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Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma

Primary Purpose

Renal Cell Carcinoma

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Sunitinib
Bevacizumab
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Cell Carcinoma focused on measuring mRCC, sunitinib, bevacizumab

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed metastatic renal cell carcinoma with clear cell histology
  • Patients must be off sunitinib for 14 days prior to day 1 of treatment on protocol
  • Evidence of unidimensionally measurable disease based on RECIST criteria, with at least 1 measurable lesion
  • Radiographic evidence of disease progression defined by RECIST during or within 6 weeks of completion of sunitinib treatment
  • Participants must have received at least 14 doses of sunitinib therapy
  • Participants must enroll within 3 months of the last dose of sunitinib
  • Males or females, age of 18 years or older
  • ECOG Performance status 0-2
  • Resolution of all acute toxic effects of prior therapy, radiotherapy or surgical procedures to NCI CTCAE version 3.0 grade 1 or less
  • Laboratory values as defined in protocol
  • 4 weeks or more must have elapsed from the time of major surgery and subjects must have recovered from the procedure prior to day 1 of randomization
  • No anticipated need for major surgical procedure during the course of the study
  • 2 weeks or more must have elapsed from the time of minor surgery and subjects must have recovered from the procedure prior to day 1 of randomization
  • 4 weeks of more must have elapsed from the time of major radiotherapy prior to day 1 of randomization

Exclusion Criteria:

  • Prior treatment with bevacizumab
  • Unacceptable toxicity on prior sunitinib therapy at 37.5mg or lower
  • Prior systemic therapy for RCC with > 2 regimens
  • Systemic therapy other than sunitinib within 4 weeks of starting the study treatment
  • Uncontrolled high blood pressure
  • Any prior history of hypertensive crisis or hypertensive encephalopathy
  • History of abdominal fistula, gastrointestinal perforation or intraabdominal abscess within 3 months prior to day 0
  • Any of the following within the 6 months prior to sudy drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, symptomatic congestive heart failure, or ejection fraction < 30%
  • Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range without medication
  • History of or known brain metastases or spinal cord compression
  • NCI CTCAE grade 2 or above hemorrhage within 4 weeks of starting study treatment
  • Significant vascular disease (e.g., aortic aneurysm, aortic dissection)
  • Symptomatic peripheral vascular disease
  • Grade 3 or higher cardiac dysrhythmia or QT prolongation
  • Concurrent use of proarrhythmic medications including terfenadine, quinidine, procainamide, disopyramide, sotalol, probucol, bepridil, haloperidol, risperidone, indapamide and flecainide
  • Pregnancy or breastfeeding or inadequate contraception
  • Significant thromboembolic event within 6 months
  • Evidence of bleeding diathesis or coagulopathy
  • Serious, non-healing wound, ulcer or bone fracture
  • Proteinuria at screening
  • Known hypersensitivity to any component of bevacizumab
  • Psychiatric illness/social situation that would limit compliance with study requirements
  • Previous or concurrent malignancy requiring active systemic therapy

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Active Comparator

    Arm Label

    1

    2

    Arm Description

    Bevacizumab monotherapy 10 mg/kg IV q2 weeks

    Combination Sunitinib & Bevacizumab Bevacizumab 10 mg/kg IV q2 weeks Sunitinib 50 mg PO QD on 4/2 schedule

    Outcomes

    Primary Outcome Measures

    To determine the time to tumor progression (TTP) in this patient population treated with bevacizumab or combination of sunitinib and bevacizumab.

    Secondary Outcome Measures

    To determine the overall response rate in this patient population.
    To evaluate the safety and tolerability of these treatments in mRCC patients with disease progression on standard dose sunitinib.
    To collect serum research samples for analysis of predictive biomarkers of response.

    Full Information

    First Posted
    November 7, 2007
    Last Updated
    March 23, 2016
    Sponsor
    Massachusetts General Hospital
    Collaborators
    Beth Israel Deaconess Medical Center, Pfizer
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00556205
    Brief Title
    Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma
    Official Title
    Phase II, Randomized Trial of Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Patients With Metastatic Renal Cell Carcinoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2016
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Toxicity of combination from other trials
    Study Start Date
    September 2009 (undefined)
    Primary Completion Date
    September 2009 (Actual)
    Study Completion Date
    September 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Massachusetts General Hospital
    Collaborators
    Beth Israel Deaconess Medical Center, Pfizer

