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Withdrawn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
About this trial
This is an interventional treatment trial for Renal Cell Carcinoma focused on measuring mRCC, sunitinib, bevacizumab
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
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
NCT ID
NCT00556205
First Posted
November 7, 2007
Last Updated
March 23, 2016
Sponsor
Massachusetts General Hospital
Collaborators
Beth Israel Deaconess Medical Center, Pfizer
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
Learn more about this trial
Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma
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