
Anlotinib Plus Sintilimab as First-line Treatment for Advanced Non Clear Cell Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
February 28, 2022 (Anticipated)
Primary Completion Date
December 30, 2024 (Anticipated)
Study Completion Date
December 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University

4. Oversight

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

5. Study Description

Brief Summary
The combination of immune checkpoint inhibitors (ICIs) plus angiogenesis inhibitors has demonstrated significant anti-tumor activity in certain cancer. The goal of this study was to evaluate the efficacy and safety of sintilimab (a human programmed death-1 ICI) plus anlotinib (a multi-target tyrosine kinase inhibitor, inhibiting tumor angiogenesis and proliferative signaling) in advanced non clear cell renal cell carcinoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Clear Cell Renal 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
43 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Anlotinib plus Sintilimab
Arm Type
Other
Arm Description
Anlotinib was taken orally (10mg mg qd, d1-14, 21 days per cycle) .Sintilimab was administered intravenously (200mg once every 3weeks).
Intervention Type
Drug
Intervention Name(s)
Anlotinib plus Sintilimab
Intervention Description
Anlotinib was taken orally (10mg mg qd, d1-14, 21 days per cycle).Sintilimab was administered intravenously (200mg once every 3weeks).
Primary Outcome Measure Information:
Title
progression-free survival (PFS)
Description
Time from treatment until disease progression or death
Time Frame
up to 2 years
Secondary Outcome Measure Information:
Title
objective response rate (ORR)
Description
objective response rate (ORR) by RECIST1.1, the total proportion of patients with complete response (CR), partial response (PR)
Time Frame
up to 2 years
Title
disease control rate (DCR)
Description
disease control rate (DCR)by RECIST1.1, the total proportion of patients with complete response (CR), partial response (PR) and Stable Disease(SD).
Time Frame
up to 2 years
Title
overall survival (OS)
Description
Time from treatment until death from any cause
Time Frame
up to 2 years
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time Frame
up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects voluntarily joined the study and signed informed consent; Aged > 18 years; ECOG body status score is 0 or 1,Expected survival time is greater than 3 months. Locally advanced or metastatic, histological confirmed, non-clear cell RCC of all subtypes. Patients must have advanced non-clear cell of one of the following subtypes: papillary, chromophobe, collecting duct carcinoma (CDC), renal medullary carcinoma (RMC), or unclassified. Patients must have measurable lesions as defined by the RECIST 1.1 standard; Adequate hematologic and end-organ function as defined by the following laboratory results obtained within 28 days prior to the first study treatment: Absolute neutrophil count (ANC) ≥1.5x 109/L Lymphocyte count ≥ 500/uL. Platelet count ≥ 80x109/L. Hemoglobin ≥ 80 g/L (patients may be transfused to meet this criterion). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x upper limit of normal (ULN) with the following exceptions: Patients with documented liver/bone metastases should have AST and ALT ≤ 5 x ULN. Serum bilirubin ≤ 1.5 x ULN. Creatinine clearance ≥ 60 mL/min. For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use highly effective forms of contraception and to continue its use 4 weeks after the last dose of anlotinib or sintilimab. Signed informed consent form. Ability and capacity to comply with study and follow-up procedures. Exclusion Criteria: Those who are known to be allergic to pharmaceutical ingredients. Receive anti-tumor monoclonal antibody or other research drugs within 4 weeks before enrollment; have received other anti-PD-1 antibody therapy or other treatment for PD-1/PD-L1; Previous use of anlotinib or other angiogenesis inhibitors The patient has any active autoimmune disease or a history of autoimmune disease; There are uncontrolled heart clinical symptoms or diseases; Patients with congenital or acquired immune deficiency; Receive chemotherapy, targeted therapy, radiotherapy within 2 weeks before enrollment; A history of gastrointestinal perforation or major surgery within 4 weeks before enrollment; Overactive/venous thrombosis occurred within 6 months prior to enrollment, such as cardiovascular-cerebral vascular (including transient ischemic attack),deep vein thrombosis (except for patients who have recovered from venous catheterization due to previous chemotherapy)and pulmonary embolism; Those with active bleeding or bleeding tendency; Presence of a drug uncontrolled hypertension; Urine routine indicates more than urinary protein 2+; Correct QT interval > 470msec; if the patient has a prolonged QT interval, but the investigator's study evaluates that the prolongation is due to a cardiac pacemaker (and no other abnormalities in the heart), it is necessary to discuss with the sponsor's researcher to determine if the patient is Suitable for group study; Patients suspected of having other primary cancers; Those who are known to be allergic to pharmaceutical ingredients. Patients with active or chronic hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening). Patients with past/resolved HBV infection (defined as having negative HBsAg test and a positive antibody to hepatitis B core antigen [anti-HBc] antibody test) are eligible. A negative HBA DNA test must be obtained in patients with positive hepatitis B core antibody prior to Cycle 1 Day 1. Active hepatitis C infection. Patients positive hepatitis C antibody test are eligible if PCR is negative for hepatitis C viral DNA. Pregnant or lactating women.
Facility Information:
Facility Name
Cancer Center, Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fang-Jian Zhou, M.D Ph.D
Phone
+8613922735659
Email
zhoufj@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Pei Dong, M.D Ph.D
Phone
13512738496
Email
dongpei@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Fang-Jian Zhou, M.D Ph.D
First Name & Middle Initial & Last Name & Degree
Pei Dong, M.D Ph.D
First Name & Middle Initial & Last Name & Degree
Xiu-Yu Cai, M.D Ph.D

