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Testen der Zugabe eines Krebsmedikaments, Cabozantinib zum Immuntherapie-Medikament Cemiplimab (REGN2810), bei Jugendlichen und Erwachsenen mit fortgeschrittenem Adrenokortikalkrebs

5. November 2026 aktualisiert von: National Cancer Institute (NCI)

Eine Phase-II-Studie von Cabozantinib in Kombination mit Cemiplimab (Cabo-Cemiplimab) gegen Cabozantinib allein bei Jugendlichen und Erwachsenen mit fortgeschrittenem Adrenokortikalkrebs allein

This phase II trial compares the effect of giving cabozantinib with or without cemiplimab in patients with adrenocortical cancer that has spread to nearby tissue or lymph nodes (locally advanced), and that cannot be removed by surgery (unresectable) or that has come back after a period of improvement (recurrent) or that has spread from where it first started (primary site) to other places in the body (metastatic). Cabozantinib is in a class of medications called tyrosine kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply, which may help keep cancer cells from growing. Immunotherapy with monoclonal antibodies, such as cemiplimab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving cabozantinib with cemiplimab may kill more tumor cells in patients with locally advanced unresectable or recurrent/metastatic adrenocortical cancer.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

PRIMARY OBJECTIVE:

I. To determine whether the combination of cabozantinib plus cemiplimab (REGN2810) (Cabo-Cemiplimab [REGN2810]) improves progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) version (v.) 1.1 relative to cabozantinib alone in patients with locally advanced unresectable or recurrent/metastatic advanced adrenocortical cancer.

SECONDARY OBJECTIVES:

I. To assess tolerability and adverse events of Cabo-Cemiplimab (REGN2810) in advanced adrenocortical cancer (ACC) patients.

II. To assess objective response rate as per RECIST v 1.1. III. To assess duration of objective response, time to progression (TTP), and overall survival (OS) in ACC patients receiving Cabo-Cemiplimab (REGN2810).

EXPLORATORY OBJECTIVE:

I. To assess PFS from re-registration (per RECIST 1.1) and OS for patients who crossover to receive Cabo-Cemiplimab after progressing on cabozantinib alone.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive cabozantinib orally (PO) once daily (QD) on days 1-21 of each cycle. Cycles repeat every 21 days for 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) scan or magnetic resonance imaging (MRI) and blood sample collection throughout the study. Upon disease progression, patients may elect to crossover to receive combination therapy on Arm B.

ARM B: Patients receive cemiplimab intravenously (IV) over 30 minutes on day 1 and cabozantinib PO QD on days 1-21 of each cycle. Cycles repeat every 21 days for 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan or MRI and blood sample collection throughout the study.

After completion of study treatment, patients are followed up every 12 weeks until disease progression and then every 6 months for 4 years post-registration.

Studientyp

Interventionell

Einschreibung (Geschätzt)

48

Phase

  • Phase 2

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Vereinigte Staaten
    • Arizona
      • Phoenix, Arizona, Vereinigte Staaten, 85054
        • Rekrutierung
        • Mayo Clinic Hospital in Arizona
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 855-776-0015
        • Hauptermittler:
          • Julie E. Hallanger Johnson
    • California
      • La Jolla, California, Vereinigte Staaten, 92093
        • Rekrutierung
        • UC San Diego Moores Cancer Center
        • Kontakt:
        • Hauptermittler:
          • Yu-Wei Chen
      • Madera, California, Vereinigte Staaten, 93636
        • Rekrutierung
        • Valley Children's Hospital
        • Kontakt:
        • Hauptermittler:
          • Ruetima Titapiwatanakun
    • Colorado
      • Aurora, Colorado, Vereinigte Staaten, 80045
        • Rekrutierung
        • UCHealth University of Colorado Hospital
        • Hauptermittler:
          • Laura Graham
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 720-848-0650
    • Florida
      • Jacksonville, Florida, Vereinigte Staaten, 32224-9980
        • Rekrutierung
        • Mayo Clinic in Florida
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 855-776-0015
        • Hauptermittler:
          • Julie E. Hallanger Johnson
    • Illinois
      • Chicago, Illinois, Vereinigte Staaten, 60611
        • Rekrutierung
        • Lurie Children's Hospital-Chicago
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 773-880-4562
        • Hauptermittler:
          • Elizabeth A. Sokol
      • Chicago, Illinois, Vereinigte Staaten, 60611
        • Rekrutierung
        • Northwestern University
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
      • Danville, Illinois, Vereinigte Staaten, 61832
        • Rekrutierung
        • Carle at The Riverfront
        • Hauptermittler:
          • Priyank P. Patel
        • Kontakt:
      • DeKalb, Illinois, Vereinigte Staaten, 60115
        • Rekrutierung
        • Northwestern Medicine Cancer Center Kishwaukee
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
      • Effingham, Illinois, Vereinigte Staaten, 62401
        • Rekrutierung
        • Carle Physician Group-Effingham
        • Kontakt:
        • Hauptermittler:
          • Priyank P. Patel
      • Geneva, Illinois, Vereinigte Staaten, 60134
        • Rekrutierung
        • Northwestern Medicine Cancer Center Delnor
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
      • Glenview, Illinois, Vereinigte Staaten, 60026
        • Rekrutierung
        • Northwestern Medicine Glenview Outpatient Center
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 312-695-1102
      • Grayslake, Illinois, Vereinigte Staaten, 60030
        • Rekrutierung
        • Northwestern Medicine Grayslake Outpatient Center
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 312-695-1102
      • Lake Forest, Illinois, Vereinigte Staaten, 60045
        • Rekrutierung
        • Northwestern Medicine Lake Forest Hospital
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
      • Mattoon, Illinois, Vereinigte Staaten, 61938
        • Rekrutierung
        • Carle Physician Group-Mattoon/Charleston
        • Kontakt:
        • Hauptermittler:
          • Priyank P. Patel
      • Normal, Illinois, Vereinigte Staaten, 61761
        • Rekrutierung
        • Carle BroMenn Medical Center
        • Hauptermittler:
          • Priyank P. Patel
        • Kontakt:
      • Normal, Illinois, Vereinigte Staaten, 61761
        • Rekrutierung
        • Carle Cancer Institute Normal
        • Hauptermittler:
          • Priyank P. Patel
        • Kontakt:
      • Oak Brook, Illinois, Vereinigte Staaten, 60523
      • Orland Park, Illinois, Vereinigte Staaten, 60462
      • Shiloh, Illinois, Vereinigte Staaten, 62269
        • Rekrutierung
        • Memorial Hospital East
        • Kontakt:
        • Hauptermittler:
          • Nikolaos Trikalinos
      • Urbana, Illinois, Vereinigte Staaten, 61801
        • Rekrutierung
        • Carle Cancer Center
        • Kontakt:
        • Hauptermittler:
          • Priyank P. Patel
      • Warrenville, Illinois, Vereinigte Staaten, 60555
        • Rekrutierung
        • Northwestern Medicine Cancer Center Warrenville
        • Hauptermittler:
          • Mary F. Mulcahy
        • Kontakt:
    • Iowa
      • Ankeny, Iowa, Vereinigte Staaten, 50023
        • Rekrutierung
        • UI Health Care Mission Cancer and Blood - Ankeny Clinic
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-3305
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Carroll, Iowa, Vereinigte Staaten, 51401
        • Rekrutierung
        • Saint Anthony Regional Hospital
        • Kontakt:
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Clive, Iowa, Vereinigte Staaten, 50325
        • Rekrutierung
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-3305
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • Rekrutierung
        • Broadlawns Medical Center
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-282-2200
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • Rekrutierung
        • Mercy Medical Center - Des Moines
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-3305
        • Hauptermittler:
          • Richard L. Deming
      • Des Moines, Iowa, Vereinigte Staaten, 50309
