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Prueba de la adición de un medicamento anticancerígeno, Cabozantinib al medicamento de inmunoterapia cemiplimab (REGN2810), en adolescentes y adultos con cáncer adrenocortical avanzado

5 de noviembre de 2026 actualizado por: National Cancer Institute (NCI)

Un estudio de fase II de Cabozantinib en combinación con cemiplimab (Cabo-Cemiplimab) versus Cabozantinib solo en adolescentes y adultos con cáncer adrenocortical avanzado

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.

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Descripción detallada

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.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

48

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Estados Unidos
    • Arizona
      • Phoenix, Arizona, Estados Unidos, 85054
        • Reclutamiento
        • Mayo Clinic Hospital in Arizona
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 855-776-0015
        • Investigador principal:
          • Julie E. Hallanger Johnson
    • California
      • La Jolla, California, Estados Unidos, 92093
        • Reclutamiento
        • UC San Diego Moores Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 858-822-5354
          • Correo electrónico: cancercto@ucsd.edu
        • Investigador principal:
          • Yu-Wei Chen
      • Madera, California, Estados Unidos, 93636
        • Reclutamiento
        • Valley Children's Hospital
        • Contacto:
        • Investigador principal:
          • Ruetima Titapiwatanakun
    • Colorado
      • Aurora, Colorado, Estados Unidos, 80045
        • Reclutamiento
        • UCHealth University of Colorado Hospital
        • Investigador principal:
          • Laura Graham
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 720-848-0650
    • Florida
      • Jacksonville, Florida, Estados Unidos, 32224-9980
        • Reclutamiento
        • Mayo Clinic in Florida
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 855-776-0015
        • Investigador principal:
          • Julie E. Hallanger Johnson
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60611
        • Reclutamiento
        • Lurie Children's Hospital-Chicago
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 773-880-4562
        • Investigador principal:
          • Elizabeth A. Sokol
      • Chicago, Illinois, Estados Unidos, 60611
        • Reclutamiento
        • Northwestern University
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
      • Danville, Illinois, Estados Unidos, 61832
        • Reclutamiento
        • Carle at The Riverfront
        • Investigador principal:
          • Priyank P. Patel
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@Carle.com
      • DeKalb, Illinois, Estados Unidos, 60115
        • Reclutamiento
        • Northwestern Medicine Cancer Center Kishwaukee
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
      • Effingham, Illinois, Estados Unidos, 62401
        • Reclutamiento
        • Carle Physician Group-Effingham
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@carle.com
        • Investigador principal:
          • Priyank P. Patel
      • Geneva, Illinois, Estados Unidos, 60134
        • Reclutamiento
        • Northwestern Medicine Cancer Center Delnor
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
      • Glenview, Illinois, Estados Unidos, 60026
        • Reclutamiento
        • Northwestern Medicine Glenview Outpatient Center
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 312-695-1102
      • Grayslake, Illinois, Estados Unidos, 60030
        • Reclutamiento
        • Northwestern Medicine Grayslake Outpatient Center
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 312-695-1102
      • Lake Forest, Illinois, Estados Unidos, 60045
        • Reclutamiento
        • Northwestern Medicine Lake Forest Hospital
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
      • Mattoon, Illinois, Estados Unidos, 61938
        • Reclutamiento
        • Carle Physician Group-Mattoon/Charleston
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@carle.com
        • Investigador principal:
          • Priyank P. Patel
      • Normal, Illinois, Estados Unidos, 61761
        • Reclutamiento
        • Carle BroMenn Medical Center
        • Investigador principal:
          • Priyank P. Patel
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@Carle.com
      • Normal, Illinois, Estados Unidos, 61761
        • Reclutamiento
        • Carle Cancer Institute Normal
        • Investigador principal:
          • Priyank P. Patel
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@Carle.com
      • Oak Brook, Illinois, Estados Unidos, 60523
      • Orland Park, Illinois, Estados Unidos, 60462
        • Reclutamiento
        • Northwestern Medicine Orland Park
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
      • Shiloh, Illinois, Estados Unidos, 62269
        • Reclutamiento
        • Memorial Hospital East
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 314-747-9912
          • Correo electrónico: dschwab@wustl.edu
        • Investigador principal:
          • Nikolaos Trikalinos
      • Urbana, Illinois, Estados Unidos, 61801
        • Reclutamiento
        • Carle Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@carle.com
        • Investigador principal:
          • Priyank P. Patel
      • Warrenville, Illinois, Estados Unidos, 60555
        • Reclutamiento
        • Northwestern Medicine Cancer Center Warrenville
        • Investigador principal:
          • Mary F. Mulcahy
        • Contacto:
    • Iowa
      • Ankeny, Iowa, Estados Unidos, 50023
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Ankeny Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Carroll, Iowa, Estados Unidos, 51401
        • Reclutamiento
        • Saint Anthony Regional Hospital
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-689-7658
          • Correo electrónico: sbenson@iora.org
        • Investigador principal:
          • Seema Harichand-Herdt
      • Clive, Iowa, Estados Unidos, 50325
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50314
        • Reclutamiento
        • Broadlawns Medical Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-282-2200
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50314
        • Reclutamiento
        • Mercy Medical Center - Des Moines
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Richard L. Deming
      • Des Moines, Iowa, Estados Unidos, 50309
        • Reclutamiento
        • Iowa Methodist Medical Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-6727
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50309
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50314
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Fort Dodge, Iowa, Estados Unidos, 50501
        • Reclutamiento
        • UI Healthcare Mission Cancer and Blood - Fort Dodge
        • Investigador principal:
          • Seema Harichand-Herdt
        • Contacto:
      • Waukee, Iowa, Estados Unidos, 50263
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Waukee Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02215
        • Reclutamiento
        • Dana-Farber Cancer Institute
        • Investigador principal:
          • Stephanie A. Berg
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-442-3324
    • Michigan
      • Ann Arbor, Michigan, Estados Unidos, 48109
        • Reclutamiento
        • University of Michigan Rogel Cancer Center
        • Investigador principal:
          • Francis P. Worden
        • Contacto:
    • Minnesota
      • Rochester, Minnesota, Estados Unidos, 55905
        • Reclutamiento
        • Mayo Clinic in Rochester
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 855-776-0015
        • Investigador principal:
          • Julie E. Hallanger Johnson
    • Missouri
      • City of Saint Peters, Missouri, Estados Unidos, 63376
        • Reclutamiento
        • Siteman Cancer Center at Saint Peters Hospital
        • Contacto:
        • Investigador principal:
          • Nikolaos Trikalinos
      • Creve Coeur, Missouri, Estados Unidos, 63141
        • Reclutamiento
        • Siteman Cancer Center at West County Hospital
        • Contacto:
        • Investigador principal:
          • Nikolaos Trikalinos
      • Kansas City, Missouri, Estados Unidos, 64108
        • Reclutamiento
        • Children's Mercy Hospitals and Clinics
        • Investigador principal:
          • Keith J. August
        • Contacto:
      • Springfield, Missouri, Estados Unidos, 65807
        • Reclutamiento
        • CoxHealth South Hospital
        • Investigador principal:
          • Jay W. Carlson
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 417-269-4520
      • St Louis, Missouri, Estados Unidos, 63110
        • Reclutamiento
        • Washington University School of Medicine
        • Contacto:
        • Investigador principal:
          • Nikolaos Trikalinos
      • St Louis, Missouri, Estados Unidos, 63129
        • Reclutamiento
        • Siteman Cancer Center-South County
        • Contacto:
        • Investigador principal:
          • Nikolaos Trikalinos
      • St Louis, Missouri, Estados Unidos, 63136
        • Reclutamiento
        • Siteman Cancer Center at Christian Hospital
        • Contacto:
        • Investigador principal:
          • Nikolaos Trikalinos
    • Nebraska
      • Bellevue, Nebraska, Estados Unidos, 68123
        • Reclutamiento
        • Nebraska Medicine-Bellevue
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 402-559-6941
          • Correo electrónico: unmcrsa@unmc.edu
        • Investigador principal:
          • Apar Kishor Ganti
      • Omaha, Nebraska, Estados Unidos, 68198
        • Reclutamiento
        • University of Nebraska Medical Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 402-559-6941
          • Correo electrónico: unmcrsa@unmc.edu
        • Investigador principal:
          • Apar Kishor Ganti
      • Omaha, Nebraska, Estados Unidos, 68118
        • Reclutamiento
        • Nebraska Medicine-Village Pointe
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 402-559-5600
        • Investigador principal:
          • Apar Kishor Ganti
    • New Jersey
      • Basking Ridge, New Jersey, Estados Unidos, 07920
        • Reclutamiento
        • Memorial Sloan Kettering Basking Ridge
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
      • Middletown, New Jersey, Estados Unidos, 07748
        • Reclutamiento
        • Memorial Sloan Kettering Monmouth
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
      • Montvale, New Jersey, Estados Unidos, 07645
        • Reclutamiento
        • Memorial Sloan Kettering Bergen
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
    • New York
      • Commack, New York, Estados Unidos, 11725
        • Reclutamiento
        • Memorial Sloan Kettering Commack
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
      • Harrison, New York, Estados Unidos, 10604
        • Reclutamiento
        • Memorial Sloan Kettering Westchester
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
      • New York, New York, Estados Unidos, 10065
        • Reclutamiento
        • Memorial Sloan Kettering Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
      • Uniondale, New York, Estados Unidos, 11553
        • Reclutamiento
        • Memorial Sloan Kettering Nassau
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
        • Investigador principal:
          • Nitya P. Raj
    • North Carolina
      • Cary, North Carolina, Estados Unidos, 27518
        • Suspendido
        • Duke Cancer Center Cary
      • Durham, North Carolina, Estados Unidos, 27710
        • Reclutamiento
        • Duke University Medical Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 888-275-3853
        • Investigador principal:
          • Diane L. Reidy-lagunes
      • Raleigh, North Carolina, Estados Unidos, 27609
        • Reclutamiento
        • Duke Cancer Center Raleigh
        • Contacto:
        • Investigador principal:
          • Diane L. Reidy-lagunes
    • Ohio
      • Columbus, Ohio, Estados Unidos, 43210
        • Reclutamiento
        • Ohio State University Comprehensive Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-293-5066
          • Correo electrónico: Jamesline@osumc.edu
        • Investigador principal:
          • Bhavana Konda
    • Oklahoma
      • Oklahoma City, Oklahoma, Estados Unidos, 73104
        • Reclutamiento
        • University of Oklahoma Health Sciences Center
        • Contacto:
        • Investigador principal:
          • Adanma Anji Ayanambakkam Attanathi
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Estados Unidos, 15224
        • Reclutamiento
        • Children's Hospital of Pittsburgh of UPMC
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 412-692-8570
          • Correo electrónico: jean.tersak@chp.edu
        • Investigador principal:
          • Brittani K. Seynnaeve
    • South Carolina
      • Boiling Springs, South Carolina, Estados Unidos, 29316
        • Reclutamiento
        • Prisma Health Cancer Institute - Spartanburg
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Columbia, South Carolina, Estados Unidos, 29203
        • Reclutamiento
        • Prisma Health Richland Hospital
