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A Study of Belzutifan (MK-6482) in Participants With Advanced Renal Cell Carcinoma (MK-6482-013)

Phase 2
Active, not recruiting
Conditions
Carcinoma, Renal Cell
Interventions
Registration Number
NCT04489771
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

This study will compare the efficacy and safety of two doses of belzutifan in participants with advanced renal cell carcinoma (RCC) with clear cell component after prior therapy.

The primary hypothesis is that the higher dose of belzutifan is superior to the standard dose in terms of objective response rate (ORR).

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
154
Inclusion Criteria
  • Has a histologically confirmed diagnosis of locally advanced/metastatic RCC with clear cell component
  • Has measurable disease per RECIST 1.1 as assessed by BICR
  • Can submit an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated
  • Has experienced disease progression on or after systemic treatment with an anti-programmed cell death 1 (PD-1)/Ligand 1 (L1) therapy for locally advanced or metastatic RCC. The anti-PD-1/L1 therapy may be monotherapy or in combination with other agent(s) such as anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) or vascular endothelial growth factor (VEGF) targeted- tyrosine kinase inhibitor (TKI). The immediately preceding line of treatment has to have been an anti-PD-1/L1 therapy
  • Has received no more than 3 prior systemic regimens for locally advanced or metastatic RCC
  • Has received only 1 prior anti-PD-1/L1 therapy for locally advanced or metastatic RCC
  • Has recovered from all AEs due to previous therapies to ≤Grade 1 or baseline, with the exception of ≤Grade 2 neuropathy or endocrine-related AEs ≤Grade 2 requiring treatment or hormone replacement
  • Has a Karnofsky performance status (KPS) score of at least 70% assessed within 10 days prior to the first dose of study intervention
  • A male participant is eligible to participate if he is abstinent from heterosexual intercourse or agrees to use contraception during the intervention period and for at least 7 days after the last dose of study intervention
  • A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least 1 of the following conditions applies: Not a (woman of childbearing potential) WOCBP or a WOCBP who agrees to follow the contraceptive guidance during the intervention period and for at least 30 days after the last dose of study intervention
  • A WOCBP must have a negative highly sensitive pregnancy test (urine or serum) within 24 hours before the first dose of study intervention
Exclusion Criteria
  • Has hypoxia (a pulse oximeter reading <92% at rest), requires intermittent supplemental oxygen, or requires chronic supplemental oxygen
  • Has a known additional malignancy that is progressing or has required active treatment within the past 3 years except for basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ [e.g., breast carcinoma, cervical cancer in situ] that have undergone potentially curative therapy
  • Has known central nervous system (CNS) metastases and/or carcinomatous meningitis
  • Has clinically significant cardiac disease, including unstable angina, acute myocardial infarction ≤6 months from Day 1 of study drug administration or New York Heart Association Class III or IV congestive heart failure
  • Has moderate to severe hepatic impairment (Child-Pugh B or C)
  • Has received colony-stimulating factors (eg, granulocyte colony-stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor [GM-CSF], or recombinant erythropoietin [EPO]) ≤28 days prior to the first dose of study intervention
  • Has a known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the study
  • Is unable to swallow orally administered medication or has a gastrointestinal disorder affecting absorption (eg, gastrectomy, partial bowel obstruction, malabsorption)
  • Has known hypersensitivity or allergy to the active pharmaceutical ingredient or any component of the study intervention (belzutifan) formulations
  • Has received prior treatment with belzutifan or another hypoxia-inducible factor (HIF)-2α inhibitor
  • Has received any type of small molecule kinase inhibitor (including investigational kinase inhibitor) ≤2 weeks before randomization
  • Has received any type of systemic anticancer antibody (including investigational antibody) ≤4 weeks before randomization
  • Has received prior radiotherapy ≤2 weeks prior to first dose of study intervention. Participants must have recovered from all radiation-related toxicities and not require corticosteroids
  • Has had major surgery ≤3 weeks prior to first dose of study intervention
  • Is currently receiving either strong (phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John's Wort) or moderate (eg, bosentan, efavirenz, modafinil) inducers of cytochrome P450 (CYP)3A4 that cannot be discontinued for the duration of the study
  • Is currently participating in a study of an investigational agent or is currently using an investigational device
  • Has an active infection requiring systemic therapy
  • Has active tuberculosis (TB)
  • Has a diagnosis of immunodeficiency
  • Has a known history of human immunodeficiency virus (HIV) infection
  • Has a known history of hepatitis B (HBV) or known active hepatitis C (HCV) infection
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not the best interest of the participant to participate, in the opinion of the treating investigator