        • Rekrutierung
        • Iowa Methodist Medical Center
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-6727
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Vereinigte Staaten, 50309
        • Rekrutierung
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-3305
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • Rekrutierung
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-3305
        • Hauptermittler:
          • Seema Harichand-Herdt
      • Fort Dodge, Iowa, Vereinigte Staaten, 50501
        • Rekrutierung
        • UI Healthcare Mission Cancer and Blood - Fort Dodge
        • Hauptermittler:
          • Seema Harichand-Herdt
        • Kontakt:
      • Waukee, Iowa, Vereinigte Staaten, 50263
        • Rekrutierung
        • UI Health Care Mission Cancer and Blood - Waukee Clinic
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 515-241-3305
        • Hauptermittler:
          • Seema Harichand-Herdt
    • Massachusetts
      • Boston, Massachusetts, Vereinigte Staaten, 02215
        • Rekrutierung
        • Dana-Farber Cancer Institute
        • Hauptermittler:
          • Stephanie A. Berg
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 877-442-3324
    • Michigan
      • Ann Arbor, Michigan, Vereinigte Staaten, 48109
        • Rekrutierung
        • University of Michigan Rogel Cancer Center
        • Hauptermittler:
          • Francis P. Worden
        • Kontakt:
    • Minnesota
      • Rochester, Minnesota, Vereinigte Staaten, 55905
        • Rekrutierung
        • Mayo Clinic in Rochester
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 855-776-0015
        • Hauptermittler:
          • Julie E. Hallanger Johnson
    • Missouri
      • City of Saint Peters, Missouri, Vereinigte Staaten, 63376
        • Rekrutierung
        • Siteman Cancer Center at Saint Peters Hospital
        • Kontakt:
        • Hauptermittler:
          • Nikolaos Trikalinos
      • Creve Coeur, Missouri, Vereinigte Staaten, 63141
        • Rekrutierung
        • Siteman Cancer Center at West County Hospital
        • Kontakt:
        • Hauptermittler:
          • Nikolaos Trikalinos
      • Kansas City, Missouri, Vereinigte Staaten, 64108
        • Rekrutierung
        • Children's Mercy Hospitals and Clinics
        • Hauptermittler:
          • Keith J. August
        • Kontakt:
      • Springfield, Missouri, Vereinigte Staaten, 65807
        • Rekrutierung
        • CoxHealth South Hospital
        • Hauptermittler:
          • Jay W. Carlson
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 417-269-4520
      • St Louis, Missouri, Vereinigte Staaten, 63110
        • Rekrutierung
        • Washington University School of Medicine
        • Kontakt:
        • Hauptermittler:
          • Nikolaos Trikalinos
      • St Louis, Missouri, Vereinigte Staaten, 63129
        • Rekrutierung
        • Siteman Cancer Center-South County
        • Kontakt:
        • Hauptermittler:
          • Nikolaos Trikalinos
      • St Louis, Missouri, Vereinigte Staaten, 63136
        • Rekrutierung
        • Siteman Cancer Center at Christian Hospital
        • Kontakt:
        • Hauptermittler:
          • Nikolaos Trikalinos
    • Nebraska
      • Bellevue, Nebraska, Vereinigte Staaten, 68123
        • Rekrutierung
        • Nebraska Medicine-Bellevue
        • Kontakt:
        • Hauptermittler:
          • Apar Kishor Ganti
      • Omaha, Nebraska, Vereinigte Staaten, 68198
        • Rekrutierung
        • University of Nebraska Medical Center
        • Kontakt:
        • Hauptermittler:
          • Apar Kishor Ganti
      • Omaha, Nebraska, Vereinigte Staaten, 68118
        • Rekrutierung
        • Nebraska Medicine-Village Pointe
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 402-559-5600
        • Hauptermittler:
          • Apar Kishor Ganti
    • New Jersey
      • Basking Ridge, New Jersey, Vereinigte Staaten, 07920
        • Rekrutierung
        • Memorial Sloan Kettering Basking Ridge
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
      • Middletown, New Jersey, Vereinigte Staaten, 07748
        • Rekrutierung
        • Memorial Sloan Kettering Monmouth
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
      • Montvale, New Jersey, Vereinigte Staaten, 07645
        • Rekrutierung
        • Memorial Sloan Kettering Bergen
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
    • New York
      • Commack, New York, Vereinigte Staaten, 11725
        • Rekrutierung
        • Memorial Sloan Kettering Commack
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
      • Harrison, New York, Vereinigte Staaten, 10604
        • Rekrutierung
        • Memorial Sloan Kettering Westchester
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
      • New York, New York, Vereinigte Staaten, 10065
        • Rekrutierung
        • Memorial Sloan Kettering Cancer Center
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
      • Uniondale, New York, Vereinigte Staaten, 11553
        • Rekrutierung
        • Memorial Sloan Kettering Nassau
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 212-639-7592
        • Hauptermittler:
          • Nitya P. Raj
    • North Carolina
      • Cary, North Carolina, Vereinigte Staaten, 27518
        • Suspendiert
        • Duke Cancer Center Cary