12. IPD Sharing Statement

Citations:
Citation
1. Bray F,Ferlay J,Soerjomatarm I,et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2018,68(6):394-424. 2. Choueiri T,Motzer R.Systemic therapy for metastatic renal-cell carcinoma[J].N Engl J Med,2017,376(4):354-366 3. ESCUDIER B,EISEN T,STADLER W M,et al.Sorafenib in advanced clear cell renal-cell carcinoma[J].N Engl J Med,2007,356(2):125-134 4. MOTZER R J,HUTSON T E,TOMCZAK P,et al.Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma[J].J Clin Oncol,2009,27(22):3584-3590 5. Armstrong AJ, Halabi S, Eisen T, et al. Everolimus versus sunitinib for patients with metastatic non-clear cell renal cell carcinoma (ASPEN): a multicentre, open-label, randomised phase 2 trial. Lancet Oncol. 2016;17(3):378-388. 6. Nizar M Tannir, Eric Jonasch, Laurence Albiges, et al. Everolimus Versus Sunitinib Prospective Evaluation in Metastatic Non-Clear Cell Renal Cell Carcinoma (ESPN): A Randomized Multicenter Phase 2 Trial[J]. European Urology, 2016, 69(5):866-874. 7. Motzer RJ, Barrios CH, Kim TM, et al.: Phase II randomized trial comparing sequential first-line everolimus and second-line sunitinib versus first-line sunitinib and secondline everolimus in patients with metastatic renal cell carcinoma. J Clin Oncol 2014; 32:2765-2772. 8. Zhou AP,Bai Y,Song Y,et al. Anlotinib Versus Sunitinib as First-Line Treatment for Metastatic Renal Cell Carcinoma:A Randomized PhaseⅡClinical Trial[J]. Oncologist,2019,24(8):e702-e708. DOI:10.1634/theoncologist.2018-0839. 9. CHOUEIRI T K,FISHMAN M N,ESCUDIER B,et al.Immunomodulatory activity of nivolumab in metastatic renal cell carcinoma[J].Clin Cancer Res,2016,22(22):5461-5471. 10. MCDERMOTT D F,SOSMAN J A,SZNOL M,et al.Atezolizumab,an antiprogrammed death-ligand 1 antibody,in metastatic renal cell carcinoma:long-term safety,clinical activity,and immune correlates from a phase Ⅰa study[J].J Clin Oncol,2016,34(8):833-842. 11. Rini, BI; Plimack, ER; Stus, V; et al.Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma.[J].N Engl J Med.2019,380(12):1116-1127 12. YASUDA S,SHO M,YAMATO I,et al.Simultaneous blockade of programmed death 1 and vascular endothelial growth factor receptor 2 (VEGFR2) induces synergistic anti-tumour effect in vivo[J].Clin Exp Immunol,2013,172:500-506
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Anlotinib Plus Sintilimab as First-line Treatment for Advanced Non Clear Cell Renal Cell Carcinoma

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