Pucotenlimab, Lenvatinib, and SBRT Before Surgery for Localized Clear Cell Renal Cell Carcinoma (PLS-NEO-RCC)
A Single-Arm Phase II Study of Neoadjuvant Pucotenlimab, Lenvatinib, and Stereotactic Body Radiotherapy in Patients With Localized Clear Cell Renal Cell Carcinoma and High-Risk Partial Nephrectomy
This single-arm Phase II study will evaluate the efficacy and safety of neoadjuvant pucotenlimab, lenvatinib, and stereotactic body radiotherapy (SBRT) in adults with localized clear cell renal cell carcinoma who are candidates for partial nephrectomy but have tumors that make the operation technically difficult. Approximately 24 participants will receive up to six cycles of pucotenlimab with daily lenvatinib. SBRT will be delivered to the primary renal tumor during neoadjuvant treatment. Surgery is planned after neoadjuvant treatment. The primary outcome is objective response rate.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
This is a prospective, single-arm Phase II study using a Simon optimal two-stage design. The study plans to enroll 24 participants. In stage 1, eight participants will be enrolled; if no more than three have an objective response, the study will stop for futility. Otherwise, 16 additional participants will be enrolled.
Participants will receive pucotenlimab 200 mg by intravenous infusion every 3 weeks for up to six cycles and lenvatinib 12 mg orally once daily during neoadjuvant treatment. SBRT will be delivered to the primary renal tumor at a total dose of 40 Gy in five fractions after completion of the second pucotenlimab cycle and before the fourth cycle. Tumor imaging will be performed during neoadjuvant treatment. Surgery, preferably partial nephrectomy when feasible, is planned 2 to 4 weeks after the sixth pucotenlimab cycle. Efficacy, surgical outcomes, and adverse events will be evaluated.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 2
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Yulu Peng, Doc
- Telefoonnummer: 02087342318
- E-mail: pengyl1@sysucc.org.cn
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Voluntary written informed consent.
- Age 18 years or older.
- ECOG performance status of 0 or 1.
- Life expectancy of at least 3 months.
- Preoperative biopsy confirming clear cell renal cell carcinoma or renal cell carcinoma with a predominant clear cell component.
- Willingness to undergo partial nephrectomy.
- A localized renal tumor for which partial nephrectomy is indicated but technically difficult: a 4-7 cm hilar tumor; a 4-7 cm tumor that is at least 75% endophytic; or a tumor larger than 7 cm.
- At least one measurable lesion suitable for repeated, accurate measurement.
- Adequate organ function: absolute neutrophil count ≥1.5 × 10^9/L; platelet count ≥100 × 10^9/L; hemoglobin ≥90 g/L; total bilirubin ≤1.5 × upper limit of normal (ULN); ALT and AST ≤2.5 × ULN, or ≤5 × ULN for participants with liver metastases; albumin ≥28 g/L; INR and APTT ≤1.5 × ULN. No blood component transfusion or hematopoietic growth-factor support is permitted within 2 weeks before treatment.
- Willingness and ability to comply with study visits, treatment, laboratory assessments, and other study requirements.
Exclusion Criteria:
- Lymph node metastasis or metastatic renal cell carcinoma.
- Tumor encasement of the renal artery, tumor thrombus in the renal vein, or diffuse tumor growth without a clear boundary from normal renal parenchyma.
- Inability to tolerate general anesthesia according to the preoperative assessment.
- Severe cardiovascular or cerebrovascular disease, or uncontrolled hypertension or diabetes.
- Long-term immunosuppressive therapy after organ transplantation, or current use of immunosuppressive medication.
- Active infection or fever.
- T-cell lymphoma or multiple myeloma.
- Concurrent malignancy, current treatment for another benign or malignant tumor, or a history of another malignancy within the previous 6 months.
- Use of herbal medicines with an anticancer indication or systemic immunomodulatory agents, including thymosin, interferon, or interleukin, within 14 days before the first study treatment; local use to control pleural effusion is permitted.
