Treatment of Refractory Metastatic Renal Cell Carcinoma With Bevacizumab and RAD001 (Everolimus)

This study has been terminated.
(slow accrual)
Sponsor:
Collaborators:
Genentech, Inc.
Novartis
Information provided by (Responsible Party):
Sandy Srinivas, Stanford University
ClinicalTrials.gov Identifier:
NCT00651482
First received: March 28, 2008
Last updated: June 30, 2014
Last verified: June 2014

March 28, 2008
June 30, 2014
August 2008
March 2012   (final data collection date for primary outcome measure)
Progression-free Survival (PFS) [ Time Frame: 24 months ] [ Designated as safety issue: No ]
Progression-free survival (PFS) per RECIST criteria
To assess the effect of the combination therapy bevacizumab and RAD001 on progression-free survival in treatment-refractory mRCC using Response Evaluation Criteria in Solid Tumors (RECIST)
Complete list of historical versions of study NCT00651482 on ClinicalTrials.gov Archive Site
  • Objective Response (OR) [ Time Frame: 24 months ] [ Designated as safety issue: No ]
    Number of subjects with objective response (OR)
  • Objective Response (OR) Duration [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  • Time-to-Treatment Failure (TTF) [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  • Overall Survival (OS) [ Time Frame: 44 months ] [ Designated as safety issue: No ]
  • Number of Subjects With Drug-related SAEs [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  • Total Number of Drug-related SAEs [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  • Treatment Discontinuation Due to Toxicity [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
    Number of subjects whose treatment was discontinued due to toxicity
  • Treatment Discontinuation Due to Disease Progression [ Time Frame: 24 months ] [ Designated as safety issue: No ]
    Number of subjects whose treatment was discontinued due to disease progression
  • To assess the efficacy of combining bevacizumab w/ RADOO1 as 2nd or 3rd-line treatment for patients with metastatic RCC, as measured by objective response, duration of objective response, time to treatment failure, & overall survival
  • To assess the safety of combining bevacizumab with RAD001.
  • To assess fasting total cholesterol, & triglyceride levels as potential biomarkers for RAD001 activity.
  • To assess serum VEGF and glucose as potential biomarkers for bevacizumab & RAD001 activity
  • To assess serum erythropoietin, reticulocyte counts, & hemoglobin/hematocrit as potential biomarkers for bevacizumab activity
  • To perform subgroup analysis based on Motzer risk types
Not Provided
Not Provided
 
Treatment of Refractory Metastatic Renal Cell Carcinoma With Bevacizumab and RAD001 (Everolimus)
Treatment of Refractory Metastatic Renal Cell Carcinoma With Bevacizumab and RAD001 (Everolimus)

To determine the safety and efficacy of the combination of bevacizumab and everolimus (RAD001) for the treatment of metastatic renal cell cancer

Not Provided
Interventional
Phase 2
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Kidney Neoplasms
  • Kidney (Renal Cell) Cancer
  • Drug: Everolimus
    Other Names:
    • Zortress
    • Certican
    • RAD001
  • Drug: Bevacizumab
    Other Name: Avastin
Experimental: Bevacizumab + RAD001 (everolimus)

Study treatment, consisting of bevacizumab + everolimus, was administered as 28-day cycles

Bevacizumab 10 mg/kg administered by IV infusion every 14 days (dose suspension permitted, dose reduction not permitted)

Everolimus 10 mg daily was administered orally (dose reduction to 5 mg daily and then 5 mg every other day, was permitted as needed for toxicity or tolerability)

Interventions:
  • Drug: Everolimus
  • Drug: Bevacizumab
Harshman LC, Barbeau S, McMillian A, Srinivas S. A phase II study of bevacizumab and everolimus as treatment for refractory metastatic renal cell carcinoma. Clin Genitourin Cancer. 2013 Jun;11(2):100-6. doi: 10.1016/j.clgc.2012.12.002. Epub 2013 Jan 24.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
10
March 2012
March 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Signed Informed Consent Form
  • Histologically confirmed metastatic RCC that is predominantly clear cell Measurable disease, as defined by RECIST
  • Age ≥ 18 years
  • ECOG performance status of 0 or 1
  • No more than 1 prior targeted therapy (eg, sorafenib, sunitinib) (prior cytokine therapy allowed)
  • No more than 2 prior systemic therapies
  • Ability and capacity to comply with the study and follow-up procedures

General Exclusion Criteria

  • Inability to comply with study and/or follow-up procedures
  • Life expectancy of < 12 weeks
  • Inadequate organ function, as evidenced by any of the following at screening:

