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Biomarker Study of Pts With Metastatic ccRCC Undergoing Sequential Therapy With 1st Line Sunitinib and 2nd Line Axitinib (SuAx)

Primary Purpose

Clear Cell Renal Cell Carcinoma

Status
Unknown status
Phase
Phase 2
Locations
Brazil
Study Type
Interventional
Intervention
Sunitinib
Sponsored by
Instituto do Cancer do Estado de São Paulo
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Clear Cell Renal Cell Carcinoma focused on measuring biomarker, metastatic, sunitinib, axitinib, next generation sequencing, clear cell renal cell carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of Locally advanced (defined as disease not amenable to curative surgery or radiation therapy) or metastatic RCC (equivalent to Stage IV RCC according to American Joint Committee on Cancer staging) renal cell carcinoma;
  • Histologic confirmed clear cell renal cell carcinoma;
  • No prior systemic therapy (interleukin-2, interferon-α, chemotherapy, bevacizumab, sunitinib, sorafenib, pazopanib, axitinib, everolimus or temsirolimus) for advanced or metastatic RCC;
  • Measurable disease by RECIST;
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0 to 2;
  • Adequate organ system functions;
  • Patients must understand and be willing to sign the written informed consent form of this study.

Exclusion Criteria:

  • Non-clear cell renal cell carcinoma
  • Pregnant or lactating female.
  • History of another malignancy. Note: Subjects who have had another malignancy and have been disease-free for 3 years, or subjects with a history of completely resected non-melanoma skin carcinoma or successfully treated in situ carcinoma are eligible.
  • History or clinical evidence of central nervous system (CNS) metastases. Note: Subjects who have previously-treated CNS metastases (surgery ± radiotherapy, radiosurgery) and meet all 3 of the following criteria are eligible:

    1. Are asymptomatic
    2. No evidence of active CNS metastases for ≥3 months prior to enrolment
    3. Have no requirement for steroids or anticonvulsants
  • Clinically significant gastrointestinal abnormalities including, but not limited to:

    1. Malabsorption syndrome
    2. Major resection of the stomach or small bowel that could affect the absorption of study drug
    3. Active peptic ulcer disease
    4. Inflammatory bowel disease
    5. Ulcerative colitis, or other gastrointestinal conditions with increased risk of perforation
    6. History of abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within 28 days prior to beginning study treatment.
  • History of any one or more of the following cardiovascular conditions within the past 12 months:

    1. Cardiac angioplasty or stenting
    2. Myocardial infarction
    3. Unstable angina
    4. Symptomatic peripheral vascular disease
    5. Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA)
    6. History of cerebrovascular accident including transient ischemic attack (TIA).
    7. Poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥150 millimeters of mercury (mmHg) or diastolic blood pressure (DBP) of ≥ 90 mmHg

Sites / Locations

  • Instituto do Cancer do Estado de São Paulo

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1st Line Sunitinib and 2nd Line Axitinib

Arm Description

1st line sunitinib on a 4/2 schedule followed by axitinib 5 mg twice a day on 2nd line therapy

Outcomes

Primary Outcome Measures

1st line Response Rate (RR) with Sunitinib in patients with VEGF pathway mutation
First Line Response Rate (RR) With Sunitinib (RECIST 1.1) in patients with VEGF pathway mutation

Secondary Outcome Measures

1sr line RR with Sunitinib
First Line Response Rate (RR) with Sunitinib (RECIST 1.1)
2nd Line RR with Axitinib
Second Line Response Rate (RR) with Axitinib (RECIST 1.1)
1st line PFS with Sunitinib
First Line Progression Free Survival (PFS) with Sunitinib
2nd PFS with Axitinib
Second Line Progression Free Survival (PFS) with Axitinib
Overall Survival (OS)
Overall Survival
Incidence of Treatment-Emergent Adverse Events
CTCAE v.4.0

Full Information

First Posted
December 27, 2017
Last Updated
September 2, 2019
Sponsor
Instituto do Cancer do Estado de São Paulo
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT03592199
Brief Title
Biomarker Study of Pts With Metastatic ccRCC Undergoing Sequential Therapy With 1st Line Sunitinib and 2nd Line Axitinib
Acronym
SuAx
Official Title
Biomarker Study of Patients With Metastatic Clear Cell Renal Carcinoma (ccRCC) Undergoing Sequential Therapy With 1st Line Sunitinib and 2nd Line Axitinib
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Unknown status
Study Start Date
December 11, 2017 (Actual)
Primary Completion Date
December 11, 2019 (Anticipated)
Study Completion Date
December 11, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Instituto do Cancer do Estado de São Paulo
Collaborators
Pfizer

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a prospective single arm phase II study to evaluate potential prognostic and/or predictive biomarkers in patients with metastatic ccRCC undergoing treatment with 1st line sunitinib on a 4/2 schedule followed by axitinib on 2nd line therapy.
Detailed Description
In this study, all included patients will receive sunitinib until disease progression and/or limiting toxicity. If patients develop toxicities ≥ Grade 2 on 50 mg per day 4 weeks-on / 2 weeks-off schedule, a modified schedule of 50 mg/day 2 weeks-on / 1 week-off will be offered. After disease progression on sunitinib, all eligible patients will receive axitinib 5 mg twice a day. The investigators plan to assess, by next generation sequencing, the prevalence of mutations in several cancer related genes in baseline archived tissue from the patients included in the study, and the potential correlations between these somatic mutations and anti-VEGF (Vascular Endothelial Growth Factor) therapy efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clear Cell Renal Cell Carcinoma
Keywords
biomarker, metastatic, sunitinib, axitinib, next generation sequencing, clear cell renal cell 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
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1st Line Sunitinib and 2nd Line Axitinib
Arm Type
Experimental
Arm Description
1st line sunitinib on a 4/2 schedule followed by axitinib 5 mg twice a day on 2nd line therapy
Intervention Type
Drug
Intervention Name(s)
Sunitinib
Other Intervention Name(s)
Axitinib
Intervention Description
1st line sunitinib on a 4/2 schedule followed by axitinib 5 mg twice a day on 2nd line therapy
Primary Outcome Measure Information:
Title
1st line Response Rate (RR) with Sunitinib in patients with VEGF pathway mutation
Description
First Line Response Rate (RR) With Sunitinib (RECIST 1.1) in patients with VEGF pathway mutation
Time Frame
through study completion (up to 2 years)
Secondary Outcome Measure Information:
Title
1sr line RR with Sunitinib
Description
First Line Response Rate (RR) with Sunitinib (RECIST 1.1)
Time Frame
through study completion (up to 2 years)
Title
2nd Line RR with Axitinib
Description
Second Line Response Rate (RR) with Axitinib (RECIST 1.1)
Time Frame
through study completion (up to 2 years)
Title
1st line PFS with Sunitinib
Description
First Line Progression Free Survival (PFS) with Sunitinib
Time Frame
through study completion (up to 2 years)
Title
2nd PFS with Axitinib
Description
Second Line Progression Free Survival (PFS) with Axitinib
Time Frame
through study completion (up to 2 years)
Title
Overall Survival (OS)
Description
Overall Survival
Time Frame
through study completion (up to 2 years)
Title
Incidence of Treatment-Emergent Adverse Events
Description
CTCAE v.4.0
Time Frame
through study completion (up to 2 years)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of Locally advanced (defined as disease not amenable to curative surgery or radiation therapy) or metastatic RCC (equivalent to Stage IV RCC according to American Joint Committee on Cancer staging) renal cell carcinoma; Histologic confirmed clear cell renal cell carcinoma; No prior systemic therapy (interleukin-2, interferon-α, chemotherapy, bevacizumab, sunitinib, sorafenib, pazopanib, axitinib, everolimus or temsirolimus) for advanced or metastatic RCC; Measurable disease by RECIST; Eastern Cooperative Oncology Group (ECOG) Performance Status 0 to 2; Adequate organ system functions; Patients must understand and be willing to sign the written informed consent form of this study. Exclusion Criteria: Non-clear cell renal cell carcinoma Pregnant or lactating female. History of another malignancy. Note: Subjects who have had another malignancy and have been disease-free for 3 years, or subjects with a history of completely resected non-melanoma skin carcinoma or successfully treated in situ carcinoma are eligible. History or clinical evidence of central nervous system (CNS) metastases. Note: Subjects who have previously-treated CNS metastases (surgery ± radiotherapy, radiosurgery) and meet all 3 of the following criteria are eligible: Are asymptomatic No evidence of active CNS metastases for ≥3 months prior to enrolment Have no requirement for steroids or anticonvulsants Clinically significant gastrointestinal abnormalities including, but not limited to: Malabsorption syndrome Major resection of the stomach or small bowel that could affect the absorption of study drug Active peptic ulcer disease Inflammatory bowel disease Ulcerative colitis, or other gastrointestinal conditions with increased risk of perforation History of abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within 28 days prior to beginning study treatment. History of any one or more of the following cardiovascular conditions within the past 12 months: Cardiac angioplasty or stenting Myocardial infarction Unstable angina Symptomatic peripheral vascular disease Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA) History of cerebrovascular accident including transient ischemic attack (TIA). Poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥150 millimeters of mercury (mmHg) or diastolic blood pressure (DBP) of ≥ 90 mmHg
Facility Information:
Facility Name
Instituto do Cancer do Estado de São Paulo
City
São Paulo
ZIP/Postal Code
01246000
Country
Brazil

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Biomarker Study of Pts With Metastatic ccRCC Undergoing Sequential Therapy With 1st Line Sunitinib and 2nd Line Axitinib

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