      • Durham, North Carolina, Vereinigte Staaten, 27710
        • Rekrutierung
        • Duke University Medical Center
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 888-275-3853
        • Hauptermittler:
          • Diane L. Reidy-lagunes
      • Raleigh, North Carolina, Vereinigte Staaten, 27609
        • Rekrutierung
        • Duke Cancer Center Raleigh
        • Kontakt:
        • Hauptermittler:
          • Diane L. Reidy-lagunes
    • Ohio
      • Columbus, Ohio, Vereinigte Staaten, 43210
        • Rekrutierung
        • Ohio State University Comprehensive Cancer Center
        • Kontakt:
        • Hauptermittler:
          • Bhavana Konda
    • Oklahoma
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
        • Rekrutierung
        • University of Oklahoma Health Sciences Center
        • Kontakt:
        • Hauptermittler:
          • Adanma Anji Ayanambakkam Attanathi
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Vereinigte Staaten, 15224
        • Rekrutierung
        • Children's Hospital of Pittsburgh of UPMC
        • Kontakt:
        • Hauptermittler:
          • Brittani K. Seynnaeve
    • South Carolina
      • Boiling Springs, South Carolina, Vereinigte Staaten, 29316
        • Rekrutierung
        • Prisma Health Cancer Institute - Spartanburg
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Columbia, South Carolina, Vereinigte Staaten, 29203
        • Rekrutierung
        • Prisma Health Richland Hospital
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Easley, South Carolina, Vereinigte Staaten, 29640
        • Rekrutierung
        • Prisma Health Cancer Institute - Easley
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Greenville, South Carolina, Vereinigte Staaten, 29605
        • Rekrutierung
        • BI-LO Charities Children's Cancer Center
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Greenville, South Carolina, Vereinigte Staaten, 29605
        • Rekrutierung
        • Prisma Health Cancer Institute - Faris
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Greenville, South Carolina, Vereinigte Staaten, 29605
        • Rekrutierung
        • Prisma Health Cancer Institute - Butternut
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Greenville, South Carolina, Vereinigte Staaten, 29615
        • Rekrutierung
        • Prisma Health Cancer Institute - Eastside
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Greer, South Carolina, Vereinigte Staaten, 29650
        • Rekrutierung
        • Prisma Health Cancer Institute - Greer
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
      • Seneca, South Carolina, Vereinigte Staaten, 29672
        • Rekrutierung
        • Prisma Health Cancer Institute - Seneca
        • Hauptermittler:
          • Aniket Saha
        • Kontakt:
    • Tennessee
      • Memphis, Tennessee, Vereinigte Staaten, 38105
        • Rekrutierung
        • Saint Jude Children's Research Hospital
        • Kontakt:
        • Hauptermittler:
          • Catherine G. Lam
    • Texas
      • Austin, Texas, Vereinigte Staaten, 78723
      • Dallas, Texas, Vereinigte Staaten, 75390
        • Rekrutierung
        • UT Southwestern/Simmons Cancer Center-Dallas
        • Kontakt:
        • Hauptermittler:
          • Suzanne M. Cole
      • Dallas, Texas, Vereinigte Staaten, 75235
      • Dallas, Texas, Vereinigte Staaten, 75237
        • Rekrutierung
        • UT Southwestern Simmons Cancer Center - RedBird
        • Hauptermittler:
          • Suzanne M. Cole
        • Kontakt:
      • Fort Worth, Texas, Vereinigte Staaten, 76104
      • Fort Worth, Texas, Vereinigte Staaten, 76104
        • Rekrutierung
        • UT Southwestern/Simmons Cancer Center-Fort Worth
        • Kontakt:
        • Hauptermittler:
          • Suzanne M. Cole
      • Richardson, Texas, Vereinigte Staaten, 75080
        • Rekrutierung
        • UT Southwestern Clinical Center at Richardson/Plano
        • Kontakt:
        • Hauptermittler:
          • Suzanne M. Cole
      • San Antonio, Texas, Vereinigte Staaten, 78207
        • Rekrutierung
        • Children's Hospital of San Antonio
        • Kontakt:
        • Hauptermittler:
          • Julie Voeller
      • San Antonio, Texas, Vereinigte Staaten, 78229
        • Rekrutierung
        • University of Texas Health Science Center at San Antonio
        • Kontakt:
        • Hauptermittler:
          • Aaron J. Sugalski
    • Virginia
      • Richmond, Virginia, Vereinigte Staaten, 23235
        • Rekrutierung
        • VCU Massey Cancer Center at Stony Point
        • Kontakt:
        • Hauptermittler:
          • Asit K. Paul
      • Richmond, Virginia, Vereinigte Staaten, 23298
        • Rekrutierung
        • VCU Massey Comprehensive Cancer Center
        • Hauptermittler:
          • Asit K. Paul
        • Kontakt:
    • Washington
      • Seattle, Washington, Vereinigte Staaten, 98195
        • Rekrutierung
        • University of Washington Medical Center - Montlake
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 800-804-8824
        • Hauptermittler:
          • Keith D. Eaton
      • Seattle, Washington, Vereinigte Staaten, 98109
        • Rekrutierung
        • Fred Hutchinson Cancer Center
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 800-804-8824
        • Hauptermittler:
          • Keith D. Eaton

