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Cabo-POLARIS : A Trial to Evaluate Cabozantinib Among Haemodialysied Patients (Cabo-POLARIS)

Primary Purpose

Cancer of Kidney

Status
Not yet recruiting
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Cabozantinib
Blood sample
Questionnaires of quality of life
Sponsored by
Centre Hospitalier Universitaire de Besancon
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer of Kidney

Eligibility Criteria

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

Main Inclusion Criteria:

  1. Documented histological diagnosis of advanced or metastatic renal cell cancer with a clear-cell or papillary component.
  2. Must have received at least one prior line of systemic therapy.
  3. Undergoing haemodialysis for more than 3 months without major complications that might confound the results of the trial, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
  4. Recovery to baseline or ≤ Grade 1 CTCAE v.4.0 from toxicities related to any prior treatments, unless AE(s) are considered clinically nonsignificant by the investigator and/or stable on supportive therapy.
  5. Age eighteen years or older on the day of consent.
  6. Karnofsky Performance Status (KPS) score of ≥ 70%.
  7. Adequate organ and marrow function.

Main exclusion Criteria:

  1. Prior treatment with cabozantinib.
  2. Kidney cancer without clear-cell or papillary component.
  3. Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitor) within 2 weeks before cabozantinib initiation.
  4. Receipt of any type of anticancer antibody within 2 weeks before randomization. For investigational antibody the delay is 4 weeks.

5 Major surgery within 4 weeks or major radiotherapy within 2 weeks prior to starting cabozantinib. Previous palliative radiotherapy (≤ 10 fractions) for metastatic lesions is permitted, provided that this has been completed at least 48 hours prior to starting cabozantinib. Subjects with clinically relevant ongoing complications from prior radiation therapy are not eligible. Subjects with clinically relevant ongoing complications from prior surgery are not eligible.

6. Known brain metastases or spinal compression unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 6 weeks before randomization. Eligible subjects must be neurologically asymptomatic and without corticosteroid treatment at the time of randomization. Patients with a past history of meningeal carcinomatosis are not eligible.

7. The subject has uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:

7a. Cardiovascular disorders

7b Active infection requiring systemic treatment.

7c. Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation

7d. Clinically significant haematuria, hematemesis, or haemoptysis of > 0.5 teaspoon (2.5 ml) of red blood, or other history of significant bleeding (eg, pulmonary haemorrhage) within 3 months before randomization.

7e. Cavitating pulmonary lesion(s) or known endobronchial disease manifestation.

7f. Lesions invading major pulmonary blood vessels. 7g. Other clinically significant disorders.

8. Corrected QT interval > 480 msec within 1 month before randomization. Three ECGs must be performed. If the average of these three consecutive results for QTcF is ≤ 480 msec, the subject meets eligibility in this regard.

9. - Existence of a past history of cancer within 3 years prior to inclusion into the study (excluding cured localized cancer such as non-melanomatous skin cancers, superficial bladder cancers, or in situ for breast or uterine cervical cancer, and localized prostate cancer without biochemical PSA relapse).

Sites / Locations

  • Centre Hospitalier Universitaire de Besançon

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cabozantinib

Arm Description

Outcomes

Primary Outcome Measures

rate of patients permanently discontinuing for any reason cabozantinib at 6 months after initiation of treatment

Secondary Outcome Measures

rate of patients permanently discontinuing cabozantinib at 6 months after initiation of treatment due to toxicity
progression free survival
Absolute and relative frequency of dose reductions and temporary or permanent discontinuation of cabozantinib
total duration of treatment with cabozantinib
progression-free survival (PFS)
overall survival (OS)
objective response rate
overall safety profile of cabozantinib
time to deterioration in quality of life on cabozantinib

Full Information

First Posted
January 21, 2022
Last Updated
May 31, 2022
Sponsor
Centre Hospitalier Universitaire de Besancon
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1. Study Identification

Unique Protocol Identification Number
NCT05241561
Brief Title
Cabo-POLARIS : A Trial to Evaluate Cabozantinib Among Haemodialysied Patients
Acronym
Cabo-POLARIS
Official Title
Open-label, Multicenter, Prospective Phase 2 Study to Evaluate the Duration of Treatment With Cabozantinib Among Patients With Metastatic or Locally Advanced Renal Cell Carcinoma on Hemodialysis (HD).
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 2022 (Anticipated)
Primary Completion Date
March 2027 (Anticipated)
Study Completion Date
March 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Hospitalier Universitaire de Besancon

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
Among patients with renal cell carcinoma (RCC), 2.7 to 4.7 % of patients are at risk of progressing to dialysis or transplantation after partial and radical nephrectomy respectively. Of note, similar risk factors can be seen in both disease: RCC and renal impairment leading to dialysis. Currently, three types of systemic therapies (ST) are mainly used among patients with metastatic renal cell carcinoma (mRCC): anti-angiogenics (mostly tyrosine kinase inhibitors and bevacizumab), mTOR inhibitors and immune checkpoint inhibitor. ST prescription for patients undergoing HD may be more dangerous than in other patients. This is partially explained by the fact that several adverse events can be induced by both the ST and HD e.g. thromboembolic disease, or hypertension. Patients in HD are usually excluded from major clinical trials and available data concerning safety and activity of ST in this specific population are lacking. In most cases, drugs' label is driven by the eligibility criteria of large randomized phase 3 trials that exclude this type of patients. The main source of information for these patients comes from academic publications of patients' cases or small cohorts, but they are not included within the drug label. Moreover, no clear guidelines are given by savant societies regarding those patients. It is known that patients with HD are at high risk of specific adverse events that can sometimes overlap with the safety profile of anti-cancer drugs: thromboembolic complications, cardio-vascular comorbidities, hematologic and metabolic abnormalities. Having a dedicated clinical trial to this particular population would definitely help the community to improve the care of HD patients by getting prospective data in order to increase the level of evidence and therefore to optimize anticancer drug use in this specific population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer of Kidney

