Phase II Study for Combination of Camrelizumab and Apatinib in the Second-line Treatment of Recurrent or Metastatic Adrenocortical Carcinoma

• ClinicalTrials.gov Identifier: NCT04318730
• Recruitment Status: Recruiting
• First Posted: March 24, 2020
• Last Update Posted: December 19, 2022
• Sponsor: West China Hospital
• Information provided by (Responsible Party): Xingchen Peng, West China Hospital

Study Description

Brief Summary:

Adrenocortical carcinoma (ACC) is a rare aggressive malignant tumor. According to the literature, the 5-year survival rate of ACC is 12%-47%. For patients with advanced ACC, mitotane alone or combined with traditional chemotherapy was the first-line standard treatment, but its progression-free survival was only about 1 year. However, for patients who fail the first-line treatment, there is a lack of effective treatment. For ACC patients who had failed first-line chemotherapy, a phase II clinical trial found that the objective response rate and the disease control rate of PD-1 inhibitor Keytruda were 14% and 64% respectively, and no grade 3 or 4 adverse events were observed. Anti-tumor angiogenic drugs combined with PD-1 inhibitors have shown impressive clinical data in many solid tumors. This study is aimed to evaluate the efficacy and safety of PD-1 inhibitor camrelizumab combined with apatinib in patients with recurrent or metastatic ACC after standard treatment failure, and to seek new treatment for this population.

Condition or disease	Intervention/treatment	Phase
Adrenocortical Carcinoma	Drug: Camrelizumab	Phase 2

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 21 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Phase II Study for Combination of Camrelizumab and Apatinib in the Second-line Treatment of Recurrent or Metastatic Adrenocortical Carcinoma
• Actual Study Start Date: June 12, 2021
• Estimated Primary Completion Date: April 1, 2023
• Estimated Study Completion Date: April 1, 2025

Arms and Interventions

Arm	Intervention/treatment
Experimental: Arm 1	Drug: Camrelizumab; Camrelizumab was administered 200mg iv every 3 weeks, Apatinib was administered 250 mg p.o. qd.; Other Name: Apatinib

Outcome Measures

Primary Outcome Measures :

1. objective response rate [ Time Frame: up to 60 months ]
   The rate of complete response and partial response.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Histologically confirmed diagnosis of adrenocortical carcinoma;
2. Patients with metastatic or inoperable adrenocortical carcinoma that has progressed, metastasized, or recurred after first-line standard treatment (mitotane monotherapy, chemotherapy alone, mitotane combined chemotherapy);
3. Aged >=18 years;
4. Eastern Cooperative Oncology Group (ECOG) performance status 0-1;
5. At least one measurable lesion, according to RECIST 1.1;
6. Major organ functions within 28 days prior to treatment meet the following criteria(14 days without transfusion): HB≥80g/L, ANC≥1.5x10^9/L, PLT ≥80x10^9/L; TBIL≤1.5 ULN, ALT and AST ≤2.5 ULN, if there exists hepatic metastases, ALT and AST ≤5 ULN, Cr ≤1.5 ULN or CCr ≥60ml/min; INR or PT ≤1.5 ULN, APTT ≤1.5 ULN (if the patient is receiving anticoagulant therapy, PT and APTT should be within the expected treatment range); Cardiac Markers and BNP≤ULN；TSH≤ULN (If TSH is abnormal, T3 and T4 should be normal)
7. Appropriate contraception should be used from the start of treatment to 120 days after the end of treatment;
8. Have signed consent form.

Exclusion Criteria:

1. Patients with another primary malignancy within 5 years prior to starting the study drug, except for cured in situ cervical carcinoma and cured non-melanoma skin cancer;
2. Have central nervous system metastasis with symptoms and need hormonal intervention;
3. Had received strong CYP3A4 inhibitors within one week prior to enrollment or received strong CYP3A4 inducers within two weeks prior to enrollment;
4. Poor control of high blood pressure (SBP>140mmHg or DBP>90mmHg);
5. Congestive heart failure of New York Heart Association (NYHA) Class III or IV;
6. Thromboembolic events occurred within 1 year prior to enrollment;
7. ECG QT interval >500ms;
8. Previous systemic immunosuppressive therapy;
9. Previous anti-PD-1, anti-PD-L1 antibody or anti- CTLA-4 antibody treatment;
10. Received TKI treatment within 2 weeks prior to starting the study drug;
11. Participate in clinical trials of other interventional drugs within 4 weeks prior to starting the study drug;
12. Received systemic therapy with corticosteroids or other immunosuppressants within 2 weeks prior to starting the study drug;
13. An anti-tumor vaccine or a live vaccine was given within 4 weeks prior to starting the study drug;
14. Major surgery or severe trauma within 4 weeks prior to starting the study drug;
15. Severe infections occurred within 4 weeks prior to starting the study drug;
16. Have an active autoimmune disease or a history of autoimmune diseases;
17. Have a history of immunodeficiency;
18. Have an active tuberculosis infection;
19. Have active hepatitis;
20. Patients with symptoms of gastrointestinal bleeding or risk of bleeding;
21. Active infection, or patients are pregnant or breast-feeding.

Contacts and Locations

Contacts

Contact: Xingchen Peng; +86 18980606753; pxx2014@scu.edu.cn

Locations

China, Sichuan

West China Hospital, Sichuan University; Recruiting

Chengdu, Sichuan, China, 610041

Contact: Xingchen Peng +86 18980606753 pxx2014@scu.edu.cn

Sponsors and Collaborators

West China Hospital

More Information

• Responsible Party: Xingchen Peng, PhD, Associate Professor, West China Hospital
• ClinicalTrials.gov Identifier: NCT04318730
• Other Study ID Numbers: ChiCTR1900028111
• First Posted: March 24, 2020
• Last Update Posted: December 19, 2022
• Last Verified: December 2022

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Carcinoma; Adrenocortical Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Adenocarcinoma; Adrenal Cortex Neoplasms; Adrenal Gland Neoplasms; Endocrine Gland Neoplasms; Neoplasms by Site; Adrenal Cortex Diseases; Adrenal Gland Diseases; Endocrine System Diseases; Apatinib; Antineoplastic Agents; Protein Kinase Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action