Phase 3 Trial of Autologous Dendritic Cell Immunotherapy Plus Standard Treatment of Advanced Renal Cell Carcinoma (ADAPT)
Primary Purpose
Advanced Renal Cell Carcinoma, Renal Cell Carcinoma, Metastatic Renal Cell Carcinoma
Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Standard Treatment
AGS-003
Sponsored by
About this trial
This is an interventional treatment trial for Advanced Renal Cell Carcinoma focused on measuring RCC, Kidney Cancer
Eligibility Criteria
Key Inclusion Criteria for Tumor Collection:
- Diagnosis or clinical signs of advanced RCC
- Scheduled for cytoreductive or partial nephrectomy
Key Exclusion Criteria for Tumor Collection:
- Known inability to undergo sunitinib treatment as currently labeled, due to pre-existing medical conditions
- Requirement for systemic chronic immunosuppressive drugs or corticosteroids
- Evidence of brain metastases prior to nephrectomy
Key Inclusion Criteria for Treatment Study:
- Advanced disease, histologically assessed as RCC, with predominantly clear cell histology
- Metastatic disease (measurable or non-measurable) that can be monitored throughout the course of the study participation per RECIST 1.1
- Subjects who are candidates for standard first-line therapy initiating with sunitinib
- Time from diagnosis to treatment < 1 year
- Karnofsky performance status (KPS) ≥ 70%
- Life expectancy of 6 months or greater
- Resolution of all acute toxic effects of prior radiotherapy or surgical procedures to Grade ≤ 1 according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
- Adequate hematologic, renal, hepatic, and coagulation function
- Negative serum pregnancy test for female subjects with reproductive potential, and agreement of all male and female subjects of reproductive potential to use a reliable form of contraception during the study and for 12 weeks after the last dose of study drug
- Normal ECG or clinically non-significant finding(s) at Screening
- Able to abstain from taking prohibited drugs, either prescription or non-prescription, during the treatment phase of the study
- Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures
Key Exclusion Criteria for Treatment Study:
- Prior systemic therapy (including adjuvant or neoadjuvant) of any kind for RCC, including immunotherapy, chemotherapy, hormonal, or investigational therapy
- Prior history of malignancy within the preceding 3 years, except for adequately treated in situ carcinomas or non-melanoma skin cancer, adequately treated early stage breast cancer, superficial bladder cancer, and non-metastatic prostate cancer with a normal PSA
- History of or known brain metastases, spinal cord compression, or carcinomatous meningitis, or evidence of brain or leptomeningeal disease
Patients with 4 or more of the following risk factors:
- Hgb < LLN
- Corrected calcium > 10.0 mg/dL
- KPS < 80%
- Neutrophils > ULN
- Platelets > ULN
- Planned or elective surgical treatment post-nephrectomy for the direct management of RCC, within 28 days before Visit 1 (Week 0)
- NCI CTCAE Grade 3 hemorrhage < 28 days before Visit 1 (Day 0)
- Clinically significant cardiovascular conditions within 3 months prior to Randomization
- Significant gastrointestinal abnormalities
- Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication
- Active autoimmune disease or condition requiring chronic immunosuppressive therapy
- Clinically significant infections, including human immunodeficiency virus, syphilis, and active hepatitis B or C
- Current treatment with an investigational therapy on another clinical trial
- Pregnancy or breastfeeding
- Any serious medical condition or illness considered by the investigator to constitute an unwarranted high risk for investigational treatment
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
AGS-003 + Standard Treatment
Standard Treatment
Arm Description
Subjects on this arm will receive standard treatment for Renal Cell Carcinoma. In addition, subjects will receive AGS-003.
Subjects on this arm will receive standard treatment for Renal Cell Carcinoma.
Outcomes
Primary Outcome Measures
Overall Survival
Duration from randomization to death
Secondary Outcome Measures
Progression Free Survival
Tumor Response
Monitor for evidence of the following tumor responses: Objective response rate, Duration of overall response, and Disease control rate.
