Interferon Alfa-2b With or Without Bevacizumab in Treating Patients With Advanced Renal Cell Carcinoma (Kidney Cancer)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
NCIC Clinical Trials Group
Eastern Cooperative Oncology Group
Information provided by (Responsible Party):
Cancer and Leukemia Group B
ClinicalTrials.gov Identifier:
NCT00072046
First received: November 4, 2003
Last updated: March 15, 2012
Last verified: April 2011
  Purpose

RATIONALE: Biological therapies, such as interferon alfa-2b, may interfere with the growth of tumor cells. Bevacizumab may stop the growth of tumor cells by stopping blood flow to the tumor. It is not yet known whether interferon alfa-2b is more effective with or without bevacizumab in treating advanced renal cell carcinoma (kidney cancer).

PURPOSE: This randomized phase III trial is studying interferon alfa-2b and bevacizumab to see how well they work compared to interferon alfa-2b alone in treating patients with advanced renal cell carcinoma.


Condition Intervention Phase
Kidney Cancer
Biological: bevacizumab
Biological: recombinant interferon alfa
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized Phase III Trial Of Interferon Alfa-2B Or Interferon Alfa-2B Plus Bevacizumab In Patients With Advanced Renal Carcinoma

Resource links provided by NLM:


Further study details as provided by Cancer and Leukemia Group B:

Primary Outcome Measures:
  • Overall Survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to progression [ Time Frame: q 3 cycles ] [ Designated as safety issue: No ]
  • Toxicity [ Time Frame: q cycle ] [ Designated as safety issue: Yes ]

Enrollment: 732
Study Start Date: October 2003
Estimated Study Completion Date: July 2015
Primary Completion Date: January 2004 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Interferon
Treatment with interferon alfa 2b
Biological: recombinant interferon alfa
9 million units subQ injection 3 x/week for 4 weeks
Experimental: Interferon + bevacizumab
Addition of bevacizumab to interferon alfa 2b treatment
Biological: bevacizumab
10mg/kg IV infusion on Days 1 & 15 of each cycle
Biological: recombinant interferon alfa
9 million units subQ injection 3 x/week for 4 weeks

Detailed Description:

OBJECTIVES:

Primary

  • Compare the overall survival of patients with advanced renal cell carcinoma treated with interferon alfa-2b alone or interferon alfa-2b with bevacizumab.

Secondary

  • Compare the time to disease progression and objective response rates in patients treated with these regimens.
  • Determine the toxicity of interferon alfa-2b in combination with bevacizumab in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior nephrectomy (yes vs no) and number of risk factors for disease progression (0 vs 1-2 vs 3 or more). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive interferon alfa-2b subcutaneously (SC) three times a week.
  • Arm II: Patients receive interferon alfa-2b as in arm I and bevacizumab IV over 30-90 minutes on days 1 and 15.

In both arms, courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 2 years and then annually for up to 10 years after study entry.

PROJECTED ACCRUAL: A total of 700 patients (350 per treatment arm) will be accrued for this study within 3 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed renal cell carcinoma (RCC)

    • Conventional clear cell carcinoma
    • Metastatic or unresectable disease
  • The following characteristics and cellular types are excluded:

    • True papillary
    • Sarcomatoid features without a clear cell component
    • Chromophobe
    • Oncocytoma
    • Collecting duct tumor
    • Transitional cell carcinoma
  • Measurable or nonmeasurable disease, including any of the following:

    • Unidimensionally measurable lesion ≥ 20 mm by conventional techniques (e.g., physical exam or chest x-ray) OR 10 mm by spiral CT scan or MRI
    • The following are considered nonmeasurable disease:

      • Small lesions
      • Bone lesions
      • Leptomeningeal disease
      • Ascites
      • Pleural/pericardial effusion
      • Lymphangitis cutis/pulmonis
      • Abdominal masses that are not confirmed and followed by imaging techniques
      • Cystic lesions
      • Irradiated lesions, unless progression is documented after radiotherapy
  • RCC paraffin tissue blocks or unstained slides must be available
  • No evidence of prior or concurrent CNS metastases by MRI or CT scan

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 70-100%

Life expectancy

  • Not specified

Hematopoietic

  • Granulocyte count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • No history of clinically significant bleeding

Hepatic

  • AST/ALT ≤ 2.5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 2.5 times ULN
  • Bilirubin ≤ 1.5 times ULN