- Active or potentially recurrent autoimmune disease, except vitiligo, alopecia, psoriasis, or eczema not requiring systemic therapy; hypothyroidism due to autoimmune thyroiditis requiring only a stable dose of hormone replacement; or type 1 diabetes requiring only a stable dose of insulin.
- Concurrent enrollment in another interventional clinical study, except participation in its follow-up period; participation in a noninterventional observational study is permitted.
- Known psychiatric illness or a history of drug abuse, alcohol abuse, or illicit drug use.
- Pregnancy or breastfeeding.
- Any other disease, treatment, or laboratory abnormality that may confound the study results, prevent full participation, or make participation contrary to the participant's best interests.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Experimenteel: Pucotenlimab Plus Lenvatinib and SBRT
Participants will receive neoadjuvant pucotenlimab 200 mg intravenously every 3 weeks for up to six cycles and lenvatinib 12 mg orally once daily. SBRT at 40 Gy in five fractions will be delivered to the primary renal tumor after cycle 2 and before cycle 4. Surgery is planned after neoadjuvant treatment, with partial nephrectomy preferred when feasible. |
200 mg administered by intravenous infusion once every 3 weeks for up to six cycles. Lenvatinib 12 mg taken orally once daily during neoadjuvant treatment; treatment is stopped at least 3 days before surgery. SBRT to the primary renal tumor at a total dose of 40 Gy in five fractions, delivered after completion of pucotenlimab cycle 2 and before cycle 4. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Objective Response Rate (ORR)
Tijdsspanne: From baseline through completion of neoadjuvant treatment, approximately 18 weeks.
|
Percentage of participants with a complete response or partial response of the primary renal tumor according to RECIST version 1.1 during neoadjuvant treatment. |
From baseline through completion of neoadjuvant treatment, approximately 18 weeks.
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Major Pathological Response (MPR) Rate
Tijdsspanne: At surgery, approximately 20 to 22 weeks after treatment initiation.
|
Percentage of participants with major pathological response in the resected primary tumor. |
At surgery, approximately 20 to 22 weeks after treatment initiation.
|
|
Partial Nephrectomy Success Rate
Tijdsspanne: At surgery, approximately 20 to 22 weeks after treatment initiation.
|
Percentage of participants who undergo partial nephrectomy after neoadjuvant treatment. |
At surgery, approximately 20 to 22 weeks after treatment initiation.
|
|
R0 Resection Rate
Tijdsspanne: At surgery, approximately 20 to 22 weeks after treatment initiation.
|
Percentage of surgically treated participants with microscopically negative surgical margins. |
At surgery, approximately 20 to 22 weeks after treatment initiation.
|
|
Surgical Complications
Tijdsspanne: From surgery through the 3-month postoperative visit.
|
Number and percentage of participants with surgical complications, including bleeding and urinary leakage. |
From surgery through the 3-month postoperative visit.
|
|
Adverse Events
Tijdsspanne: From informed consent through 30 days after the last dose of study medication.
|
Number and percentage of participants with adverse events, graded according to NCI-CTCAE version 4.0. |
From informed consent through 30 days after the last dose of study medication.
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Urogenitale neoplasmata
- Neoplasmata per site
- Neoplasmata
- Mannelijke urogenitale ziekten
- Nier Ziekten
- Urologische ziekten
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Neoplasmata per histologisch type
- Neoplasmata, glandulair en epitheel
- Adenocarcinoom
- Urologische neoplasmata
- Carcinoom
- Nierneoplasmata
- Carcinoom, niercel
- Onderzoekstechnieken
- Therapeutica
- Chirurgische procedures, operatief
- Radiotherapie
- Stereotaxische technieken
- Neurochirurgische procedures
- Radiochirurgie
- Lenvatinib
Andere studie-ID-nummers
Andere studie-ID-nummers
- 2024-FXY-321-Urology
- 2024-FXY-321-Urology (Andere identificatie: Sun Yat-sen University cancer center)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Individual participant data will not be shared because this small study collects sensitive clinical, imaging, and molecular data that could increase the risk of participant re-identification. Study results will be reported in aggregate form.
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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