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A Study of Two Different Doses of Cabozantinib (XL184) in Progressive, Metastatic Medullary Thyroid Cancer (EXAMINER)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT01896479
Recruitment Status : Recruiting
First Posted : July 11, 2013
Last Update Posted : December 6, 2018
Information provided by (Responsible Party):

Brief Summary:
The objective of this study is to evaluate the efficacy and safety of oral cabozantinib at a 60 mg dose compared with a 140 mg dose in subjects with progressive, metastatic MTC. It will test if the lower dose results in similar progression free survival (PFS) and overall response rate (ORR) with fewer adverse events compared to the PFS, ORR and adverse events found in previous clinical trials of 140 mg.

Condition or disease Intervention/treatment Phase
Medullary Thyroid Cancer Drug: Cabozantinib (XL184) 140 mg Drug: Cabozantinib (XL184) 60 mg Drug: Placebo tablet Drug: Placebo capsule Phase 4

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 188 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind Study To Evaluate the Efficacy and Safety of Cabozantinib (XL184) at 60 mg/Day Compared to a 140 mg/Day in Progressive, Metastatic Medullary Thyroid Cancer Patients
Study Start Date : December 2014
Estimated Primary Completion Date : May 2020
Estimated Study Completion Date : October 2020

Arm Intervention/treatment
Experimental: Cabozantinib (XL184) 140 mg
Cabozantinib (XL184) 140 mg as capsules and placebo tablets administered orally once a day.
Drug: Cabozantinib (XL184) 140 mg
Drug: Placebo tablet
Experimental: Cabozantinib (XL184) 60 mg
Cabozantinib (XL184) 60 mg as tablets and placebo capsules administered orally once a day.
Drug: Cabozantinib (XL184) 60 mg
Drug: Placebo capsule

Primary Outcome Measures :
  1. Progression Free Survival [ Time Frame: Up to 31 months ]
    PFS is measured from randomization until the date of first documented disease progression or date of death from any cause, whichever comes first. Assessed for up to 31 months.

Secondary Outcome Measures :
  1. Objective Response Rate [ Time Frame: Up to 31 months ]
    ORR is the proportion of subjects with measurable disease at baseline and who experience a best overall response of complete response (CR) or partial response (PR) which is confirmed ≥ 28 days later. Assessed for up to 31 months.

Other Outcome Measures:
  1. Safety and tolerability of cabozantinib as assessed by adverse events. [ Time Frame: Up to 31 months ]
    Adverse events are measured from informed consent and at least through 30 days after the date of a decision to discontinue study treatment. Assessed for up to 31 months.

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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

Inclusion Criteria:

  1. The subject has a histologically confirmed diagnosis of MTC.
  2. All subjects will need to be tested for RET mutational status. If subjects do not have documentation confirming they have a RET mutation, a sample of their tumor (taken either during screening or from a procedure within 6 months prior to randomization) will need to be tested.
  3. The subject has measurable disease per RECIST 1.1 that is metastatic as determined by the investigator based upon computerized tomography (CT), magnetic resonance imaging (MRI), PET scan, bone scan, or X-ray taken within 28 days before randomization.
  4. The subject has documented worsening of disease (progressive disease) at screening as compared with a previous CT, PETor MRI scan, bone scan, or X-ray as determined by the investigator per RECIST 1.1 on qualifying screening images taken within 28 days prior to randomization as compared to previous images taken within 14 months before the qualifying screening images.
  5. The subject has recovered to baseline or CTCAE v4.0 (Common Terminology Criteria for Adverse Events, version 4.0) ≤ Grade 1 from toxicities related to any prior treatments, unless AE(s) are clinically non-significant and/or stable on supportive therapy.
  6. The subject has an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1 at screening.
  7. The subject has adequate organ and marrow function
  8. The subject is capable of understanding and complying with the protocol requirements and has signed the informed consent document.
  9. Sexually active fertile subjects and their partners must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study treatment.

Exclusion Criteria:

  1. The subject has previously received cabozantinib.
  2. Receipt of any type of small molecule kinase inhibitor or hormonal therapy within 28 days or 5 half-lives of the compound or active metabolites, whichever is shorter, before randomization.
  3. Receipt of any systemic anti-tumor therapy within 28 days of randomization (42 days for nitrosoureas or/ mitomycin C).
  4. Receipt of any other type of investigational agent within 28 days of randomization.
  5. Receipt of radiation therapy within 28 days (14 days for radiation for bone metastases) of randomization or radionuclide treatment within 42 days of randomization. Subject is ineligible if there are any clinically relevant ongoing complications from prior radiation therapy.
  6. The subject has untreated and/or active (progressing or requiring anticonvulsants or corticosteroids for symptomatic control) central nervous system (CNS) metastasis. Must have completed radiation therapy ≥ 28 days prior to randomization and be stable without corticosteroids or anti-convulsant treatment for ≥ 10 days.
  7. Treatment at therapeutic doses with oral anticoagulants or platelet inhibitors (examples are warfarin and clopidogrel).
  8. The subject has uncontrolled, significant intercurrent illness including, but not limited to, cardiovascular disorders, gastrointestinal disorders, active infections, non-healing wounds, recent surgery.
  9. Corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms within 28 days before randomization.
  10. The subject is unable to swallow multiple tablets or capsules.
  11. The subject has a previously identified allergy or hypersensitivity to components of the study treatment formulation.
  12. The subject is pregnant or breastfeeding.
  13. The subject has had a diagnosis of another malignancy within 2 years before randomization, except for superficial skin cancers, or localized, low-grade tumors deemed cured and not treated with systemic therapy.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01896479

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Contact: Exelixis Clinical Trials 1-888-EXELIXIS (888-393-5494)
Contact: Backup or International 650-837-7400

Hide Hide 52 study locations
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Australia, New South Wales
St. Leonards, New South Wales, Australia, 2065
Contact: Bruce Robinson    +61 2 9926 7267   
Australia, Queensland
Herston, Queensland, Australia, 4006
Contact: Annette Cubbitt    '+61 7 3636 7712   
Australia, South Australia
Kurralta Park, South Australia, Australia, 5037
Contact: Francis Parnis, MD    61 8 8292 2220   
Australia, Victoria
Heidelberg, Victoria, Australia, 3084
Contact: Hui Gan    +61 3 9496 3088   
Parkville, Victoria, Australia, 3050
Contact: Jeanne Tie    61 3 9345 2707   
Canada, Quebec
Active, not recruiting
Québec, Quebec, Canada, JIH 5N4
Québec, Canada, JIH 5N4
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Toronto, Canada, M5G 2M9
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Active, not recruiting
Osijek, Croatia, 31000
Active, not recruiting
Zagreb, Croatia, 10000
Active, not recruiting
Zagreb, Croatia, 1000
Bordeaux, Gironde, France, 33076
Contact: Yann Godbert    +33 5 56 33 33 21   
Angers, Maine-et-Loire, France, 49933
Contact: Patrice Rodien    +33 2 41 35 42 63   
Lyon, Rhône, France, 69373
Contact: Christelle De La Fouchardière    +33 4 78 78 51 36   
Villejuif, Val-de-Marne, France, 94805
Contact: Martin Schlumberger    +33 1 42 11 60 95   
Active, not recruiting
Dijon, France, 21079
Active, not recruiting
Paris, France, 75013
Active, not recruiting
Strasbourg Cedex, France, 67065
Budapest, Hungary, 1088
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Debrecen, Hungary, 4032
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Jerusalem, Israel, 91120
Contact: David Gross    972- 2-6777648   
Petach Tikva, Israel, 49100
Contact: Aron Popovtzer    972-3-9378055   
Safed, Israel, 13100
Contact: Jamal Zidan    972-4-6828951 ext 550   
Catania, CT, Italy, 95124
Contact: Gabriella Pellegriti    390957598813   
Roma, RM, Italy, 00161
Contact: Cosimo Durante    3906499789390   
Sienna, SI, Italy, 53100
Contact: Maria Graza Czxgzbnz    390577233382   
Pisa, Toscana, Italy, 56124
Contact: Rosella Elisei    +39050995120   
Milano, Italy, 20133
Contact: Laura Locati    +390223902150   
Padua, Italy, 35138
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Torino, Italy, 10153
Contact: Messuti Ilaria    390118151339   
Korea, Republic of
Active, not recruiting
Goyang, Gyeonggido, Korea, Republic of, 410769
Active, not recruiting
Seoul, Korea, Republic of, 110744
Active, not recruiting
Seoul, Korea, Republic of, 135-710
Amsterdam, Noord Holland, Netherlands, 1066 CX
Contact: Jan Paul de Boer    ' +31 (0) 20 512 9111   
Principal Investigator: Investigator         
Leiden, Zuid-Holland, Netherlands, 2333 ZA
Contact: Helena Kapiteijn    +31 715263486   
Active, not recruiting
Groningen, Netherlands, 9713 GZ
Gliwice, Slaskie, Poland, 44-100
Contact: Barbara Jarzab    +48322789301   
Active, not recruiting
Poznań, Wielkopolskie, Poland, 60-355
Bucharest, Romania, 10825
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Bucharest, Romania, 11863
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Not yet recruiting
Cluj-Napoca, Romania, 400058
Contact: Contact    1-888-EXELIXIS (888-393-5494)      
Principal Investigator: Investigator         
Active, not recruiting
Cluj-Napoca, Romania
Active, not recruiting
Timisoara, Romania, 300723
Russian Federation
Novosibirsk, Russian Federation, 630068
Contact: Pavel Taranov    +79133851090   
Obninsk, Russian Federation, 249036
Contact: Pavel Isavev    79038174194   
St. Petersburg, Russian Federation, 197089
Contact: Andrey Akopov    +79219393723   
Yaroslavl, Russian Federation, 150040
Contact: Mikhail Klochikhin    +79036466903   
Barcelona, Spain, 08035
Contact: Jaume Capdevila    +34932746085   
Madrid, Spain, 28034
Contact: Pablo Gajate borau    +34913368263   
Madrid, Spain, 28046
Contact: Cristina Álvarez-Escola    +34646824708   
Lund, Skane Ian, Sweden, SE-22185
Contact: Iréne Schönström    4646178559   
Uppsala, Uppsala Ian, Sweden, 75185
Contact: Barbro Eriksson    46186112716   
Sponsors and Collaborators
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Responsible Party: Exelixis Identifier: NCT01896479    
Other Study ID Numbers: XL184-401
First Posted: July 11, 2013    Key Record Dates
Last Update Posted: December 6, 2018
Last Verified: December 2018
Keywords provided by Exelixis:
thyroid cancer
medullary thyroid cancer
Additional relevant MeSH terms:
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Thyroid Neoplasms
Carcinoma, Neuroendocrine
Thyroid Diseases
Endocrine System Diseases
Endocrine Gland Neoplasms
Neoplasms by Site
Head and Neck Neoplasms
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue