- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03628859
BIOREN (Predictive BIOmarkers in Metastatic RENal Cancer) (BIOREN)
BIOREN (Predictive BIOmarkers in Metastatic RENal Cancer) - A Translational Study on Immunotherapy for Metastatic Renal Cancer
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Around 338,000 new cases of renal cell carcinoma (RCC) are diagnosed worldwide per year (1). RCC is one of the most immune responsive human cancers. For a long time the only available treatment were high-dose IL-2 and IFN-α with only a few patients achieving durable responses. Clinical trials conducted in the past 15 years have led to the approval of several anti-angiogenic treatments, mainly vascular endothelial growth factor receptor (VEGFR) inhibitors and mTOR inhibitors. Currently most patients receive first line anti-VEGF therapy.
Recently a better understanding of the mechanisms by which tumours evade the immune system has led to the development of checkpoint inhibitors, such as anti CTLA-4, anti-PD-1 and anti-PD-L1 antibodies that have been tested in various tumour types.
Recently, the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have approved the human IgG4 anti-PD1 monoclonal antibody, nivolumab, for advanced/metastatic clear cell RCC (ccRCC) patients who have received prior antiangiogenic therapy. PD-1 is a key immune-checkpoint receptor (ICR) expressed by activated T cells, which mediates immunosuppression primarily in peripheral tissues, where T cells may encounter the immunosuppressive PD-1 ligands, PD-L1 (B7-H1) and PD-L2(B7-DC) on tumour cells, stromal cells or both.
Despite encouraging results, the clinical response to anti-PD1 is not as wide as expected and there are not any biomarkers 1) that are able to predict which patients will respond and 2) that predict response to nivolumab in patients with ccRCC.
BIOREN is a translational, prospective, observational 3-cohort study.
The aims of BIOREN are to characterize the genetic background of the tumours and also their immune environment, to try and identify biomarkers of response and to better understand the mechanisms of resistance to nivolumab in renal cancer. We will focus on:
- Tregs function and modulation of function,
- NK cells known to be regulated by nivolumab,
- The biological rationale for coupling CXCR4 antagonist with anti PD-1 therapy, analysed with mice models,
- To try to identify biomarkers of response by further characterization of the tumours and evaluating the immune status.
The project will enrol patients receiving in 2nd or 3rd line treatment for metastatic ccRCC: Nivolumab but also, as control cohorts, either everolimus or axitinib (approved treatments in this setting), as well as cabozantinib in France (recently approved in 2nd or 3rd line).
French blood samples and archival FFPE (formalin-fixed paraffin embedded) specimens will be analysed in in France, and also sent to the partners of the Transcan project Consortium (Israel, Italy and Spain).
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: BLANC Ellen
- Phone Number: +33 4.78.78.29.67
- Email: ellen.blanc@lyon.unicancer.fr
Study Contact Backup
- Name: BOYLE J Helen, MD
- Phone Number: +33 4.26.55.67.52
- Email: helen.boyle@lyon.unicancer.fr
Study Locations
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-
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Lyon, France, 69008
- Recruiting
- Centre Leon Bérard
-
Contact:
- BOYLE Ellen, MD
- Phone Number: +33 4.26.55.67.52
- Email: helen.boyle@lyon.unicancer.fr
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Adult patients presenting a renal metastatic cancer included in Centre Leon Berard for evaluating the mechanisms involved in resistance to immunotherapy:
- Cohort 1: ccRCC patients receiving nivolumab,
- Cohort 2: ccRCC patients receiving axitinib or cabozantinib or sunitinib or pazopanib,
- Cohort 3: ccRCC patients receiving everolimus.
Description
Inclusion Criteria:
- Age ≥ 18 years-old.
- Histology proven locally advanced (unresectable) or metastatic clear cell renal cell carcinoma (mccRCC).
- Starting 2nd or 3rd line of treatment with nivolumab, everolimus, axitinib or cabozantinib as per summaries of product characteristics (SmPC) or 1st line treatment with sunitinib or pazopanib or receiving 2nd or 3rd line of treatment with nivolumab
- Signed informed consent.
Exclusion Criteria:
- Psychological, familial, sociological, geographical conditions that would limit compliance with study protocol requirements.
- Pregnant or breastfeeding woman
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of Tregs function on peripheral blood/neoplastic tissue from mRCC patients undergoing nivolumab treatment
Time Frame: Evolution of percentage of CD4+CD25+ CD127low FOXP3+ cells between inclusion and up to 24 months
|
Ex vivo effect of CXCR4 antagonists (PCT/IB2011/000120/ EP2528936B1/ US2013/0079292A1) and other Tregs targets antagonists (ICOS, CD39/CD73) or agonists (TLR7L) as putative anti-PD1 resistance mechanisms
|
Evolution of percentage of CD4+CD25+ CD127low FOXP3+ cells between inclusion and up to 24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of NK function/cytotoxicity on peripheral blood/neoplastic tissue from mRCC patients undergoing nivolumab treatment
Time Frame: Evolution between inclusion and up to 24 months
|
NK cytotoxicity will be evaluated through NK cell degranulation (CD107a assay), intracellular staining of the lytic proteins, Grz A and GrzB and intracellular cytokines, GM-CSF, IFNγ, IL-10, TNF.
NK cell will be characterized for CXCR4; maturation markers: CD16, CD56, CD57, CD62L, NKG2A; activating receptors markers: CD25, CD69, NKp44, NKp30, NKp46, NKG2D.
Ex vivo effect of CXCR4 antagonists on NK cytotoxicity.
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Evolution between inclusion and up to 24 months
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Exploration of the biological rationale for coupling CXCR4 antagonist with anti-PD-1 in in vivo models of renal cancer (mice models).
Time Frame: Up to 24 months
|
immunocompetent model (RENCA), human xenograft model (786 cell) and humanized model
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Up to 24 months
|
Identification of response biomarkers
Time Frame: Up to 24 months
|
Characterization of the tumours using different techniques (RNASeq whole genome, NGS analysis, IHC, HTG focus RNAseq)
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Up to 24 months
|
Identification of biomarkers of response
Time Frame: Evolution between inclusion and up to 24 months
|
Immune status (Multi-IF analysis, TCR sequencing and clonality analysis, Anti-HERV T cell and humoral response)
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Evolution between inclusion and up to 24 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: BOYLE J Helen, MD, Centre Leon Bérard
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BIOREN (ET18-017)
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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