- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03341845
Neoadjuvant AXITINIB and AVELUMAB for Patients With Localized Clear-cell RCC
May 18, 2018 updated by: The Netherlands Cancer Institute
Neoadjuvant AXITINIB and AVELUMAB for Patients With Localized Clear-cell RCC and a Moderate to High Risk
a monocenter, open label, single arm, phase II study of the combination of axitinib with avelumab as neoadjuvant therapy in patients with intermediate to high-risk non-metastatic RCC.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Renal cell carcinoma (RCC) accounts for 3% of adult malignancies and constitutes 95% of renal tumors.
Surgical complete resection is currently the only curative treatment of RCC, including patients with locally advanced RCC or limited metastatic disease.
However, these patients carry a high risk to develop locally recurrent disease and systemic progression.
High risk patients with no evidence of disease following complete resection may therefore benefit from adjuvant and neo-adjuvant systemic treatment strategies which primarily aim to prolong disease free (DFS) and ultimately overall survival (OS).
Neoadjuvant studies are a unique opportunity to further investigate the way in which immune checkpoint inhibition works and to identify predictors of treatment response.
Recent research on intratumoral immune components after pretreatment of human renal cell carcinoma suggest a potential synergism for TKI with anti-PD-L1 therapy that could be exploited.
In terms of downsizing tumours by pretreatment, axitinib has been shown to be more effective than sunitinib when comparing trials that have been performed with each drug.
However, the immunemodulatory effect of axitinib has been ill defined.
Since axitinib and anti-PD-L1 therapy would make for a potential synergism, two phase Ib dose-finding studies to evaluate safety, pharmacokinetics and pharmacodynamics of avelumab, an anti-PD-L1 monoclonal antibody, or pembrolizumab, an anti-PD1 monoclonal antibody, in combination with axitinib were performed.
First results on response rate and safety profile presented at ESMO 2016 were promising with objective response rates of 67-70 % and toxicity profiles as seen with VEGFR-treatment.
The investigator proposes a monocenter, open label, single arm, phase II study of the combination of axitinib with avelumab as neoadjuvant therapy in patients with intermediate to high-risk non-metastatic RCC.
The statistical calculation of the primary endpoint is based on efficacy on the local tumour.
The safety of this combination prior to surgery will be an important secondary endpoint.
Study Type
Interventional
Enrollment (Anticipated)
40
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Axel Bex, MD
- Phone Number: 9111 003120512
- Email: a.bex@nki.nl
Study Contact Backup
- Name: Hans van Thienen, MD
- Phone Number: 9111 003120512
- Email: h.v.thienen@nki.nl
Study Locations
-
-
-
Amsterdam, Netherlands, 1066CX
- Recruiting
- Antoni van Leeuwenhoek
-
Contact:
- Axel Bex, MD, PhD
- Phone Number: 0205129111
- Email: a.bex@nki.nl
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
Signed and written informed consent
- Male or female patients age ≥ 18 years
- Histologically confirmed diagnosis of non-metastatic clear-cell renal cell carcinoma of intermediate to high risk with completely resectable primary tumours.
- World Health Organization performance status of 0-1.
- Adequate coagulation function as defined in protocol
- Adequate hematological function as defined in protocol
- Adequate hepatic function as defined in protocol
- Adequate renal function as defined in protocol
- Negative serum pregnancy test at screening for women of childbearing potential.
- Highly effective contraception for both male and female subjects if the risk of conception exists.
Exclusion Criteria:
Renal tumors of low risk or M1
- Non-clear cell histology at biopsy
- Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product
- Corrected QT interval (QTc) > 480 msecs
- History of any of the cardiovascular conditions defined in the protocol within the past 6 months
- Poorly controlled hypertension
- History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.
- Major surgery or trauma within 28 days prior to first dose of investigational product and/or presence of any non-healing wound, fracture, or ulcer
- Evidence of active bleeding or bleeding diathesis.
- Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subject's safety, provision of informed consent, or compliance to study procedures.
- Unable or unwilling to discontinue use of prohibited medications to be listed in protocol for at least 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of study drug and for the duration of the study
- Treatment with any of the following anti-cancer therapies: chemotherapy, immunotherapy, biologic therapy, investigational therapy or hormonal therapy within 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of axitinib or avelumab
- Administration of any non-oncologic investigational drug within 30 days or 5 half lives whichever is longer prior to receiving the first dose of study treatment
- Prior organ transplantation, including allogeneic stem cell transplantation
- Significant acute or chronic infections as defined in protocol
- Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent
- Known severe hypersensitivity reactions to monoclonal antibodies
- Pregnancy or lactation
- Known alcohol or drug abuse
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: axitinib and avelumab
axitinib 5MG BID and avelumab 10mg/kg Q2W
|
axitinib in combination with avelumab
axitinib in combination with avelumab
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
number of patients with partial remission
Time Frame: week 12 of neoadjuvant treatment
|
according to RECIST 1.1.
|
week 12 of neoadjuvant treatment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
toxicity
Time Frame: up to 90 days after end of treatment
|
measured by number and grade of adverse events
|
up to 90 days after end of treatment
|
event free survival and overall survival
Time Frame: assessed up to 10 years
|
Time from registration to disease progression or death
|
assessed up to 10 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Axel Bex, MD, NKI-AVL
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 28, 2018
Primary Completion (Anticipated)
January 31, 2023
Study Completion (Anticipated)
January 31, 2025
Study Registration Dates
First Submitted
November 9, 2017
First Submitted That Met QC Criteria
November 9, 2017
First Posted (Actual)
November 14, 2017
Study Record Updates
Last Update Posted (Actual)
May 21, 2018
Last Update Submitted That Met QC Criteria
May 18, 2018
Last Verified
April 1, 2018
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
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Protein Kinase Inhibitors
- Avelumab
- Axitinib
Other Study ID Numbers
- N17JAV
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Undecided
IPD Plan Description
decided by PI at each request for data
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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