- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00873236
MRI Scans of Blood Vessel Changes Caused by Bevacizumab Alone or Given Together With Interferon Alpha-2a in Treating Patients With Stage III or Stage IV Kidney Cancer
Dynamic Contrast Enhanced MRI (DCE-MRI) Assessment of the Vascular Changes Induced With Bevacizumab Alone and in Combination With Interferon-α in Patients With Advanced Renal Cell Carcinoma
RATIONALE: Comparing results of MRI scans done after bevacizumab may help doctors predict a patient's response to treatment and help plan the best treatment. It is not yet known whether giving bevacizumab alone is more effective than giving bevacizumab together with interferon alpha-2a in detecting kidney cancer.
PURPOSE: This randomized phase II trial is studying MRI scans of blood vessel changes caused by bevacizumab to see how well it works compared with bevacizumab given together with interferon alpha-2a in treating patients with stage III or stage IV kidney cancer.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
Primary
- To establish whether bevacizumab-induced changes in dynamic contrast-enhanced (DCE)-MRI vascular parameters are significantly enhanced by recombinant interferon alpha-2a.
- To establish whether there is an interferon alpha-2a dose response in potentiating bevacizumab-induced changes in DCE-MRI vascular parameters.
Secondary
- To correlate changes in DCE-MRI vascular parameters for each treatment group with progression-free survival.
- To correlate changes in DCE-MRI vascular parameters for each treatment group with tumor response and changes in tumor size.
- To correlate changes in DCE-MRI vascular parameters for each treatment group with other surrogate biomarkers.
- To assess the degree of change in baseline K^trans within each arm of treatment.
- To investigate changes in diffusion and blood oxygen-level dependent MRI and their correlation with other pharmacodynamic endpoints.
- To assess the efficacy and safety profile of bevacizumab monotherapy or in combination with low or standard doses of recombinant interferon alpha-2a.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive bevacizumab IV over 30-90 minutes once every 2 weeks.
- Arm II: Patients receive bevacizumab as in arm I and low-dose recombinant interferon alpha-2a subcutaneously (SC) 3 times weekly beginning on day 0.
- Arm III: Patients receive bevacizumab as in arm I and standard-dose recombinant interferon alpha-2a SC 3 times weekly beginning on day 0.
After 8 weeks of treatment, recombinant interferon alpha-2a dosage may be modified or discontinued at the discretion of the investigator. Treatment continues in the absence of disease progression or unacceptable toxicity.
Patients undergo dynamic contrast-enhanced (gadopentetate dimeglumine) MRI scans at baseline and weeks 2 and 6. Peripheral blood and serum samples are collected at baseline and weeks 2, 6, and 8 for analysis of surrogate biomarkers by flow cytometry and mRNA analysis by PCR. Archival histopathological specimens are analyzed by IHC, fluorescence resonance-energy transfer, and fluorescence lifetime-imaging. Urine samples are also collected at baseline for proteomic profiling by MALDI-TOF.
After completion of study treatment, patients are followed at 30 days.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
England
-
Cambridge, England, United Kingdom, CB2 2QQ
- Recruiting
- Addenbrooke's Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1223-245-151
-
London, England, United Kingdom, SW3 6JJ
- Recruiting
- Royal Marsden - London
-
Contact:
- Contact Person
- Phone Number: 44-20-7352-8171
-
Northwood, England, United Kingdom, HA6 2RN
- Recruiting
- Mount Vernon Cancer Centre at Mount Vernon Hospital
-
Contact:
- Paul Nathan, MD
- Phone Number: 44-192-384-4966
-
Oxford, England, United Kingdom, OX3 7LJ
- Recruiting
- Churchill Hospital
-
Contact:
- Contact Person
- Phone Number: 44-186-574-1841
-
Sutton, England, United Kingdom, SM2 5PT
- Recruiting
- Royal Marsden - Surrey
-
Contact:
- Contact Person
- Phone Number: 44-20-8642-6011
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed advanced renal cell carcinoma
- Metastatic (stage IV) disease
- Locally advanced (unresectable stage III) disease
- Previously untreated disease
- Majority component of conventional clear-cell type is mandatory (tumors of mixed histology should be categorized by the predominant cell type)
- Good- or intermediate-prognosis disease as defined by Motzer score
- Lesions measurable by RECIST criteria and amenable to dynamic contrast-enhanced MRI scanning
- No brain metastasis
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Life expectancy ≥ 12 weeks
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 8 g/dL (may be transfused to maintain or exceed this level)
- Total bilirubin < 1.5 times upper limit of normal (ULN)
- AST and ALT < 2.5 times ULN (< 5 times ULN in patients with liver metastases)
- Serum creatinine ≤ 1.5 times ULN
- Urine dipstick for proteinuria < 2+ OR < 1 g of protein in 24-hour urine collection
- INR ≤ 1.5
- Not pregnant or nursing
- Negative pregnancy test
- Fertile women must use effective contraception during and for 9 months after completion of study treatment