Monitor treatment emergent adverse events between both arms
Compare adverse events between both arms.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01582672
Brief Title
Phase 3 Trial of Autologous Dendritic Cell Immunotherapy Plus Standard Treatment of Advanced Renal Cell Carcinoma
Acronym
ADAPT
Official Title
An International Phase 3 Randomized Trial of Autologous Dendritic Cell Immunotherapy (AGS-003) Plus Standard Treatment of Advanced Renal Cell Carcinoma (ADAPT)
Study Type
Interventional
2. Study Status
Record Verification Date
June 2017
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy
Study Start Date
November 2012 (undefined)
Primary Completion Date
April 2018 (Actual)
Study Completion Date
April 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Argos Therapeutics
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a trial of AGS-003, which is being studied as a possible treatment for Advanced Renal Cell Carcinoma. The purpose of this study is to determine whether there is an overall survival (OS) benefit between subjects treated with AGS-003 in combination with standard treatment versus subjects treated with standard treatment alone.
Detailed Description
This study will investigate the combination of an autologous ribonucleic acid (RNA) electroporated dendritic cell (DC) based immunotherapy, AGS-003, plus standard treatment (initiating with sunitinib). The primary objective in this study is to determine the median OS achieved by this combination compared to the OS resulting from use of active control (standard treatment), in a population of adults with advanced renal cell carcinoma (RCC), with nephrectomy indicated, and with remaining metastatic disease.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Renal Cell Carcinoma, Renal Cell Carcinoma, Metastatic Renal Cell Carcinoma
Keywords
RCC, Kidney Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
462 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AGS-003 + Standard Treatment
Arm Type
Experimental
Arm Description
Subjects on this arm will receive standard treatment for Renal Cell Carcinoma. In addition, subjects will receive AGS-003.
Arm Title
Standard Treatment
Arm Type
Active Comparator
Arm Description
Subjects on this arm will receive standard treatment for Renal Cell Carcinoma.
Intervention Type
Drug
Intervention Name(s)
Standard Treatment
Other Intervention Name(s)
Sunitinib
Intervention Description
Standard treatment for Renal Cell Carcinoma
Intervention Type
Biological
Intervention Name(s)
AGS-003
Intervention Description
Autologous Dendritic Cell product. Intradermal injections; 8 injections in the 1st year followed by quarterly boosters.
Primary Outcome Measure Information:
Title
Overall Survival
Description
Duration from randomization to death
Time Frame
From date of subject randomization to date of death; assessed up to 42 months or until 290 deaths have been accrued on study
Secondary Outcome Measure Information:
Title
Progression Free Survival
Time Frame
From date of subject randomization to date of progression; assessed up to 42 months
Title
Tumor Response
Description
Monitor for evidence of the following tumor responses: Objective response rate, Duration of overall response, and Disease control rate.
Time Frame
From date of subject randomization to date of progression; assessed up to 42 months
Title
Monitor treatment emergent adverse events between both arms
Description
Compare adverse events between both arms.
Time Frame
From safety baseline until either meeting a discontinuation criterion or death; assessed up to 42 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria for Tumor Collection:
Diagnosis or clinical signs of advanced RCC
Scheduled for cytoreductive or partial nephrectomy
Key Exclusion Criteria for Tumor Collection:
Known inability to undergo sunitinib treatment as currently labeled, due to pre-existing medical conditions
Requirement for systemic chronic immunosuppressive drugs or corticosteroids
Evidence of brain metastases prior to nephrectomy
Key Inclusion Criteria for Treatment Study:
Advanced disease, histologically assessed as RCC, with predominantly clear cell histology
Metastatic disease (measurable or non-measurable) that can be monitored throughout the course of the study participation per RECIST 1.1
Subjects who are candidates for standard first-line therapy initiating with sunitinib
Time from diagnosis to treatment < 1 year
Karnofsky performance status (KPS) ≥ 70%
Life expectancy of 6 months or greater
Resolution of all acute toxic effects of prior radiotherapy or surgical procedures to Grade ≤ 1 according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
Adequate hematologic, renal, hepatic, and coagulation function
Negative serum pregnancy test for female subjects with reproductive potential, and agreement of all male and female subjects of reproductive potential to use a reliable form of contraception during the study and for 12 weeks after the last dose of study drug
Normal ECG or clinically non-significant finding(s) at Screening
Able to abstain from taking prohibited drugs, either prescription or non-prescription, during the treatment phase of the study
Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures
Key Exclusion Criteria for Treatment Study:
Prior systemic therapy (including adjuvant or neoadjuvant) of any kind for RCC, including immunotherapy, chemotherapy, hormonal, or investigational therapy
Prior history of malignancy within the preceding 3 years, except for adequately treated in situ carcinomas or non-melanoma skin cancer, adequately treated early stage breast cancer, superficial bladder cancer, and non-metastatic prostate cancer with a normal PSA
History of or known brain metastases, spinal cord compression, or carcinomatous meningitis, or evidence of brain or leptomeningeal disease
