Nivolumab and Stereotactic Ablative Radiation Therapy (SAbR) for Metastatic Clear Cell Renal Cell Carcinoma

NCT02781506 | Terminated Phase 2 Results DMC

• 1 other identifier: STU 122015-052
• Study Type: interventional
• Target: 7
• Locations: 1 country
• Sites: 1

Brief Summary

Nivolumab (brand name Opdivo): IV, administered per standard of care according to institutional guidelines at the discretion of the treating medical oncologist, until disease progression or unacceptable toxicity; SABR, dose variable, in 1-3 fractions.

Conditions

Metastatic Clear Cell Renal Cell Carcinoma

Outcome Measures

Primary Outcomes (1)

• Response Rate (RR)

  The primary objective of the randomized phase II trial will be to increase the RR (response rate) of treatment with Nivolumab by the concurrent administration of SAbR. The assessment of RR will be based on the evaluation of ir-RECIST (Response Evaluation Criteria in Solid Tumors) criteria and radiated lesions will be excluded from target lesions. Treatment response will be measured using both the RECIST and immune related RECIST criteria (ir-RECIST), a minor modification of RECIST 1.1 for immunotherapy. Radiated lesions will be excluded from target lesions.

  3 years

Secondary Outcomes (10)

• Overall Survival

  3 years

• Progression Free Survival

  3 years

• Complete Response Rate

  3 years

• Time to Progression

  3 years

• Median Response Duration

  3 years

Other Outcomes (3)

• Immunological Biomarkers

  3 years

• Cost-effectiveness

  3 years

• Immunogenicity

  3 years

Study Arms (1)

Nivolumab and SABR

EXPERIMENTAL

Nivolumab alone: IV, administered per standard of care according to institutional guidelines at the discretion of the treating medical oncologist, until disease progression or unacceptable toxicity. SABR, dose variable, in 1-3 fractions.

Drug: Nivolumab; Radiation: SAbR

Interventions

Nivolumab DRUG

Nivolumab IV, administered per standard of care according to institutional guidelines at the discretion of the treating medical oncologist

Also known as: Opdivo

Nivolumab and SABR

SAbR RADIATION

SAbR (1-3 lesions)

Also known as: SBRT, Stereotactic Ablative Radiation Therapy

Nivolumab and SABR

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• At least 18 years of age
• Willing and able to provide consent
• Pathologic diagnosis of metastatic RCC with clear cell component
• Measurable disease in at least 2 non-radiated sites. Progression or intolerance to at least one prior systemic anti-angiogenic therapy.
• Eligible for extra-CNS SAbR to 1-6 sites of disease
• Must have received at least one prior anti-angiogenic therapy in the advanced or metastatic setting. Prior cytokine therapy (eg, IL-2, IFN-α), vaccine therapy, or treatment with cytotoxic therapy is also allowed but not any other drug specifically targeting T-cell co-stimulation or checkpoint pathways.
• Previous treatment with surgery, radiation, chemotherapy, targeted agents (see above) are allowed provided that: Chemotherapy/Major surgery was administered \> 14 days before the start Nivolumab; Minor surgery, radiation, or any targeted agents were administered \> 7 days before the start of Nivolumab
• Performance status ECOG 0, 1, 2 or 3.
• Adequate organ and marrow function as defined below (obtained within 14 days of first dose of drug):
• leukocytes≥ 2,000/mcL
• absolute neutrophil count ≥ 1,500/mcL
• platelets ≥ 50,000/mcl
• total bilirubin ≤ 2mg/dL
• AST(SGOT)/ALT(SPGT) ≤ 3 X institutional upper limit of normal
• Women of child-bearing potential

You may not qualify if:

• Subjects who have had major surgery (such as nephrectomy) or chemotherapy within 2 weeks prior to first dose of drug
• Subjects who have had radiation therapy within 2 weeks prior to first dose of drug
• Uncontrolled adrenal insufficiency or active chronic liver disease
• Any history of CNS metastases that is not adequately treated with surgery or SABR \>14 days prior.
• Prior treatment with any anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways.
• Any positive history for HIV/AIDS, HTLV, hepatitis B or hepatitis C virus indicating acute or chronic infection.
• Any active known or suspected autoimmune disease. Subjects with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll.
• Any condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days prior to the first dose of study drug. Inhaled steroids and adrenal replacement steroid doses up to 10 mg daily prednisone equivalent are permitted (although not encouraged) in the absence of active autoimmune disease.
• Subjects with life expectancy \< 6 months
• Subjects receiving any other investigational or standard antineoplastic agents.
• Prior malignancies active within the previous 3 years except for locally curable cancers that have been apparently cured, such as basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the prostate, cervix, breast?, or etc.
• Psychiatric illness/social situations that would limit consenting and compliance with study requirements.
• Patients with history of hypersensitivity to monoclonal antibodies
• Subjects who are pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants

Sponsors & Collaborators

• University of Texas Southwestern Medical Center: lead

Study Sites (1)

University of Texas Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

MeSH Terms

Conditions

Clear-cell metastatic renal cell carcinoma

Interventions

Nivolumab

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins

Results Point of Contact

• Title: Dr. Raquibul Hannan
• Organization: UT Southwestern Medical Center

Raquibul.Hannan@UTSouthwestern.edu

214-645-8525

Study Officials

• Raquibul Hannan, MD, PhD

  UT Southwestern Medical Center at Dallas

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Medicine

Study Record Dates

• First Submitted: May 19, 2016
• First Posted: May 24, 2016
• Study Start: June 20, 2016
• Primary Completion: May 24, 2021
• Study Completion: May 24, 2021
• Last Updated: August 8, 2022
• Results First Posted: August 8, 2022

Record last verified: 2022-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)