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cabozantinib
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Cabozantinib
Intervention Description
Cabozantinib will be prescribed following its Marketing Authorization with an initiation at a reduced dose of 40 mg per day. The dose will be adjusted according to safety. At the end of the first cycle, patients may be eligible for an increase in the dose of cabozantinib (up to 60 mg per day) if the following criteria are met: no adverse effects of grade 3 or 4 cabozantinib-related, no dose reduction or interruption for safety reasons, no long-lasting grade 2 cabozantinib-related adverse effects requiring maximum supportive care. Continuation to 40 mg per day or reduction to 20 mg per day are the other alternatives depending on the safety profile.
Intervention Type
Biological
Intervention Name(s)
Blood sample
Intervention Description
biomonitoring and pharmacokinetics
Intervention Type
Other
Intervention Name(s)
Questionnaires of quality of life
Intervention Description
FKSI-19 and FKSI-DRS and EUROQOL EQ-5D-5L
Primary Outcome Measure Information:
Title
rate of patients permanently discontinuing for any reason cabozantinib at 6 months after initiation of treatment
Time Frame
6 months
Secondary Outcome Measure Information:
Title
rate of patients permanently discontinuing cabozantinib at 6 months after initiation of treatment due to toxicity
Time Frame
6 months
Title
progression free survival
Time Frame
24 months
Title
Absolute and relative frequency of dose reductions and temporary or permanent discontinuation of cabozantinib
Time Frame
24 months
Title
total duration of treatment with cabozantinib
Time Frame
24 months
Title
progression-free survival (PFS)
Time Frame
24 months
Title
overall survival (OS)
Time Frame
24 months
Title
objective response rate
Time Frame
24 months
Title
overall safety profile of cabozantinib
Time Frame
24 months
Title
time to deterioration in quality of life on cabozantinib
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Documented histological diagnosis of advanced or metastatic renal cell cancer with a clear-cell or papillary component. Must have received at least one prior line of systemic therapy. Undergoing haemodialysis for more than 3 months without major complications that might confound the results of the trial, or is not in the best interest of the participant to participate, in the opinion of the treating investigator Recovery to baseline or ≤ Grade 1 CTCAE v.4.0 from toxicities related to any prior treatments, unless AE(s) are considered clinically nonsignificant by the investigator and/or stable on supportive therapy. Age eighteen years or older on the day of consent. Karnofsky Performance Status (KPS) score of ≥ 70%. Adequate organ and marrow function. Main exclusion Criteria: Prior treatment with cabozantinib. Kidney cancer without clear-cell or papillary component. Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitor) within 2 weeks before cabozantinib initiation. Receipt of any type of anticancer antibody within 2 weeks before randomization. For investigational antibody the delay is 4 weeks. 5 Major surgery within 4 weeks or major radiotherapy within 2 weeks prior to starting cabozantinib. Previous palliative radiotherapy (≤ 10 fractions) for metastatic lesions is permitted, provided that this has been completed at least 48 hours prior to starting cabozantinib. Subjects with clinically relevant ongoing complications from prior radiation therapy are not eligible. Subjects with clinically relevant ongoing complications from prior surgery are not eligible. 6. Known brain metastases or spinal compression unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 6 weeks before randomization. Eligible subjects must be neurologically asymptomatic and without corticosteroid treatment at the time of randomization. Patients with a past history of meningeal carcinomatosis are not eligible. 7. The subject has uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions: 7a. Cardiovascular disorders 7b Active infection requiring systemic treatment. 7c. Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation 7d. Clinically significant haematuria, hematemesis, or haemoptysis of > 0.5 teaspoon (2.5 ml) of red blood, or other history of significant bleeding (eg, pulmonary haemorrhage) within 3 months before randomization. 7e. Cavitating pulmonary lesion(s) or known endobronchial disease manifestation. 7f. Lesions invading major pulmonary blood vessels. 7g. Other clinically significant disorders. 8. Corrected QT interval > 480 msec within 1 month before randomization. Three ECGs must be performed. If the average of these three consecutive results for QTcF is ≤ 480 msec, the subject meets eligibility in this regard. 9. - Existence of a past history of cancer within 3 years prior to inclusion into the study (excluding cured localized cancer such as non-melanomatous skin cancers, superficial bladder cancers, or in situ for breast or uterine cervical cancer, and localized prostate cancer without biochemical PSA relapse).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Elise Robert
Phone
+33 3 81 66 81 66
Email
e1robert@chu-besancon.fr
Facility Information:
Facility Name
Centre Hospitalier Universitaire de Besançon
City
Besançon
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antoine Thiery-Vuillemin, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Cabo-POLARIS : A Trial to Evaluate Cabozantinib Among Haemodialysied Patients

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