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Study of Cabozantinib Efficacy, Safety and Tolerability in Metastatic Renal Carcinoma in Aged Fragile Patients: CABOMAYOR Study (CABOMAYOR)

Primary Purpose

Old Age; Debility, Renal Carcinoma Metastatic

Status
Active
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Cabozantinib
Sponsored by
Spanish Oncology Genito-Urinary Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Old Age; Debility focused on measuring fragile, renal carcinoma, old age

Eligibility Criteria

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

Inclusion Criteria:

  1. Documented histological or cytological diagnosis of renal cell cancer.
  2. Measurable disease per RECIST 1.1 as determined by the investigator.
  3. Metastatic disease.
  4. Patient must have signed the informed consent document.
  5. Capable of understanding and complying with the protocol requirements.
  6. Eastern Cooperative Oncology Group Performance Status (ECOG-PS) 0-2.
  7. Patients aged >70 years old with Society of Geriatric Oncology (SIOG) defined fragile population or patients >75 years with or without SIOG defined fragility.
  8. No previous treatment for Metastatic Renal Cell Carcinoma (mRCC)
  9. Adequate organ function based on standard laboratory tests including haematology, serum chemistry, lipids, coagulation, thyroid function, and urinalysis.
  10. Sexually active fertile subjects and their partners must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study treatment.

Exclusion Criteria:

  1. Previous treatment for mRCC.
  2. Radiation therapy for bone metastasis within 2 weeks, any other external radiation therapy within 4 weeks before inclusion.
  3. Known brain metastases or cranial epidural disease unless adequately treated and stable for at least 3 months before inclusion.
  4. Concomitant anticoagulation at therapeutic doses with oral anticoagulants or platelet inhibitors or low molecular weight heparins (LMWH).
  5. Chronic treatment with corticosteroids or other immunosuppressive agents
  6. Uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions: Cardiovascular disorders, Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation, Clinically significant hematuria, hematemesis, or hemoptysis of > 0.5 teaspoon of red blood, or other history of significant bleeding (eg, pulmonary hemorrhage) within 3 months before inclusion, Cavitating pulmonary lesion(s) or known endobronchial disease manifestation and/or Lesions invading major pulmonary blood vessels.
  7. Major surgery within 2 months before inclusion.
  8. Corrected QT interval calculated by the Fridericia formula (QTcF) > 500 msec within 10 days before inclusion.
  9. Inability to swallow tablets or capsules.
  10. Previously identified allergy or hypersensitivity to components of the study treatment formulation.
  11. Diagnosis of another malignancy within 2 years before inclusion, except for superficial skin cancers, or localized, low grade tumors deemed cured and not treated with systemic therapy.

Sites / Locations

  • Hospital de Ciudad Real
  • ICO L'Hospitalet
  • Hospital Insular de Gran Canarias
  • Hospital Lucus Augusti
  • Hospital Infanta Sofia
  • Hospital Universitario de Donostia
  • Fundación Instituto Valenciano de Oncologia
  • Hospital Doctor Peset
  • Hospital Universitario La Fe
  • Hospital Clinico de Valladolid

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cabozantinib

Arm Description

Cabozantinib 40 mg p.o. once daily in 28-day cycles.

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR)
Complete Response (CR) evaluated by Evaluation Criteria In Solid Tumors (RECIST) 1.1 according to investigator criteria.
Objective Response Rate (ORR)
Partial Response (PR) evaluated by Evaluation Criteria In Solid Tumors (RECIST) 1.1 according to investigator criteria.