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

12 Jahre und älter (Kind, Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • STEP 1: Patients must have documented histologically or cytologically confirmed adrenocortical carcinoma

  • STEP 1: Locally advanced unresectable or recurrent/metastatic disease

  • STEP 1: Evaluable disease as defined by RECIST v 1.1

  • STEP 1: Up to 3 prior lines of systemic therapy will be allowed in the unresectable/recurrent/metastatic setting. Treatment naïve patients will be allowed.

    • Note: Combination etoposide, doxorubicin, cisplatin, and mitotane (EDP-M) is considered 1 line of therapy. For patients who received mitotane ≤ 6 months prior to registration, mitotane should be discontinued 28 days prior to study registration AND a mitotane level must be documented to be < 2 mg/L prior to registration. Patients who have received mitotane within 6 months of enrollment and who have mitotane levels ≥ 2 mg/L will not be eligible to enroll

  • STEP 1: No prior treatment with cabozantinib or other cMET inhibitors, or anti-CTLA-4, or anti-PD-1/PD-L1 therapy

  • STEP 1: Prior external beam radiation therapy (any area radiated within a month prior to study registration cannot be used as an index lesion and only growth outside of the radiation field can be considered for disease progression), systemic cytotoxic chemotherapy, targeted therapies will be allowed, as long as not administered within 14 days before study registration, and provided any acute treatment-related associated toxicities have recovered to ≤ grade 1 except for alopecia, peripheral neuropathy or other residual toxicities that are not deemed clinically significant

  • STEP 1: Potential trial participants should have recovered from clinically significant adverse events, and wound healing is clinically adequate of their most recent therapy/intervention prior to enrollment

  • STEP 1: Age 12 years and above; and BSA ≥ 1.2m^2

  • STEP 1:

