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Study Evaluating the Effect of Sirolimus on Non-Melanoma Skin Cancer in Kidney Transplant Recipients

Primary Purpose

Skin Neoplasms, Kidney Transplantation

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
sirolimus
cyclosporine or tacrolimus
Sponsored by
Wyeth is now a wholly owned subsidiary of Pfizer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Skin Neoplasms focused on measuring Kidney, Transplant, Skin Cancer

Eligibility Criteria

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

Inclusion Criteria: Kidney transplant at least 1 year prior Subjects with a functioning renal allograft with calculated glomerular filtration rate (GFR) ≥40mL/min (Nankivell method) and proteinuria ≤500mg/day. Stable on cyclosporine or tacrolimus-based multi-drug immunosuppressive regimen History of NMSC within last 3 years Exclusion Criteria: History of other cancer within last 3 years NMSC with metastatic disease or more than 20 NMSC lesions in last 12 months Multiple organ transplant

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

Conversion to a sirolimus-based regimen

Continuation of a CNI-based regimen

Outcomes

Primary Outcome Measures

New Biopsy-Confirmed Nonmelanoma Skin Cancer (NMSC) Lesions Per Subject Per Year
The number of new biopsy-confirmed NMSC lesions per subject per year was calculated by summarizing the total number of new BCC and SCC lesions reported over the observation period and standardizing it to an annual rate by multiplying by 365 and dividing by days on study.

Secondary Outcome Measures

Time to First Biopsy Confirmed New NMSC Lesion.
The time to first biopsy confirmed new NMSC lesion starts at 1 day post randomization to biopsy and/or treatment of newly confirmed NMSC lesion.
Number of Lesion Free Subjects
The overall number of subjects who were lesion free were compared between treatment groups with the Cochran Mantel Haenszel test stratified by baseline NMSC stratum. Within each stratum, the Fisher exact test was used to compare the proportions of lesion free subjects between treatment groups.
Percentage of Patients With New Biopsy-confirmed NMSC: Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC)
Grade Distribution of NMSC Lesions
Number of subjects with at least 1 biopsy-confirmed new squamous cell carcinoma (SCC) or basal cell carcinoma (BCC).
Number of Recurrent NMSC Lesions Per Subject-year
Recurrent NMSC lesions is defined as recurring at the site of a previously treated lesion.
Subjects Reporting Incidence of Metastatic Disease Related to NMSC.
The number of subjects with metastatic disease related to NMSC.
Death Due to NMSC
Number of Subjects Who Discontinue Assigned Therapy
Nankivell-Calculated Glomerular Filtration Rate (GFR)
GFR is an index of kidney function. GFR describes the flow rate of filtered fluid through the kidney. GFR can be measured directly or estimated using established formulas. For this study, GFR was calculated using Nankivell. A normal GFR is > 90 mL/min, although children and older people usually have a lower GFR. Lower values indicate poor kidney function. A GFR <15 is consistent with kidney failure.
Serum Creatinine Level
Serum creatinine is an indicator of kidney function. Creatinine is a substance formed from the metabolism of creatinine, commonly found in blood, urine, and muscle tissue. It is removed from the blood by the kidneys and excreted in urine. An increased level of creatinine in the blood indicates decreased kidney function. Normal adult blood levels of creatinine are 0.5 to 1.1 mg/dL for females and 0.6 to 1.2 mg/dL for males, however the normal values are age-dependent as elderly patients typically have smaller muscle mass.
Number of Participants That Died
Graft Survival Measured by Graft Loss
Graft loss was defined as physical loss (nephrectomy), functional loss (necessitating maintenance dialysis for >8 consecutive weeks), retransplant, or death.
Number of Subjects With Biopsy-Confirmed Acute Rejection
Spot Urine Protein:Creatinine Ratio
Subjects' urine protein:creatinine ratios were summarized by each scheduled visit, and the nonparametric Wilcoxon rank sum test was used to compare the difference between groups.

Full Information

First Posted
August 1, 2005
Last Updated
April 9, 2012
Sponsor
Wyeth is now a wholly owned subsidiary of Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT00129961
Brief Title
Study Evaluating the Effect of Sirolimus on Non-Melanoma Skin Cancer in Kidney Transplant Recipients
Official Title
A Randomized, Open-Label Study to Compare the Rate of New Non-Melanoma Skin Cancer in Maintenance Renal Allograft Recipients Converted to a Sirolimus-based Regimen Versus Continuation of a Calcineurin Inhibitor-based Regimen
Study Type
Interventional

2. Study Status

Record Verification Date
April 2012
Overall Recruitment Status
Completed
Study Start Date
August 2005 (undefined)
Primary Completion Date
January 2009 (Actual)
Study Completion Date
January 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wyeth is now a wholly owned subsidiary of Pfizer

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the effect of sirolimus on the prevention of new non-melanoma skin cancer (NMSC) in kidney transplant recipients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Skin Neoplasms, Kidney Transplantation
Keywords
Kidney, Transplant, Skin Cancer