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Belzutifan 200 mgBelzutifanParticipants receive 200 mg of belzutifan by oral administration, once a day (QD), until disease progression or discontinuation.
Belzutifan 120 mgBelzutifanParticipants receive 120 mg of belzutifan by oral administration, QD, until disease progression or discontinuation.
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR)Up to approximately 27 months

ORR was defined as the percentage of participants who had a complete response (CR: Disappearance of all target lesions) or a partial response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1. The percentage of participants who experienced a CR or PR as assessed by blinded independent central review based on RECIST 1.1 was presented.

Secondary Outcome Measures
NameTimeMethod
Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICRUp to approximately 27 months

For participants who demonstrated a confirmed complete response (CR: Disappearance of all target lesions) or confirmed partial response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR was defined as the time from first documented evidence of CR or PR until disease progression or death. The DOR as assessed by blinded independent central review was presented.

Clinical Benefit Rate (CBR) Per RECIST 1.1 as Assessed by BICRUp to approximately 27 months

CBR is defined as the percentage of participants who have a complete response (CR: Disappearance of all target lesions) or a partial response (PR: At least a 30% decrease in the sum of diameters of target lesions) or stable disease (SD: Neither sufficient decrease to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.) ≥6 months per RECIST 1.1. The percentage of participants with CBR will be presented.

Number of Participants Who Experience One or More Adverse Events (AEs)Up to approximately 27 months

An AE was defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experienced one or more AEs was presented.

Progression-Free Survival (PFS) According to RECIST 1.1 as Assessed by BICRUp to approximately 27 months

PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. PFS as assessed by blinded independent central review was presented.

Overall Survival (OS)Up to approximately 27 months

OS was defined as the time from randomization to death due to any cause.

Number of Participants Who Discontinue Study Treatment Due to an AEUp to approximately 26 months

An AE was defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinued study treatment due to an AE was presented.

Maximum Plasma Concentration (Cmax) of BelzutifanWeeks 1 and 3 on Day 1: predose and 1, 2, and 4 hours. Week 5 on Day 1: predose only

Blood samples were obtained at designated time points for the determination of the Cmax of belzutifan.

Trough Plasma Concentration (Ctrough) of BelzutifanWeeks 1 and 3 on Day 1: predose and 1, 2, and 4 hours. Week 5 on Day 1: predose only

Blood samples were obtained at designated time points for the determination of the Ctrough of belzutifan.

Trial Locations

Locations (48)

Georgetown University Medical Center ( Site 0002)

🇺🇸

Washington, District of Columbia, United States

Univ of Miami- Sylvester Comprehensive Cancer Center ( Site 0023)

🇺🇸

Miami, Florida, United States

Norton Cancer Institute - St. Matthews ( Site 0025)

🇺🇸

Louisville, Kentucky, United States

Weinberg Cancer Institute at Franklin Square ( Site 0007)

🇺🇸

Baltimore, Maryland, United States

Cancer Partners of Nebraska ( Site 0003)

🇺🇸

Lincoln, Nebraska, United States

Oncology Hematology West, PC dba Nebraska Cancer Specialists ( Site 0012)

🇺🇸

Omaha, Nebraska, United States

New York Oncology Hematology P.C ( Site 0028)

🇺🇸

Albany, New York, United States

Roswell Park Cancer Institute ( Site 0038)

🇺🇸

Buffalo, New York, United States

Fox Chase Cancer Center ( Site 0026)

🇺🇸

Philadelphia, Pennsylvania, United States

Sanford Cancer Center Oncology Clinic ( Site 0031)

🇺🇸

Sioux Falls, South Dakota, United States

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Georgetown University Medical Center ( Site 0002)
🇺🇸Washington, District of Columbia, United States

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