Renal

  • Creatinine ≤ 1.5 times ULN
  • No proteinuria > 1+

    • Proteinuria ≥ 2+ allowed provided protein is < 2 g/24-hour urine collection

Cardiovascular

  • No deep venous thrombosis within the past year
  • No cerebrovascular accident within the past year
  • No peripheral vascular disease with claudication on < 1 block
  • No uncontrolled hypertension defined as blood pressure ≥160 mm Hg (systolic) and/or ≥ 90 mm Hg (diastolic) while on medication
  • No New York Heart Association class II-IV congestive heart failure
  • No angina pectoris requiring nitrate therapy
  • No myocardial infarction within the past 6 months
  • No other significant cardiovascular disease

Pulmonary

  • No pulmonary embolus within the past year
  • No ongoing hemoptysis

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after study treatment
  • No preexisting thyroid abnormality in which normal thyroid function cannot be maintained by medication
  • No delayed wound healing, ulcers, or bone fractures
  • No uncontrolled psychiatric disorder
  • No other currently active* malignancy except nonmelanoma skin cancer NOTE: *Disease is not considered currently active if patient completed anticancer therapy and is considered to have < 30% risk of relapse

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior systemic immunotherapy for RCC
  • No prior thalidomide, anti-vascular endothelial growth factor (VEGF) therapy, VEGF receptor inhibitors, or antiangiogenic treatment of any kind
  • No concurrent prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF)

Chemotherapy

  • No prior systemic chemotherapy for RCC
  • No concurrent chemotherapy

Endocrine therapy

  • No concurrent systemic corticosteroid therapy except the following:

    • Topical and inhaled steroids
    • Replacement therapy for adrenal insufficiency
  • No concurrent hormones except those administered for nondisease-related conditions (e.g., insulin for diabetes)

Radiotherapy

  • See Disease Characteristics
  • At least 4 weeks since prior radiotherapy and recovered
  • Prior palliative radiotherapy to metastatic lesions allowed provided at least 1 measurable or nonmeasurable lesion remains untreated
  • No concurrent palliative radiotherapy

Surgery

  • At least 4 weeks since prior major surgery and recovered

Other

  • No other prior systemic investigational therapy for RCC
  • No other prior adjuvant or neoadjuvant systemic therapy for RCC
  • No concurrent full-dose oral or parenteral anticoagulation* NOTE: *Low-dose (1 mg) warfarin for maintenance of catheter patency and/or daily prophylactic aspirin is allowed
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00072046

  Show 493 Study Locations
Sponsors and Collaborators
Cancer and Leukemia Group B
NCIC Clinical Trials Group
Eastern Cooperative Oncology Group
Investigators
Study Chair: Brian I. Rini, MD University of California, San Francisco
  More Information

Additional Information:
Publications:
Rini BI, Halabi S, Rosenberg J, et al.: Bevacizumab plus interferon-alpha versus interferon-alpha monotherapy in patients with metastatic renal cell carcinoma: results of overall survival for CALGB 90206. [Abstract] J Clin Oncol 27 (Suppl 15): A-LBA5019, 2009.
Rini BI, Halabi S, Rosenberg JE, et al.: CALGB 90206: a phase III trial of bevacizumab plus interferon-alpha versus interferon-alpha monotherapy in metastatic renal cell carcinoma. [Abstract] American Society of Clinical Oncology 2008 Genitourinary Cancers Symposium, Feb 14-16, 2008, San Francisco, CA. A-350, 2008.

Responsible Party: Cancer and Leukemia Group B
ClinicalTrials.gov Identifier: NCT00072046     History of Changes
Other Study ID Numbers: CDR0000335292, U10CA031946, CALGB-90206, CAN-NCIC-REC1, ECOG-CALGB-90206
Study First Received: November 4, 2003
Last Updated: March 15, 2012
Health Authority: United States: Food and Drug Administration

Keywords provided by Cancer and Leukemia Group B:
stage IV renal cell cancer
clear cell renal cell carcinoma
recurrent renal cell cancer

Additional relevant MeSH terms:
Carcinoma
Carcinoma, Renal Cell
Kidney Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Adenocarcinoma
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases
Interferon-alpha
Interferon Alfa-2a
Interferon Alfa-2b
Interferons
Reaferon
Bevacizumab
Antiviral Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions
Immunologic Factors
Physiological Effects of Drugs
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents
Adjuvants, Immunologic

ClinicalTrials.gov processed this record on July 29, 2014