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Easley, South Carolina, Estados Unidos, 29640
        • Reclutamiento
        • Prisma Health Cancer Institute - Easley
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Greenville, South Carolina, Estados Unidos, 29605
        • Reclutamiento
        • BI-LO Charities Children's Cancer Center
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Greenville, South Carolina, Estados Unidos, 29605
        • Reclutamiento
        • Prisma Health Cancer Institute - Faris
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Greenville, South Carolina, Estados Unidos, 29605
        • Reclutamiento
        • Prisma Health Cancer Institute - Butternut
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Greenville, South Carolina, Estados Unidos, 29615
        • Reclutamiento
        • Prisma Health Cancer Institute - Eastside
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Greer, South Carolina, Estados Unidos, 29650
        • Reclutamiento
        • Prisma Health Cancer Institute - Greer
        • Investigador principal:
          • Aniket Saha
        • Contacto:
      • Seneca, South Carolina, Estados Unidos, 29672
        • Reclutamiento
        • Prisma Health Cancer Institute - Seneca
        • Investigador principal:
          • Aniket Saha
        • Contacto:
    • Tennessee
      • Memphis, Tennessee, Estados Unidos, 38105
        • Reclutamiento
        • Saint Jude Children's Research Hospital
        • Contacto:
        • Investigador principal:
          • Catherine G. Lam
    • Texas
      • Austin, Texas, Estados Unidos, 78723
        • Reclutamiento
        • Dell Children's Medical Center of Central Texas
        • Contacto:
        • Investigador principal:
          • Shannon M. Cohn
      • Dallas, Texas, Estados Unidos, 75390
        • Reclutamiento
        • UT Southwestern/Simmons Cancer Center-Dallas
        • Contacto:
        • Investigador principal:
          • Suzanne M. Cole
      • Dallas, Texas, Estados Unidos, 75235
        • Reclutamiento
        • Parkland Memorial Hospital
        • Contacto:
        • Investigador principal:
          • Suzanne M. Cole
      • Dallas, Texas, Estados Unidos, 75237
        • Reclutamiento
        • UT Southwestern Simmons Cancer Center - RedBird
        • Investigador principal:
          • Suzanne M. Cole
        • Contacto:
      • Fort Worth, Texas, Estados Unidos, 76104
        • Reclutamiento
        • Cook Children's Medical Center
        • Contacto:
        • Investigador principal:
          • Kelly L. Vallance
      • Fort Worth, Texas, Estados Unidos, 76104
        • Reclutamiento
        • UT Southwestern/Simmons Cancer Center-Fort Worth
        • Contacto:
        • Investigador principal:
          • Suzanne M. Cole
      • Richardson, Texas, Estados Unidos, 75080
        • Reclutamiento
        • UT Southwestern Clinical Center at Richardson/Plano
        • Contacto:
        • Investigador principal:
          • Suzanne M. Cole
      • San Antonio, Texas, Estados Unidos, 78207
        • Reclutamiento
        • Children's Hospital of San Antonio
        • Contacto:
        • Investigador principal:
          • Julie Voeller
      • San Antonio, Texas, Estados Unidos, 78229
        • Reclutamiento
        • University of Texas Health Science Center at San Antonio
        • Contacto:
        • Investigador principal:
          • Aaron J. Sugalski
    • Virginia
      • Richmond, Virginia, Estados Unidos, 23235
        • Reclutamiento
        • VCU Massey Cancer Center at Stony Point
        • Contacto:
        • Investigador principal:
          • Asit K. Paul
      • Richmond, Virginia, Estados Unidos, 23298
        • Reclutamiento
        • VCU Massey Comprehensive Cancer Center
        • Investigador principal:
          • Asit K. Paul
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 804-628-6430
          • Correo electrónico: CTOclinops@vcu.edu
    • Washington
      • Seattle, Washington, Estados Unidos, 98195
        • Reclutamiento
        • University of Washington Medical Center - Montlake
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-804-8824
        • Investigador principal:
          • Keith D. Eaton
      • Seattle, Washington, Estados Unidos, 98109
        • Reclutamiento
        • Fred Hutchinson Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-804-8824
        • Investigador principal:
          • Keith D. Eaton