    • Eastern Cooperative Oncology Group (ECOG) performance 0 - 2 (age 18 and above); or
    • Patients 12 to <16 years of age will be assessed by the Lansky scale and should have a score ≥ 50; or
    • Patients ≥ 16 to <18 years of age will be assessed by the Karnofsky scale, and should have a score ≥ 50

  • STEP 1: Absolute neutrophil count (ANC) ≥ 1,000/mcL without colony stimulating factor support within 2 weeks prior

    • Transfusion support is allowed if ≥ 7 days from obtaining required initial laboratory

  • STEP 1: Platelet count ≥ 100,000/mcL

    • Transfusion support is allowed if ≥ 7 days from obtaining required initial laboratory

  • STEP 1: Hemoglobin ≥ 8 g/dL

    • Transfusion support is allowed if ≥ 7 days from obtaining required initial laboratory

  • STEP 1: Total bilirubin ≤ 1.5 x upper limit of normal (ULN)

    • For patients with known Gilbert's disease, bilirubin ≤ 3 mg/dL

  • STEP 1: Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT])/ alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) ≤ 3 x upper limit of normal (ULN)

  • STEP 1: Random Urine Creatinine Ratio (UPCR) ≤ 1 mg/mg

  • STEP 1: Calculated (Calc.) creatinine clearance ≥ 30 mL/min

  • STEP 1: Mitotane level < 2 mg/L*

    • Only applicable for patients who have received mitotane ≤ 6 months prior to registration

  • STEP 1: Must have assessment of adrenal steroid production within 3 months prior to registration as patients will be stratified based on corticosteroid production

    • Patients will be classified as corticosteroid producing if random plasma adrenocorticotropic hormone (ACTH) is < 20 pg/mL plus random serum cortisol is > 20 mcg/dL in the absence of anti-cortisol therapy. Patients already on anti-cortisol therapy will be classified as having corticosteroid producing tumors regardless of their plasma ACTH and serum cortisol levels, as these levels can be affected by anti-cortisol therapy

  • STEP 1: Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects based on animal reproduction studies. Therefore, for women of childbearing potential only, a negative urine or serum pregnancy test, per institution standard, done ≤ 14 days prior to registration is required

  • STEP 1: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional within 28 days of registration. To be eligible for this trial, patients should be class II or better

  • STEP 1: No known history of congenital long QT syndrome

  • STEP 1: No known history of myocarditis

  • STEP 1: No myocardial infarction (MI) or unstable angina within 6 months of registration

  • STEP 1: No clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding within 6 months of registration including, but not limited to: active peptic ulcer, known endoluminal metastatic lesion(s) with history of bleeding, inflammatory bowel disease, or other gastrointestinal conditions with increased risk of perforation

  • STEP 1: No history of gastrointestinal (GI) perforation within 6 months of registration

  • STEP 1: No known tumor with invasion into the GI tract from the outside causing increased risk of perforation or bleeding within 28 days of registration

  • STEP 1: No current radiologic or clinical evidence of pancreatitis

  • STEP 1: No history of clinically significant non-healing wounds or ulcers within 28 days of registration

  • STEP 1: No uncontrolled hypertension within 14 days of registration (defined as sustained systolic blood pressure (SBP) ≥ 150 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg despite optimal medical management)

  • STEP 1: No known endobronchial lesions involving the main or lobar bronchi and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage. (CT with contrast is recommended to evaluate such lesions.). No hemoptysis greater than ½ teaspoon (2.5 mL) or any other signs of pulmonary hemorrhage within the 3 months prior to registration

  • STEP 1: No history of pneumonitis

  • STEP 1: No known tumor invading or encasing any major blood vessels

  • STEP 1: No history of fracture within 28 days of registration

  • STEP 1: No known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 4 weeks after major surgery (e.g., removal or biopsy of brain metastasis) before registration. Eligible patients must be neurologically asymptomatic and without corticosteroid treatment at the time of the start of study treatment