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
86 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Conversion to a sirolimus-based regimen
Arm Title
2
Arm Type
Active Comparator
Arm Description
Continuation of a CNI-based regimen
Intervention Type
Drug
Intervention Name(s)
sirolimus
Intervention Type
Drug
Intervention Name(s)
cyclosporine or tacrolimus
Primary Outcome Measure Information:
Title
New Biopsy-Confirmed Nonmelanoma Skin Cancer (NMSC) Lesions Per Subject Per Year
Description
The number of new biopsy-confirmed NMSC lesions per subject per year was calculated by summarizing the total number of new BCC and SCC lesions reported over the observation period and standardizing it to an annual rate by multiplying by 365 and dividing by days on study.
Time Frame
up to 24 months
Secondary Outcome Measure Information:
Title
Time to First Biopsy Confirmed New NMSC Lesion.
Description
The time to first biopsy confirmed new NMSC lesion starts at 1 day post randomization to biopsy and/or treatment of newly confirmed NMSC lesion.
Time Frame
up to 24 months
Title
Number of Lesion Free Subjects
Description
The overall number of subjects who were lesion free were compared between treatment groups with the Cochran Mantel Haenszel test stratified by baseline NMSC stratum. Within each stratum, the Fisher exact test was used to compare the proportions of lesion free subjects between treatment groups.
Time Frame
up to 24 months
Title
Percentage of Patients With New Biopsy-confirmed NMSC: Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC)
Time Frame
up to 24 months
Title
Grade Distribution of NMSC Lesions
Description
Number of subjects with at least 1 biopsy-confirmed new squamous cell carcinoma (SCC) or basal cell carcinoma (BCC).
Time Frame
up to 24 months
Title
Number of Recurrent NMSC Lesions Per Subject-year
Description
Recurrent NMSC lesions is defined as recurring at the site of a previously treated lesion.
Time Frame
up to 24 months
Title
Subjects Reporting Incidence of Metastatic Disease Related to NMSC.
Description
The number of subjects with metastatic disease related to NMSC.
Time Frame
up to 24 months
Title
Death Due to NMSC
Time Frame
up to 24 months
Title
Number of Subjects Who Discontinue Assigned Therapy
Time Frame
up to 24 months
Title
Nankivell-Calculated Glomerular Filtration Rate (GFR)
Description
GFR is an index of kidney function. GFR describes the flow rate of filtered fluid through the kidney. GFR can be measured directly or estimated using established formulas. For this study, GFR was calculated using Nankivell. A normal GFR is > 90 mL/min, although children and older people usually have a lower GFR. Lower values indicate poor kidney function. A GFR <15 is consistent with kidney failure.
Time Frame
At 24 months (week 104)
Title
Serum Creatinine Level
Description
Serum creatinine is an indicator of kidney function. Creatinine is a substance formed from the metabolism of creatinine, commonly found in blood, urine, and muscle tissue. It is removed from the blood by the kidneys and excreted in urine. An increased level of creatinine in the blood indicates decreased kidney function. Normal adult blood levels of creatinine are 0.5 to 1.1 mg/dL for females and 0.6 to 1.2 mg/dL for males, however the normal values are age-dependent as elderly patients typically have smaller muscle mass.
Time Frame
At 24 months (Week 104)
Title
Number of Participants That Died
Time Frame
up to 24 months
Title
Graft Survival Measured by Graft Loss
Description
Graft loss was defined as physical loss (nephrectomy), functional loss (necessitating maintenance dialysis for >8 consecutive weeks), retransplant, or death.
Time Frame
up to 24 months
Title
Number of Subjects With Biopsy-Confirmed Acute Rejection
Time Frame
up to 24 months
Title
Spot Urine Protein:Creatinine Ratio
Description
Subjects' urine protein:creatinine ratios were summarized by each scheduled visit, and the nonparametric Wilcoxon rank sum test was used to compare the difference between groups.
Time Frame
At 24 months (Week 104)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Kidney transplant at least 1 year prior Subjects with a functioning renal allograft with calculated glomerular filtration rate (GFR) ≥40mL/min (Nankivell method) and proteinuria ≤500mg/day. Stable on cyclosporine or tacrolimus-based multi-drug immunosuppressive regimen History of NMSC within last 3 years Exclusion Criteria: History of other cancer within last 3 years NMSC with metastatic disease or more than 20 NMSC lesions in last 12 months Multiple organ transplant
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor
Organizational Affiliation
Wyeth is now a wholly owned subsidiary of Pfizer
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Trial Manager
Organizational Affiliation
For Canada, clintrialparticipation@wyeth.com
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Trial Manager
Organizational Affiliation
For Australia, medinfo@wyeth.com
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Trial Manager
Organizational Affiliation
For New Zealand, medinfo@wyeth.com
Official's Role
Principal Investigator
Facility Information:
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
City
Camperdown
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
City
Wooloongabba
State/Province
Queensland
ZIP/Postal Code
4102
Country
Australia
City
Woodville
State/Province
South Australia
ZIP/Postal Code
5011
Country
Australia
City
Adelaide
ZIP/Postal Code
SA 5000
Country
Australia
City
Clayton
ZIP/Postal Code
VIC 3169
Country
Australia
City
Herston
ZIP/Postal Code
QLD 4029
Country
Australia
City
Parkville
ZIP/Postal Code
VIC 3050
Country
Australia
City
Randwick
ZIP/Postal Code
NSW 2031
Country
Australia
City
Westmead
ZIP/Postal Code
NSW 2145
Country
Australia
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 1M9
Country
Canada
City
Grafton
State/Province
Auckland
ZIP/Postal Code
1031
Country
New Zealand

12. IPD Sharing Statement

Citations:
PubMed Identifier
22420843
Citation
Campbell SB, Walker R, Tai SS, Jiang Q, Russ GR. Randomized controlled trial of sirolimus for renal transplant recipients at high risk for nonmelanoma skin cancer. Am J Transplant. 2012 May;12(5):1146-56. doi: 10.1111/j.1600-6143.2012.04004.x. Epub 2012 Mar 15.
Results Reference
derived

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Study Evaluating the Effect of Sirolimus on Non-Melanoma Skin Cancer in Kidney Transplant Recipients

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