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

12 años y mayores (Niño, Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

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

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación cruzada
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
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.
Procedimiento: Biospecimen Collection

Undergo blood sample collection

Otros nombres:
  • Recolección de muestras biológicas
  • Muestra biológica recolectada
  • Coleccion de especimenes
  • Recolección de muestras
Procedimiento: Magnetic Resonance Imaging

Undergo MRI

Otros nombres:
  • Resonancia magnética
  • Resonancia magnetica
  • Exploración de imágenes por resonancia magnética
  • Imágenes Médicas, Resonancia Magnética / Resonancia Magnética Nuclear
  • SRES
  • Imágenes de RM
  • Imágenes de RMN
  • RMN
  • Imágenes de resonancia magnética nuclear
  • Imágenes por resonancia magnética (IRM)
  • resonancia magnética nuclear
  • Imágenes por resonancia magnética (procedimiento)
  • Resonancias magnéticas
  • Resonancia magnética estructural
Procedimiento: Computed Tomography

Undergo CT scan

Otros nombres:
  • Connecticut
  • GATO
  • Análisis de gato
  • Tomografía Axial Computarizada
  • Tomografía axial computarizada
  • Tomografía computarizada
  • tomografía
  • Tomografía axial computarizada (procedimiento)
  • Tomografía computarizada (TC)
  • Escaneo de gato de diagnóstico
  • Tipo de servicio de escaneo de gato de diagnóstico
Droga: 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.
Procedimiento: Biospecimen Collection

Undergo blood sample collection

Otros nombres:
  • Recolección de muestras biológicas
  • Muestra biológica recolectada
  • Coleccion de especimenes
  • Recolección de muestras
Procedimiento: Magnetic Resonance Imaging

Undergo MRI

Otros nombres:
  • Resonancia magnética
  • Resonancia magnetica
  • Exploración de imágenes por resonancia magnética
  • Imágenes Médicas, Resonancia Magnética / Resonancia Magnética Nuclear
  • SRES
  • Imágenes de RM
  • Imágenes de RMN
  • RMN
  • Imágenes de resonancia magnética nuclear
  • Imágenes por resonancia magnética (IRM)
  • resonancia magnética nuclear
  • Imágenes por resonancia magnética (procedimiento)
  • Resonancias magnéticas
  • Resonancia magnética estructural
Procedimiento: Computed Tomography

Undergo CT scan

Otros nombres:
  • Connecticut
  • GATO
  • Análisis de gato
  • Tomografía Axial Computarizada
  • Tomografía axial computarizada
  • Tomografía computarizada
  • tomografía
  • Tomografía axial computarizada (procedimiento)
  • Tomografía computarizada (TC)
  • Escaneo de gato de diagnóstico
  • Tipo de servicio de escaneo de gato de diagnóstico
Droga: Cabozantinib

Given PO

Biológico: Cemiplimab

Given IV

Otros nombres:
  • REGN2810
  • Cemiplimab RWLC
  • Cemiplimab-rwlc
  • Libtáyo
  • REGN 2810
  • REGN-2810

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Progression free survival (PFS)
Periodo de tiempo: 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

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Incidence of adverse events
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Median PFS for patients who cross over
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

National Cancer Institute (NCI)

Investigadores

  • Investigador principal: Bhavana Konda, Alliance for Clinical Trials in Oncology

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

22 de febrero de 2026

Finalización primaria (Estimado)

2 de junio de 2029

Finalización del estudio (Estimado)

2 de junio de 2029

Fechas de registro del estudio

Enviado por primera vez

26 de marzo de 2025

Primero enviado que cumplió con los criterios de control de calidad

26 de marzo de 2025

Publicado por primera vez (Actual)

28 de marzo de 2025

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

6 de noviembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

5 de noviembre de 2026

Última verificación

1 de agosto de 2026

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • NCI-2025-02021
  • U10CA180821 (Subvención/contrato del NIH de EE. UU.)
  • NCI-2025-02021 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • A092204 (Otro identificador: CTEP)
  • A092204 (Otro identificador: Alliance for Clinical Trials in Oncology)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

SÍ

Descripción del plan IPD

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.

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

Sí

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

producto fabricado y exportado desde los EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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