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this research study is to further define an effective strategy for people with renal cell carcinoma and to learn the safety and effectiveness of two different types of sunitinib-refractory treatments: Bevacizumab alone or a combination of sunitinib and bevacizumab. Sunitinib is an FDA approved drug and is currently one of the standard treatments for advanced renal cell carcinoma. However, some people who receive this treatment do not respond to treatment or they stop responding to treatment. Bevacizumab is an FDA approved drug used for the treatment of several cancers however, is not yet approved for use in renal cell carcinoma.
    Detailed Description
    Participants will receive one of two treatment possibilities. Since no one knows which of the study options is best, participants will be "randomized" to one fo the three treatment groups. Group 1 will stop their current treatment with sunitinib and receive a dose of bevacizumab once every 2 weeks. Group 2 will receive the standard treatment of sunitinib with the addition of bevacizumab. All study participants will undergo the same study procedures. These study procedures will include the following at intervals specified in the protocol: medical history review; vital signs; physical exam; urine analysis; EKG and CT scan.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Renal Cell Carcinoma
    Keywords
    mRCC, sunitinib, bevacizumab

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Crossover Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    1
    Arm Type
    Active Comparator
    Arm Description
    Bevacizumab monotherapy 10 mg/kg IV q2 weeks
    Arm Title
    2
    Arm Type
    Active Comparator
    Arm Description
    Combination Sunitinib & Bevacizumab Bevacizumab 10 mg/kg IV q2 weeks Sunitinib 50 mg PO QD on 4/2 schedule
    Intervention Type
    Drug
    Intervention Name(s)
    Sunitinib
    Other Intervention Name(s)
    sutent
    Intervention Description
    Sunitinib orally once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Bevacizumab
    Other Intervention Name(s)
    avastin
    Intervention Description
    Intravenously every 14 days
    Primary Outcome Measure Information:
    Title
    To determine the time to tumor progression (TTP) in this patient population treated with bevacizumab or combination of sunitinib and bevacizumab.
    Time Frame
    Until tumor progression
    Secondary Outcome Measure Information:
    Title
    To determine the overall response rate in this patient population.
    Time Frame
    Until tumor progression
    Title
    To evaluate the safety and tolerability of these treatments in mRCC patients with disease progression on standard dose sunitinib.
    Time Frame
    Until tumor progression
    Title
    To collect serum research samples for analysis of predictive biomarkers of response.
    Time Frame
    Two months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Histologically confirmed metastatic renal cell carcinoma with clear cell histology Patients must be off sunitinib for 14 days prior to day 1 of treatment on protocol Evidence of unidimensionally measurable disease based on RECIST criteria, with at least 1 measurable lesion Radiographic evidence of disease progression defined by RECIST during or within 6 weeks of completion of sunitinib treatment Participants must have received at least 14 doses of sunitinib therapy Participants must enroll within 3 months of the last dose of sunitinib Males or females, age of 18 years or older ECOG Performance status 0-2 Resolution of all acute toxic effects of prior therapy, radiotherapy or surgical procedures to NCI CTCAE version 3.0 grade 1 or less Laboratory values as defined in protocol 4 weeks or more must have elapsed from the time of major surgery and subjects must have recovered from the procedure prior to day 1 of randomization No anticipated need for major surgical procedure during the course of the study 2 weeks or more must have elapsed from the time of minor surgery and subjects must have recovered from the procedure prior to day 1 of randomization 4 weeks of more must have elapsed from the time of major radiotherapy prior to day 1 of randomization Exclusion Criteria: Prior treatment with bevacizumab Unacceptable toxicity on prior sunitinib therapy at 37.5mg or lower Prior systemic therapy for RCC with > 2 regimens Systemic therapy other than sunitinib within 4 weeks of starting the study treatment Uncontrolled high blood pressure Any prior history of hypertensive crisis or hypertensive encephalopathy History of abdominal fistula, gastrointestinal perforation or intraabdominal abscess within 3 months prior to day 0 Any of the following within the 6 months prior to sudy drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, symptomatic congestive heart failure, or ejection fraction < 30% Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range without medication History of or known brain metastases or spinal cord compression NCI CTCAE grade 2 or above hemorrhage within 4 weeks of starting study treatment Significant vascular disease (e.g., aortic aneurysm, aortic dissection) Symptomatic peripheral vascular disease Grade 3 or higher cardiac dysrhythmia or QT prolongation Concurrent use of proarrhythmic medications including terfenadine, quinidine, procainamide, disopyramide, sotalol, probucol, bepridil, haloperidol, risperidone, indapamide and flecainide Pregnancy or breastfeeding or inadequate contraception Significant thromboembolic event within 6 months Evidence of bleeding diathesis or coagulopathy Serious, non-healing wound, ulcer or bone fracture Proteinuria at screening Known hypersensitivity to any component of bevacizumab Psychiatric illness/social situation that would limit compliance with study requirements Previous or concurrent malignancy requiring active systemic therapy
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    M. Dror Michaelson, MD, PhD
    Organizational Affiliation
    Massachusetts General Hosptial
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    IPD Sharing Plan Description
    No data to share

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    Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma

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