Clinical trial to evaluate the efficacy and safety of sorafenib followed by pazopanib compared to the treatment setting pazopanib followed by sorafenib in the treatment of advanced /metastatic renal cancer
- Conditions
- Advanced / metastatic renal cell carcinomaMedDRA version: 19.0Level: PTClassification code 10038410Term: Renal cell carcinoma recurrentSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)MedDRA version: 19.0Level: PTClassification code 10050513Term: Metastatic renal cell carcinomaSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2011-004396-36-AT
- Lead Sponsor
- Fakultät für Medizin der Technischen Universität München
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 377
1. Patients with metastatic / advanced RCC (all histologies), who are not suitable for cytokine therapy and for whom study medication constitutes first-line treatment. For cytokine-unsuitability at least one of the following criteria must be fulfilled*:
- Age 66 to 88 years
- Non-clear cell histology RCC
- Intermediate risk according to MSKCC score
- ECOG = 1 and> 1 organ metastasis + < 24 months between diagnosis and establishing indication for interleukin-2-therapy
- ECOG = 1 and „unable to carry on normal activity or do active work (Karnofsky Index 70%)
- Creatinine = 1x ULN and < 2x ULN
- Total bilirubin = 1x ULN and < 1.5x ULN
- Present autoimmune disease
- Patients who might require steroids
- Hypersensitivity against cytokines
- Severe organic disease, not interfering with other in-/exclusion criteria of the Switch-2 study
- Non-symptomatic brain metastases
- Severe lung disease (e.g. PAH, COPD) with Pa O2 < 60 mmHg on rest
2. Age = 18 and = 85 years
3. Karnofsky Index = 70% (see appendix 15.1 Performance Status (ECOG, Karnofsky)”)
4. MSKCC prognostic score (2004), low or intermediate (see appendix 15.2 Motzer Scoring”)
5. Life expectancy of at least 12 weeks
6. Subjects with at least one uni-dimensional (for RECIST 1.1, see appendix 15.3m RECIST 1.1) measurable lesion. Lesions must be measured by CT/MRI-scan
7. Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to start of therapy:
- Hemoglobin > 9.0 g/dl
- Absolute neutrophil count (ANC) >1,500/µl
- Platelet count 100,000/µl
- Total bilirubin < 1.5x the upper limit of normal (Note: Subjects with Gilbert’s Syndrome are eligible if their total bilirubin is <3.0 X ULN and direct bilirubin is = 35%.)
- ALAT and ASAT < 2.5x upper limit of normal (Note: concomitant elevations in bilirubin and ASAT/ALAT above 1.0x upper limit of normal are not permitted).
- Alkaline phosphatase < 4x upper limit of normal
- PT-INR/aPTT < 1.2x upper limit of normal [Patients who are being therapeutically anticoagulated with an agent such as coumadin or heparin will be allowed to participate provided that their INR is stable and within the recommended range for the desired level of anticoagulation and no prior evidence of underlying abnormality in these parameters exists.]
- Serum creatinine < 2 x upper limit of normal
8. Written Informed Consent
*Based on references: - Kirchner H., H. Heinzer, J. Roigas und F. Overkamp: Differentialtherapie beim metastasierenden Nierenzellkarzinom. Der Onkologe 2008; 14: 191-197;
- SmPC of interleukin-2
- SmPC of interferon alfa -2a
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 377
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 377
Excluded medical conditions:
1. History of cardiac disease: congestive heart failure >NYHA class 2 or with LVEF at baseline echocardiography < 50% (echocardiography is optional); active CAD (MI more than 6 months prior to study entry is allowed); cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted)
2. Uncontrolled hypertension (defined as blood pressure = 150 mmHg systolic and/or = 90 mmHg diastolic on medication). 3. History of HIV infection or chronic hepatitis B or C
4. Active clinically serious infections (> grade 2 NCI-CTC version 4.03)
5. Symptomatic metastatic brain or meningeal tumors (unless the patient is > 6 months from definitive therapy, has a negative imaging study within 4 weeks of study entry and is clinically stable with respect to the tumor at the time of study entry)
6. Patients with seizure disorder requiring medication (such as steroids or antiepileptics)
7. Patients with evidence or history of bleeding diathesis
8. History of organ allograft
9. Major surgery within 4 weeks of start of study
10. Autologous bone marrow transplant or stem cell rescue within 4 months before study start.
11. Any significant condition that increases the risk for bleeding, including, but not limited to active peptic ulcer disease, inflammatory bowel disease, known intraluminal or endobronchial metastatic lesions and/or lesions infiltrating major pulmonary vessels with risk of bleeding, presence of non-healing wound or trauma within 4 weeks prior to first dose of investigational drug
12. History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep vein thrombosis (DVT) within the past 6 months (Note: Subjects with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible)
13. Corrected QT Interval (QTc) > 480 msecs
14. Untreated hypothyroidism
15. Patients undergoing renal dialysis
16. Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this studyn EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors [Ta, Tis & T1] or any cancer curatively treated > 3 years prior to study entry
17. Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate barrier birth control measures (with a Pearl Index < 1) during the course of the trial and 3 months after the completion of trial. 18. Substance abuse, medical, psychological or social conditions that may interfere with the patient’s participation in the study or evaluation of the study results
19. Any condition that is unstable or could jeopardize the safety of the patient and their compliance in the study
20. Patients unable to swallow oral medications
21. Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product
22. Known allergy to Votrient® or Nexavar®(i.e. to active substance or one of the constituents)
23. Prior exposure to study drugs.
24. Investigational drug therapy within 4 weeks of study entry.
25. Use of biologic response modifiers, such as G-CSF and other hematopoietic growth factors, within 3 weeks of study entry
26. Radiotherapy within 3 weeks of start of study drug and planned radiotherapy during the study
27. Concomi
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method