  • STEP 1: Major surgery (e.g., laparoscopic nephrectomy, GI surgery, within 2 weeks before registration. Minor surgeries within 10 days before registration. Patients with clinically relevant ongoing complications from prior surgery are not eligible

  • STEP 1: Verbalizes the ability to swallow oral tablet formulation

  • STEP 1: No history of allergic reaction attributed to compounds of similar chemical or biological composition to cabozantinib

  • STEP 1: Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen will be eligible

  • STEP 1: HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible for this trial

  • STEP 1: For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

  • STEP 1: Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

  • STEP 1: No active autoimmune disease: or history of autoimmune disease that might recur, and which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids. These include but are not limited to patients with a history of:

    • immune related neurologic disease,
    • multiple sclerosis,
    • autoimmune (demyelinating) neuropathy,
    • Guillain-Barre syndrome (GBS), myasthenia gravis,
    • systemic autoimmune disease such as systemic lupus erythematosus (SLE),
    • connective tissue diseases,
    • scleroderma, inflammatory bowel disease (IBD),
    • Crohn's, ulcerative colitis,
    • patients with a history of toxic epidermal necrolysis (TEN),
    • Stevens-Johnson syndrome, or phospholipid syndrome should be excluded because of the risk of recurrence or exacerbation of disease,
    • Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible,
    • Patients with rheumatoid arthritis and other arthropathies, Sjögren's syndrome, and psoriasis controlled with topical medication and patients with only positive serology, such as antinuclear antibodies (ANA) or anti-thyroid antibodies, should be evaluated for the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible

  • STEP 1: No steroid use > 10 mg prednisone equivalents daily. A brief course of corticosteroids for prophylaxis or for treatment of non-autoimmune conditions (e.g., delayed-type hypersensitivity reaction caused by contact allergen) is permitted, as is steroid pre-medication for contrast allergy

  • STEP 1: Chronic concomitant treatment with strong inhibitors of CYP3A4 is not allowed on this study. Patients on strong CYP3A4 inhibitors must discontinue the drug for 14 days prior to registration on the study

  • STEP 1: Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients must discontinue the drug 14 days prior to the start of study treatment

  • STEP 1: Herbal supplements and traditional Chinese medicines are not allowed

  • STEP 1: Active treatment with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct Xa inhibitor betrixaban or platelet inhibitors (e.g., clopidogrel) within 5 days of registration. Allowed use of anticoagulants include: prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH), therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, apixaban. Also use of anticoagulants is allowed in patients with known brain metastases who are on a stable dose of the anticoagulant for at least 1 week prior to registration without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor

  • STEP 2 (CROSSOVER): Patients must have demonstrated radiographic progression of disease on cabozantinib monotherapy (Arm A) per RECIST version 1.1 criteria

    • Patients must cross-over to Arm C within 4 weeks (+/- 1 week) after radiographic documented progression and do not need to have a repeat radiographic assessment prior to starting cabozantinib and cemiplimab (REGN2810). The progression CT may serve as eligibility for crossover and as the baseline tumor measurement

  • STEP 2 (CROSSOVER): Patients that were discontinued on cabozantinib, or currently meet criteria for discontinuation of cabozantinib due to toxicity are not eligible to cross-over.

    • Note: Patients who underwent dose reduction of cabozantinib during treatment on Arm A will not re-escalate dose at or after cross-over to Cabo-Cemiplimab (REGN2810) (Arm B)

  • STEP 2 (CROSSOVER): Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative serum or urine pregnancy test done ≤ 14 days prior to re-registration is required

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Crossover-Aufgabe
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Arm A (cabozantinib)

Patients receive cabozantinib PO QD on days 1-21 of each cycle. Cycles repeat every 21 days for 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan or MRI and blood sample collection throughout the study. Upon disease progression, patients may elect to crossover to receive combination therapy on Arm B.
Verfahren: Biospecimen Collection

Undergo blood sample collection

Andere Namen:
  • Biologische Probensammlung
  • Bioprobe gesammelt
  • Probenentnahme
  • Beispielsammlung
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Verfahren: Computed Tomography