Patients with 4 or more of the following risk factors:
Hgb < LLN
Corrected calcium > 10.0 mg/dL
KPS < 80%
Neutrophils > ULN
Platelets > ULN
Planned or elective surgical treatment post-nephrectomy for the direct management of RCC, within 28 days before Visit 1 (Week 0)
NCI CTCAE Grade 3 hemorrhage < 28 days before Visit 1 (Day 0)
Clinically significant cardiovascular conditions within 3 months prior to Randomization
Significant gastrointestinal abnormalities
Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication
Active autoimmune disease or condition requiring chronic immunosuppressive therapy
Clinically significant infections, including human immunodeficiency virus, syphilis, and active hepatitis B or C
Current treatment with an investigational therapy on another clinical trial
Pregnancy or breastfeeding
Any serious medical condition or illness considered by the investigator to constitute an unwarranted high risk for investigational treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Figlin, MD, FACP
Organizational Affiliation
Cedars-Sinai Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Christopher G Wood, MD, FACP
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
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Scottsdale
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Arizona
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Little Rock
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Manitoba
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Canada
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Ontario
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Canada
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London
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Ontario
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Canada
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Ontario
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Canada
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Ontario
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Canada
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Quebec
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Canada
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Montreal
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Quebec
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Canada
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Montreal
State/Province
Quebec
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Canada
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Quebec
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G1R3S1
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Canada
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Hradec Kralove
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50005
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Czechia
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Liberec
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46063
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Czechia
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Olomouc
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77520
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Czechia
City
Prague
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10034
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Czechia
City
Praha 8
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18081
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Czechia
City
Budapest
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H-1062
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Hungary
City
Budapest
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H-1122
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Hungary
City
Debrecen
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H-4032
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Hungary
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Haifa
ZIP/Postal Code
31096
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Israel
City
Jerusalem
ZIP/Postal Code
91120
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Israel
City
Kfar Saba
ZIP/Postal Code
44281
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Israel
City
Rehovot
ZIP/Postal Code
76100
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Israel
City
Tel Hashomer
ZIP/Postal Code
52621
Country
Israel
City
Zerifin
ZIP/Postal Code
70300
Country
Israel
City
Roma
ZIP/Postal Code
00152
Country
Italy
City
Rome
ZIP/Postal Code
00144
Country
Italy
City
Badalona
ZIP/Postal Code
08916
Country
Spain
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
City
Madrid
ZIP/Postal Code
28033
Country
Spain
City
Madrid
ZIP/Postal Code
28046
Country
Spain
City
Madrid
ZIP/Postal Code
28050
Country
Spain
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
City
Valencia
ZIP/Postal Code
46009
Country
Spain
City
Vigo
ZIP/Postal Code
36204
Country
Spain
City
Cambridge
ZIP/Postal Code
CB20QQ
Country
United Kingdom
City
Norwich
ZIP/Postal Code
NR47UY
Country
United Kingdom
City
Preston
ZIP/Postal Code
PR29HT
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
32034074
Citation
Figlin RA, Tannir NM, Uzzo RG, Tykodi SS, Chen DYT, Master V, Kapoor A, Vaena D, Lowrance W, Bratslavsky G, DeBenedette M, Gamble A, Plachco A, Norris MS, Horvatinovich J, Tcherepanova IY, Nicolette CA, Wood CG; ADAPT study group. Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma. Clin Cancer Res. 2020 May 15;26(10):2327-2336. doi: 10.1158/1078-0432.CCR-19-2427. Epub 2020 Feb 7.
Results Reference
derived
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Phase 3 Trial of Autologous Dendritic Cell Immunotherapy Plus Standard Treatment of Advanced Renal Cell Carcinoma
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