    • Absolute neutrophil count (ANC) < 1500/uL
    • Platelet count ≤ 100 x 10^9/L
    • Total bilirubin ≥ 1.5 x upper limit of normal (ULN)
    • AST and/or ALT > 2.5 x ULN for patients without evidence of liver metastases, or 5 x ULN for patients with documented liver metastases
    • Serum creatinine > 2.0 mg/dL
    • Hemoglobin < 9 g/dL (may be transfused or receive epoetin alfa to maintain or exceed this level)
  • Active infection or fever > 38.5°C within 3 days of starting treatment
  • Women who are pregnant or breast feeding,
  • Able to conceive and unwilling to practice an effective method of birth control.
  • History of other malignancies within 5 years prior to Day 1 except for tumors with a negligible risk for metastasis or death, such as adequately controlled basal cell carcinoma, squamous-cell carcinoma of the skin, carcinoma in situ of the cervix, early-stage bladder cancer, or low-grade endometrial cancer
  • Malignancies that have undergone a putative surgical cure (i.e., localized prostate cancer post-prostatectomy) within 5 years prior to Day 1 may be discussed with the Principal Investigator.
  • Any other medical conditions (including mental illness or substance abuse) deemed by the clinician to be likely to interfere with a patient's ability to provide informed consent, cooperate, or participate in the study, or to interfere with the interpretation of the results.
  • Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study

Disease-Specific Exclusion Criteria

  • RCC with predominantly sarcomatoid features
  • Radiotherapy for RCC within 28 days prior to Day 1, with the exception of single-fraction radiotherapy given for the indication of pain control
  • Prior treatment with bevacizumab or any mTOR inhibitor (eg, temsirolimus, sirolimus, or everolimus)
  • Current need for dialysis

Bevacizumab-Specific Exclusions

  • Inadequately controlled hypertension (defined as systolic blood pressure >150 and/or diastolic blood pressure > 100 mmHg on antihypertensive medications)
  • Any prior history of hypertensive crisis or hypertensive encephalopathy
  • New York Heart Association (NYHA) Grade II or greater congestive heart failure
  • History of myocardial infarction or unstable angina within 6 months prior to study enrollment
  • History of stroke or transient ischemic attack within 6 months prior to study enrollment
  • Known CNS disease, except for treated brain metastasis. Treated brain metastases are defined as having no evidence of progression or hemorrhage after treatment and no ongoing requirement for dexamethasone, as ascertained by clinical examination and brain imaging (MRI or CT) during the screening period. Anticonvulsants (stable dose) are allowed. Treatment for brain metastases may include whole brain radiotherapy (WBRT), radiosurgery (RS; Gamma Knife, LINAC, or equivalent) or a combination as deemed appropriate by the treating physician. Patients with CNS metastases treated by neurosurgical resection or brain biopsy performed within 3 months prior to Day 1 will be excluded.
  • Significant vascular disease (eg, aortic aneurysm, aortic dissection)
  • Symptomatic peripheral vascular disease
  • Evidence of bleeding diathesis or coagulopathy that is not intentionally pharmacologically-induced
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study enrollment or anticipation of need for major surgical procedure during the course of the study
  • Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment
  • Serious, non-healing wound, ulcer, or bone fracture
  • Proteinuria at screening as demonstrated by a urine protein:
  • Creatinine (UPC) ratio ≥ 1.0. If UPC ratio ≥ 1.0, the patient must undergo a 24 hour urine collection which must demonstrate ≤ 1g of protein in 24 hours to be eligible.
  • Known hypersensitivity to any component of bevacizumab

RAD001-Specific Exclusion Criteria

  • Known hypersensitivity to any component of RAD001
  • Chronic treatment with systemic steroids or another immunosuppressive agent
  • Impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of RAD001 (eg, ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection)
  • Severely impaired lung function (spirometry and DLCO < 50% of normal and O2 saturation 88% or less at rest on room air)
  • If O2 saturation is ≤ 88% at rest on screening, pulmonary function tests (PFTs) will be ordered to confirm normal pulmonary function and eligibility.
  • Fasting total cholesterol > 350 mg/dL
  • Fasting triglyceride level > 400 mg/dL or >2.5 x ULN
  • Fasting serum glucose > 250 mg/dL
  • Serum phosphorus < 2.0 mg/dL
  • Serum corrected calcium < 8.0 mg/dL
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00651482
IRB-11789, RENAL0016, 98593, AVF4304s, 41839
Yes
Sandy Srinivas, Stanford University
Sandy Srinivas
  • Genentech, Inc.
  • Novartis
Principal Investigator: Dr. Sandy Srinivas Stanford University
Stanford University
June 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP