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Brivanib Metastatic Renal Cell Carcinoma

Primary Purpose

Renal Cell Carcinoma

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Brivanib alaninate
Polymerase chain reaction
Iodine I 124 chimeric monoclonal antibody G250
Positron emission tomography/computed tomography
Protein expression analysis
Immunohistochemistry
Sponsored by
Abramson Cancer Center at Penn Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Cell Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female adults with metastatic renal cell carcinoma
  • Patients will have tumors that bear a clear cell component that comprises greater than or equal to 50% of the tumor.
  • Disease must be measurable in accord with RECIST 1.1 guidelines.
  • Patients who have developed progressive disease or intolerance on treatment with sorafenib, sunitinib, bevacizumab, or pazopanib over a 60 day period who have not discontinued this therapy more than 100 days prior to study enrollment. Progressive disease per RECIST 1.1 guidelines will be preferred
  • Therapy with up to three prior systemic regimens will be allowed.
  • Patients may have been treated with any of the following: sorafenib, sunitinib, bevacizumab, pazopanib, temsirolimus, everolimus, interferon alpha, interleuken-2.
  • Treatment with up to one prior regimen that included cytotoxic chemotherapy will be allowed.
  • Patients may have been treated with more than 1 antiangiogenic therapy (e.g., patients may have been treated with both sorafenib and sunitinib or sunitinib and bevacizumab, or sequential combinations that include pazopanib).
  • Life expectancy of at least 3 months
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Tumor tissue must be available for correlative studies.
  • Patients must consent to allow the acquisition of formalin-fixed paraffin-embedded (FFPE) material (block or unstained slides) by study personnel for performance of correlative tissue studies.

Exclusion Criteria:

  • Known brain metastases
  • Prior therapy with brivanib, or anti-FGFR (fibroblast growth factor receptor) therapy.
  • History of thrombotic or embolic events within the last six months such as a cerebrovascular accident (including transient ischemic attacks), pulmonary embolism.
  • Gastrointestinal bleeding or any other hemorrhage/bleeding event CTCAE version 4.0 Grade greater than 3 within 30 days prior to study entry.
  • Uncontrolled or significant cardiovascular disease.
  • QTc greater than 450 msec on two consecutive ECGs (Baseline ECG should be repeated if QTc is found to be greater than 450 msec.).
  • Active infection, less than 7 days after completing systemic antibiotic therapy.
  • History of non-healing wounds or ulcers or bone fractures within 3 months of fracture.
  • Major surgical procedure, open biopsy, or significant traumatic injury less than 3 weeks prior to study enrollment or those who receive minor surgical procedures (e.g. core biopsy or fine needle aspiration)within 1 week prior to study enrollment.
  • Cytotoxic chemotherapy within 3 weeks, bevacizumab within 2 months, or radiation therapy within 2 weeks, other targeted therapies (e.g., sorafenib, sunitinib, temsirolimus, everolimus)within 2 days.
  • Inability to swallow tablets or untreated malabsorption syndrome.
  • Pre-existing thyroid abnormality with thyroid function that cannot be controlled with medication.
  • History of HIV
  • Patients with centrally cavitating lung lesions.
  • Patients requiring therapeutic anticoagulation with warfarin at baseline. However, prophylactic therapy with a low molecular weight heparin at baseline is acceptable.

Sites / Locations

  • Abramson Cancer Center of the University of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Patients receive oral brivanib alaninate daily in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Progression Free Survival (PFS)
All patients will be followed through the entire 16-week period and will be given a binary outcome assignment: progressive disease or not.

Secondary Outcome Measures

Best Overall Response Rated for Each Patients as Assessed by RECIST 1.1 Guidelines
The best overall radiographic response to therapy as measured and assessed using RECIST 1.1 guidelines will be captured for each research subject.
Overall Survival
Will record deaths on study, and, to the extent possible, after the study follow-up period is completed for each patient, will be captured. Reason for death will be identified and recorded where possible.
Change in Total Antibody Binding as Assessed by 124I-cG250 PET/CT Imaging (Correlative Studies)
Will determine the baseline and change in total antibody binding in lesions from baseline to the time on treatment that patients are assessed. The analysis dataset will be quantitated radiotracer uptake data obtained via I-cG250 PET/CT for all evaluable patients who complete the trial.
Response Rate for All Patients
Response Rate for all patients as assessed by RECIST 1.1 guidelines
Molecular Markers
Molecular markers expressed in patient tumor specimens as assessed by IHC and histocytometry (e.g., VHL, HIF, p-STAT3, p-ERK, and Ki67, VEGFR2, and FGFR1) (correlative studies)
Changes in Collagen IV Levels
Changes in collagen IV levels for each patient (correlative studies)
Germline Polymorphisms and Assessment of Relationship to Toxicity and Clinical Outcome
Germline polymorphisms and assessment of relationship to toxicity and clinical outcome (correlative studies)
Blood Pressure Data
Blood pressure data
Toxicity as Assessed by NCI CTCAE Version 4.0
Toxicity as assessed by NCI CTCAE version 4.0

Full Information

First Posted
November 30, 2010
Last Updated
March 18, 2021
Sponsor
Abramson Cancer Center at Penn Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT01253668
Brief Title
Brivanib Metastatic Renal Cell Carcinoma
Official Title
Brivanib (BMS-582664, Brivanib Alaninate) in Treatment of Refractory Metastatic Renal Cell Carcinoma - A Phase II Pharmacodynamic and Baseline Biomarker Study
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Terminated
Why Stopped
In November 2012, this study was permanently closed to new accrual at the request of the drug manufacturer (BMS), who decided not to pursue additional research activity in this patient population.
Study Start Date
November 2011 (Actual)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
September 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Abramson Cancer Center at Penn Medicine

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase II study of an investigational agent, brivanib, in patients with refractory metastatic renal cell carcinoma. This study will evaluate the safety and effectiveness of brivanib in renal cell carcinoma, and explore the activity of this drug in this population to determine whether imaging and molecular features of the tumors can be used to predict response. Approximately 30 people with advanced kidney cancer will be enrolled on this study at the University of Pennsylvania.
Detailed Description
The primary objective of this clinical trial is to determine the efficacy of brivanib in the treatment of metastatic renal cell carcinoma in terms of progression-free survival (PFS) in patients who have progressed on treatment with sunitinib, sorafenib, bevacizumab, or pazopanib. The primary endpoint of the trial will be PFS at 16 weeks. The secondary objectives are to further examine the safety and tolerability profile of brivanib, to examine the efficacy of brivanib in this population in terms of best overall response, response rate, progression-free survival, and overall survival, to describe baseline and changes in I-cG250 PET/CT in relation to observed therapeutic effects, to describe novel baseline histologic features of these tumors in relation to observed therapeutic effects. Modalities will include Von Hippel-Lindau gene (VHL) and hypoxia-inducible factor 1 gene (HIF-1) expression assessment and a novel histo-cytometric assessment of the tumor microenvironment in terms of p-STAT3, p-ERK, Ki67, VEGFR2, FGFR1 expression, to describe changes in circulating collagen IV on brivanib in relation to therapeutic effects, to explore the relationship between single nucleotide polymorphisms in angiogenesis-related genes and the activity of brivanib in the treatment of these patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
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
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Patients receive oral brivanib alaninate daily in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Brivanib alaninate
Intervention Description
Brivanib by mouth daily at a dose of 800mg.
Intervention Type
Genetic
Intervention Name(s)
Polymerase chain reaction
Other Intervention Name(s)
PCR
Intervention Description
Undergo 1241-cG250 PET/CT imaging (correlative studies)
Intervention Type
Other
Intervention Name(s)
Iodine I 124 chimeric monoclonal antibody G250
Intervention Description
Undergo 124I-cG250 PET/CT imaging (correlative studies)
Intervention Type
Procedure
Intervention Name(s)
Positron emission tomography/computed tomography
Intervention Description
Undergo 1241-cG250 PET/CT imaging (correlative studies)
Intervention Type
Genetic
Intervention Name(s)
Protein expression analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
Immunohistochemistry
Other Intervention Name(s)
immunohistochemistry staining method
Intervention Description
correlative studies
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
All patients will be followed through the entire 16-week period and will be given a binary outcome assignment: progressive disease or not.
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Best Overall Response Rated for Each Patients as Assessed by RECIST 1.1 Guidelines
Description
The best overall radiographic response to therapy as measured and assessed using RECIST 1.1 guidelines will be captured for each research subject.
Time Frame
Every 8 weeks
Title
Overall Survival
Description
Will record deaths on study, and, to the extent possible, after the study follow-up period is completed for each patient, will be captured. Reason for death will be identified and recorded where possible.
Time Frame
Every 8 weeks
Title
Change in Total Antibody Binding as Assessed by 124I-cG250 PET/CT Imaging (Correlative Studies)
Description
Will determine the baseline and change in total antibody binding in lesions from baseline to the time on treatment that patients are assessed. The analysis dataset will be quantitated radiotracer uptake data obtained via I-cG250 PET/CT for all evaluable patients who complete the trial.
Time Frame
At baseline and 8 weeks
Title
Response Rate for All Patients
Description
Response Rate for all patients as assessed by RECIST 1.1 guidelines
Time Frame
Every 8 weeks
Title
Molecular Markers
Description
Molecular markers expressed in patient tumor specimens as assessed by IHC and histocytometry (e.g., VHL, HIF, p-STAT3, p-ERK, and Ki67, VEGFR2, and FGFR1) (correlative studies)
Time Frame
At baseline
Title
Changes in Collagen IV Levels
Description
Changes in collagen IV levels for each patient (correlative studies)
Time Frame
At baseline and week 3
Title
Germline Polymorphisms and Assessment of Relationship to Toxicity and Clinical Outcome
Description
Germline polymorphisms and assessment of relationship to toxicity and clinical outcome (correlative studies)
Time Frame
At baseline and week 3
Title
Blood Pressure Data
Description
Blood pressure data
Time Frame
At baseline, day 1 weeks 3,6,8,12,16 and every 6-8 weeks thereafter
Title
Toxicity as Assessed by NCI CTCAE Version 4.0
Description
Toxicity as assessed by NCI CTCAE version 4.0
Time Frame
Day 1, weeks 3,6,9,12,16, and every 6-8 weeks thereafter