Secondary Outcome Measures

Incidence of Treatment-Emergent Adverse Events
Adverse Events (AEs) experienced by patients. AEs will be assessed according to National Cancer Institute-Common Terminology Criteria (NCI-CTC) v 5.0 criteria.
Disease Control Rate (DCR)
Complete Response (CR) evaluated by RECIST 1.1 criteria according to investigator criteria.
Disease Control Rate (DCR)
Partial Response (PR) evaluated by RECIST 1.1 criteria according to investigator criteria.
Disease Control Rate (DCR)
Stable Disease (SD) evaluated by RECIST 1.1 criteria according to investigator criteria.
Progression Free Survival (PFS)
Time in months since the patient's study enrolment until patient progression according to RECIST 1.1 criteria
Overall Survival (OS)
It is time in months since the patient's study enrolment until death

Full Information

First Posted
October 15, 2019
Last Updated
November 2, 2022
Sponsor
Spanish Oncology Genito-Urinary Group
Collaborators
Apices Soluciones S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT04134390
Brief Title
Study of Cabozantinib Efficacy, Safety and Tolerability in Metastatic Renal Carcinoma in Aged Fragile Patients: CABOMAYOR Study
Acronym
CABOMAYOR
Official Title
Pilot Study of Cabozantinib Efficacy, Safety and Tolerability in Metastatic Renal Carcinoma in Aged Fragile Patients: CABOMAYOR Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 17, 2020 (Actual)
Primary Completion Date
June 2023 (Anticipated)
Study Completion Date
June 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spanish Oncology Genito-Urinary Group
Collaborators
Apices Soluciones S.L.

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
Aged fragile patients are not usually included in clinical trials and efficacy and tolerability of the different available treatments in this population are unknown. Conversely, ageing has been associated with a decrease in the efficacy of immune checkpoint inhibitors due to a decline in the effectiveness of the immune system (immunosenescence). In the Checkmate 025 trial comparing nivolumab with everolimus, the Hazard Ratio (HR) in patients older than 75 years old favoured everolimus, 1.23 (0.66-2.31). Thus, TKis might be a better treatment option for this population. However, the absence of data and concerns about possible secondary effects associated, can preclude clinicians to treat aged fragile patients with cabozantinib. A pilot phase II trial would help to have data on safety and efficacy of cabozantinib in this aged fragile population. In METEOR trial around 60% of patients reduced the dose of cabozantinib because of toxicity and tolerance problems. It is suspected that the efficacy of cabozantinib in the population to be included in this trial (aged and fragile) will be similar to that observed in CABOSUN trial (disease control rate around 75%). However, there is no information available in this group of patients. On the other hand, in the >75 years old subgroup within the METEOR trial, 37% discontinued due to adverse events, 85% needed dose reductions and median average daily dose was 33,6 mg. For this reason, the cabozantinib initial dose chosen for patients to be included in this study is 40 mg/day.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Old Age; Debility, Renal Carcinoma Metastatic
Keywords
fragile, renal carcinoma, old age