Undergo CT scan

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Arzneimittel: Cabozantinib

Given PO
Experimental: Arm B (cabozantinib and cemiplimab)

Patients receive cemiplimab IV over 30 minutes on day 1 and cabozantinib PO QD on days 1-21 of each cycle. Cycles repeat every 21 days for 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan or MRI and blood sample collection throughout the study.
Verfahren: Biospecimen Collection

Undergo blood sample collection

Andere Namen:
  • Biologische Probensammlung
  • Bioprobe gesammelt
  • Probenentnahme
  • Beispielsammlung
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Verfahren: Computed Tomography

Undergo CT scan

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Arzneimittel: Cabozantinib

Given PO

Biologisch: Cemiplimab

Given IV

Andere Namen:
  • REGN2810
  • Cemiplimab RWLC
  • Cemiplimab-rwlc
  • Libtayo
  • REGN 2810
  • REGN-2810

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Progression free survival (PFS)
Zeitfenster: From registration to either progression or death, assessed up to 4 years post-registration

Per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v 1.1). Will be analyzed using an intention-to-treat approach. Kaplan-Meier methodology will be used to estimate the distributions for the treatment arms. The hazard ratio, median PFS, and estimated PFS rates at 5, 10 and 15 months will be estimated along with corresponding 95% confidence intervals. A one-sided log rank-test will be used to compare the PFS distributions between the two treatment arms.
From registration to either progression or death, assessed up to 4 years post-registration

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Incidence of adverse events
Zeitfenster: Up to 4 years post-registration

Adverse events will be recorded using National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 for each patient. Frequency tables and summary statistics will be used and with the appropriate methods of evaluating categorical and continuous data.
Up to 4 years post-registration
Objective response rate
Zeitfenster: Up to 4 years post-registration

Will be assessed based on RECIST 1.1 criteria and will be summarized by treatment arm. will be calculated as the number of patients who achieve a response (partial response, complete response) divided by the total number of patients randomized to the corresponding treatment arm. A contingency table comparing treatment arms and responders to non-responders will be generated and a Fisher's exact test with a p-value cutoff of 0.05 will be used for determining whether evidence of a significant association between treatment and response is found.
Up to 4 years post-registration
Duration of response
Zeitfenster: From first date of the patient achieving either a complete or partial response and progression (via RECIST v 1.1), assessed up to 4 years post-registration

Kaplan-Meier methodology will be used to estimate the distributions of duration of response and a log-rank test between treatment arm will be calculated with corresponding p-value.
From first date of the patient achieving either a complete or partial response and progression (via RECIST v 1.1), assessed up to 4 years post-registration
Time to progression
Zeitfenster: From registration date and progression date, assessed up to 4 years post-registration

Kaplan-Meier methodology will be used to estimate the distributions of time to progression.
From registration date and progression date, assessed up to 4 years post-registration
Overall survival
Zeitfenster: From registration to death, assessed up to 4 years post-registration

Kaplan-Meier methodology will be used to estimate the distributions of overall survival.
From registration to death, assessed up to 4 years post-registration

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Median PFS for patients who cross over
Zeitfenster: From re-registration to progression or death, assessed up to 4 years post-registration

Calculated with corresponding 95% confidence interval.
From re-registration to progression or death, assessed up to 4 years post-registration

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

National Cancer Institute (NCI)

Ermittler

  • Hauptermittler: Bhavana Konda, Alliance for Clinical Trials in Oncology

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

22. Februar 2026

Primärer Abschluss (Geschätzt)

2. Juni 2029

Studienabschluss (Geschätzt)

2. Juni 2029

Studienanmeldedaten

Zuerst eingereicht

26. März 2025

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

26. März 2025

Zuerst gepostet (Tatsächlich)

28. März 2025

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

6. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

5. November 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • NCI-2025-02021
  • U10CA180821 (US NIH Stipendium/Vertrag)
  • NCI-2025-02021 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
  • A092204 (Andere Kennung: CTEP)
  • A092204 (Andere Kennung: Alliance for Clinical Trials in Oncology)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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