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female adults with metastatic renal cell carcinoma Patients will have tumors that bear a clear cell component that comprises greater than or equal to 50% of the tumor. Disease must be measurable in accord with RECIST 1.1 guidelines. Patients who have developed progressive disease or intolerance on treatment with sorafenib, sunitinib, bevacizumab, or pazopanib over a 60 day period who have not discontinued this therapy more than 100 days prior to study enrollment. Progressive disease per RECIST 1.1 guidelines will be preferred Therapy with up to three prior systemic regimens will be allowed. Patients may have been treated with any of the following: sorafenib, sunitinib, bevacizumab, pazopanib, temsirolimus, everolimus, interferon alpha, interleuken-2. Treatment with up to one prior regimen that included cytotoxic chemotherapy will be allowed. Patients may have been treated with more than 1 antiangiogenic therapy (e.g., patients may have been treated with both sorafenib and sunitinib or sunitinib and bevacizumab, or sequential combinations that include pazopanib). Life expectancy of at least 3 months Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Tumor tissue must be available for correlative studies. Patients must consent to allow the acquisition of formalin-fixed paraffin-embedded (FFPE) material (block or unstained slides) by study personnel for performance of correlative tissue studies. Exclusion Criteria: Known brain metastases Prior therapy with brivanib, or anti-FGFR (fibroblast growth factor receptor) therapy. History of thrombotic or embolic events within the last six months such as a cerebrovascular accident (including transient ischemic attacks), pulmonary embolism. Gastrointestinal bleeding or any other hemorrhage/bleeding event CTCAE version 4.0 Grade greater than 3 within 30 days prior to study entry. Uncontrolled or significant cardiovascular disease. QTc greater than 450 msec on two consecutive ECGs (Baseline ECG should be repeated if QTc is found to be greater than 450 msec.). Active infection, less than 7 days after completing systemic antibiotic therapy. History of non-healing wounds or ulcers or bone fractures within 3 months of fracture. Major surgical procedure, open biopsy, or significant traumatic injury less than 3 weeks prior to study enrollment or those who receive minor surgical procedures (e.g. core biopsy or fine needle aspiration)within 1 week prior to study enrollment. Cytotoxic chemotherapy within 3 weeks, bevacizumab within 2 months, or radiation therapy within 2 weeks, other targeted therapies (e.g., sorafenib, sunitinib, temsirolimus, everolimus)within 2 days. Inability to swallow tablets or untreated malabsorption syndrome. Pre-existing thyroid abnormality with thyroid function that cannot be controlled with medication. History of HIV Patients with centrally cavitating lung lesions. Patients requiring therapeutic anticoagulation with warfarin at baseline. However, prophylactic therapy with a low molecular weight heparin at baseline is acceptable.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephen Keefe, MD
Organizational Affiliation
Abramson Cancer Center at Penn Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Abramson Cancer Center of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

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Brivanib Metastatic Renal Cell Carcinoma

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