No significant cardiovascular disease, defined as any of the following, within the past 6 months:
- NYHA class II-IV congestive heart failure
- Unstable angina pectoris
- Myocardial infarction
- No significant vascular disease (e.g., aortic aneurysm, aortic dissection) or symptomatic peripheral vacular disease
- No evidence or history of recurrent thromboembolism (> 1 episode of deep venous thrombosis/pulmonary embolism) within the past 6 months, bleeding diathesis, or coagulopathy
- No inadequately controlled hypertension (defined as a BP of > 150 mm Hg systolic and/or > 100 mm Hg diastolic on medication)
- No history of hypertensive crisis or hypertensive encephalopathy
- No stroke or transient ischemic attack within the past 6 months
- No abdominal or tracheoesophageal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
- No HIV or hepatitis B or C infection
- No active clinically serious bacterial or fungal infections (> CTCAE grade 2)
- No other infection > CTCAE grade 2
- No concurrent active second malignancy within the past 3 years other than nonmelanoma skin cancers or post-treatment for localized prostate cancer
- No gross ascites
- No seizure disorder requiring medication
- No serious non-healing wound, ulcer, or bone fracture
- No contraindications to MRI scanning (e.g., history of claustrophobia or metal fragment implantation)
- No history of allergic reactions to contrast agents
- No other significant medical illness or medically significant abnormal laboratory finding that would, in the investigator's opinion, make the patient inappropriate for this study, or would increase the risk associated with the patient's participation in the study
PRIOR CONCURRENT THERAPY:
- More than 28 days since prior major surgery (including open biopsy) or radiotherapy and recovered
More than 14 days since prior palliative radiotherapy to painful bone lesions and recovered
- Concurrent palliative radiotherapy for local pain control allowed
- More than 7 days since prior core biopsy or other minor surgical procedure, excluding placement of a vascular access device
- More than 30 days since prior and no other concurrent investigational agents
- No concurrent chronic daily intake of aspirin ≥ 325 mg/day or clopidogrel > 75 mg/day, or steroids (prednisone > 12.5 mg/day or dexamethasone > 2 mg/day), excluding inhaled steroids
- No concurrent bone marrow transplantation or stem cell rescue
- Concurrent anticoagulation allowed provided INR < 3 and INR is therapeutic on a stable dose of coumarin-type anticoagulation or if patient is on a stable dose of low molecular weight heparin for > 2 weeks at the time of enrollment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm I
Patients receive bevacizumab IV over 30-90 minutes once every 2 weeks.
|
Given IV
|
Experimental: Arm II
Patients receive bevacizumab as in arm I and low-dose recombinant interferon alpha-2a subcutaneously (SC) 3 times weekly beginning on day 0.
|
Given IV
Given SC
|
Experimental: Arm III
Patients receive bevacizumab as in arm I and standard-dose recombinant interferon alpha-2a SC 3 times weekly beginning on day 0.
|
Given IV
Given SC
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Dynamic contrast-enhanced MRI defined changes in K-trans after 6 weeks of bevacizumab monotherapy or bevacizumab and low- or standard-dose recombinant interferon alpha-2a
|
Secondary Outcome Measures
Outcome Measure |
---|
Time to progression
|
Progression-free survival
|
Incidence of adverse events
|
Best overall response
|
Change in vascular permeability (K-trans) and tumor hypoxia at 2 and 6 weeks post-commencement of treatment
|
Treatment duration of bevacizumab and recombinant interferon alpha-2a
|
Treatment withdrawal
|
Dose modification
|
Number of circulating endothelial cells, circulating endothelial progenitors, and proangiogenic monocytic cells
|
Angiogenic factors (e.g., VEGF) and hypoxia-regulated markers
|
Correlation of DCE-MRI defined changes in K-trans with clinical response
|
Correlation of DCE-MRI defined changes in K-trans with surrogate biomarkers
|
Analysis of diffusion MRI and blood oxygen-level dependent MRI changes and comparison with other pharmacodynamic markers
|
Collaborators and Investigators
Investigators
- Principal Investigator: Paul Nathan, MD, Mount Vernon Cancer Centre at Mount Vernon Hospital
Study record dates
Study Major Dates
Study Start
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Urologic Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Kidney Diseases
- Urologic Diseases
- Adenocarcinoma
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Kidney Neoplasms
- Carcinoma, Renal Cell
- Physiological Effects of Drugs
- Anti-Infective Agents
- Antiviral Agents
- Antineoplastic Agents
- Immunologic Factors
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Interferons
- Interferon-alpha
- Interferon alpha-2
- Bevacizumab
Other Study ID Numbers
- MTVERNHOSP-RD2007-114
- CDR0000637812 (Registry Identifier: PDQ (Physician Data Query))
- ENH-RD2007-114
- EUDRACT-2008-006414-19
- EU-20917
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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