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Cabozantinib 40 mg per os (p.o.) once daily in 28-day cycles. Dose can be escalated to 60 mg to avoid suboptimal exposure to the drug if 40 mg is considered tolerated. If the dose of 40 mg is not tolerated, a de-escalation to 20 mg, temporary interruption, or stopping cabozantinib will be possible.
Masking
None (Open Label)
Allocation
N/A
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cabozantinib
Arm Type
Experimental
Arm Description
Cabozantinib 40 mg p.o. once daily in 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Cabozantinib
Intervention Description
Subjects will receive cabozantinib 40mg p.o. as long as they continue to experience clinical benefit or until unacceptable toxicity, the need for alternative anticancer treatment, or other reasons for treatment discontinuation
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
Complete Response (CR) evaluated by Evaluation Criteria In Solid Tumors (RECIST) 1.1 according to investigator criteria.
Time Frame
Up to 24 months
Title
Objective Response Rate (ORR)
Description
Partial Response (PR) evaluated by Evaluation Criteria In Solid Tumors (RECIST) 1.1 according to investigator criteria.
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events
Description
Adverse Events (AEs) experienced by patients. AEs will be assessed according to National Cancer Institute-Common Terminology Criteria (NCI-CTC) v 5.0 criteria.
Time Frame
Up to 24 months
Title
Disease Control Rate (DCR)
Description
Complete Response (CR) evaluated by RECIST 1.1 criteria according to investigator criteria.
Time Frame
Up to 24 months
Title
Disease Control Rate (DCR)
Description
Partial Response (PR) evaluated by RECIST 1.1 criteria according to investigator criteria.
Time Frame
Up to 24 months
Title
Disease Control Rate (DCR)
Description
Stable Disease (SD) evaluated by RECIST 1.1 criteria according to investigator criteria.
Time Frame
Up to 24 months
Title
Progression Free Survival (PFS)
Description
Time in months since the patient's study enrolment until patient progression according to RECIST 1.1 criteria
Time Frame
Since the patient's study enrolment until patient progression, assessed up to 24 months
Title
Overall Survival (OS)
Description
It is time in months since the patient's study enrolment until death
Time Frame
Since the patient's study enrolment until death assessed up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documented histological or cytological diagnosis of renal cell cancer. Measurable disease per RECIST 1.1 as determined by the investigator. Metastatic disease. Patient must have signed the informed consent document. Capable of understanding and complying with the protocol requirements. Eastern Cooperative Oncology Group Performance Status (ECOG-PS) 0-2. Patients aged >70 years old with Society of Geriatric Oncology (SIOG) defined fragile population or patients >75 years with or without SIOG defined fragility. No previous treatment for Metastatic Renal Cell Carcinoma (mRCC) Adequate organ function based on standard laboratory tests including haematology, serum chemistry, lipids, coagulation, thyroid function, and urinalysis. Sexually active fertile subjects and their partners must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study treatment. Exclusion Criteria: Previous treatment for mRCC. Radiation therapy for bone metastasis within 2 weeks, any other external radiation therapy within 4 weeks before inclusion. Known brain metastases or cranial epidural disease unless adequately treated and stable for at least 3 months before inclusion. Concomitant anticoagulation at therapeutic doses with oral anticoagulants or platelet inhibitors or low molecular weight heparins (LMWH). Chronic treatment with corticosteroids or other immunosuppressive agents Uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions: Cardiovascular disorders, Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation, Clinically significant hematuria, hematemesis, or hemoptysis of > 0.5 teaspoon of red blood, or other history of significant bleeding (eg, pulmonary hemorrhage) within 3 months before inclusion, Cavitating pulmonary lesion(s) or known endobronchial disease manifestation and/or Lesions invading major pulmonary blood vessels. Major surgery within 2 months before inclusion. Corrected QT interval calculated by the Fridericia formula (QTcF) > 500 msec within 10 days before inclusion. Inability to swallow tablets or capsules. Previously identified allergy or hypersensitivity to components of the study treatment formulation. Diagnosis of another malignancy within 2 years before inclusion, except for superficial skin cancers, or localized, low grade tumors deemed cured and not treated with systemic therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Miguel A Climent, MD
Organizational Affiliation
FIVO
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital de Ciudad Real
City
Ciudad Real
Country
Spain
Facility Name
ICO L'Hospitalet
City
L'Hospitalet De Llobregat
Country
Spain
Facility Name
Hospital Insular de Gran Canarias
City
Las Palmas De Gran Canaria
Country
Spain
Facility Name
Hospital Lucus Augusti
City
Lugo
Country
Spain
Facility Name
Hospital Infanta Sofia
City
Madrid
Country
Spain
Facility Name
Hospital Universitario de Donostia
City
San Sebastián
Country
Spain
Facility Name
Fundación Instituto Valenciano de Oncologia
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Facility Name
Hospital Doctor Peset
City
Valencia
Country
Spain
Facility Name
Hospital Universitario La Fe
City
Valencia
Country
Spain
Facility Name
Hospital Clinico de Valladolid
City
Valladolid
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study of Cabozantinib Efficacy, Safety and Tolerability in Metastatic Renal Carcinoma in Aged Fragile Patients: CABOMAYOR Study

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