MedPath

Nivolumab Combined With Ipilimumab Versus Sunitinib in Previously Untreated Advanced or Metastatic Renal Cell Carcinoma (CheckMate 214)

Phase 3
Active, not recruiting
Conditions
Advanced Renal Cell Carcinoma
Metastatic Renal Cell Carcinoma
Interventions
Biological: Nivolumab
Biological: Ipilimumab
Registration Number
NCT02231749
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The purpose of this study is to compare the objective response rate, progression free survival and the overall survival of Nivolumab combined with Ipilimumab to Sunitinib monotherapy in patients with previously untreated Renal Cell Cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
1390
Inclusion Criteria
  • Histological confirmation of renal cell carcinoma (RCC) with a clear-cell component

  • Advanced (not amenable to curative surgery or radiation therapy) or metastatic (AJCC Stage IV) RCC

  • No prior systemic therapy for RCC with the following exception:

    1. One prior adjuvant or neoadjuvant therapy for completely resectable RCC if such therapy did not include an agent that targets vascular endothelial growth factor (VEGF) or VEGF receptors and if recurrence occurred at least 6 months after the last dose of adjuvant or neoadjuvant therapy

      • Karnofsky Performance Status (KPS) of at least 70%
      • Measurable disease as per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
      • Tumor tissue [formalin-fixed paraffin-embedded (FFPE) archival or recent acquisition] must be received by the central vendor (block or unstained slides) in order to randomize a subject to study treatment. (Note: Fine Needle Aspiration [FNA] and bone metastases samples are not acceptable for submission)
Exclusion Criteria
  • Any history of or current central nervous system (CNS) metastases. Baseline imaging of the brain is required within 28 days prior to randomization
  • Prior systemic treatment with VEGF or VEGF receptor targeted therapy (including, but not limited to, Sunitinib, Pazopanib, Axitinib, Tivozanib, and Bevacizumab)
  • Prior treatment with an anti-programmed death (PD)-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways
  • Any active or recent history of a known or suspected autoimmune disease or recent history of a syndrome that required systemic corticosteroids (>10 mg daily Prednisone equivalent) or immunosuppressive medications except for syndromes which would not be expected to recur in the absence of an external trigger. Subjects with vitiligo or type I diabetes mellitus or residual hypothyroidism due to autoimmune thyroiditis only requiring hormone replacement are permitted to enroll
  • Any condition requiring systemic treatment with corticosteroids (>10 mg daily Prednisone equivalents) or other immunosuppressive medications within 14 days prior to first dose of study drug. Inhaled steroids and adrenal replacement steroid doses >10 mg daily Prednisone equivalents are permitted in the absence of active autoimmune disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm A: Nivolumab 3 mg/kg + Ipilimumab 1 mg/kgNivolumabNivolumab 3 mg/kg combined with Ipilimumab 1 mg/kg solutions intravenously every 3 weeks for 4 doses then Nivolumab 3 mg/kg solutions intravenously every 2 weeks until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm B: Sunitinib 50 mgIpilimumabSunitinib 50 mg capsules by mouth once daily for 4 weeks then 2 weeks off, continuously until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends After completion of final analysis eligible participants may switch from receiving Sunitinib to receiving Nivolumab 3 mg/kg IV combined with Ipilimumab 1 mg/kg IV every 3 weeks for 4 doses then Nivolumab 240mg flat dose IV every 2 weeks
Arm A: Nivolumab 3 mg/kg + Ipilimumab 1 mg/kgIpilimumabNivolumab 3 mg/kg combined with Ipilimumab 1 mg/kg solutions intravenously every 3 weeks for 4 doses then Nivolumab 3 mg/kg solutions intravenously every 2 weeks until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm B: Sunitinib 50 mgNivolumabSunitinib 50 mg capsules by mouth once daily for 4 weeks then 2 weeks off, continuously until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends After completion of final analysis eligible participants may switch from receiving Sunitinib to receiving Nivolumab 3 mg/kg IV combined with Ipilimumab 1 mg/kg IV every 3 weeks for 4 doses then Nivolumab 240mg flat dose IV every 2 weeks
Arm B: Sunitinib 50 mgSunitinibSunitinib 50 mg capsules by mouth once daily for 4 weeks then 2 weeks off, continuously until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends After completion of final analysis eligible participants may switch from receiving Sunitinib to receiving Nivolumab 3 mg/kg IV combined with Ipilimumab 1 mg/kg IV every 3 weeks for 4 doses then Nivolumab 240mg flat dose IV every 2 weeks
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) in Intermediate/Poor-Risk Participants With Previously Untreated Metastatic Renal Cell Carcinoma (mRCC)From date of first dose to date of documented disease progression or death due to any cause, whichever occurs first (assessed up to June 2017, approximately 31 months)

PFS was defined as the time between the date of randomization and the first date of documented progression, as determined by the IRRC (as per RECIST 1.1 criteria), or death due to any cause, whichever occurred first. Subsequent therapy included anticancer therapy, tumor directed radiotherapy, or tumor directed surgery. Subjects who died without a reported progression were considered to have progressed on the date of their death.

Investigator-assessed Objective Response Rate(ORR) in Intermediate/Poor Risk Participants Per IRRC Using RECIST v1.1From first dose until date of documented disease progression or subsequent therapy, whichever occurs first (assessed up to June 2017, approximately 31 months)

ORR was defined as the proportion of randomized subjects who achieved a best response of complete response (CR) or partial response (PR) using the RECIST v1.1 criteria based on IRRC assessment. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), greater than or equal to 30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Overall Survival (OS) in Intermediate/Poor-Risk Participants With Previously Untreated Metastatic Renal Cell Carcinoma (mRCC)From the date of randomization to the date of death (assessed up to June 2017, approximately 31 months)

OS was defined as the time from randomization to the date of death from any cause. Survival time was censored at the date of last contact ("last known alive date") for subjects who were alive.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS) in Any Risk Participants With Previously Untreated Metastatic Renal Cell Carcinoma (mRCC)From the date of randomization to the date of death (assessed up to June 2017, approximately 31 months)

Overall survival is defined as the time from randomization to the date of death from any cause. For subjects that are alive, their survival time will be censored at the date of last contact ("last known alive date"). Overall survival will be censored for subjects at the date of randomization if they were randomized but had no follow-up. Survival follow-up will be conducted every 3 months after subject's off-treatment date.

Progression-Free Survival (PFS) in Any Risk Participants With Previously Untreated Metastatic Renal Cell Carcinoma (mRCC)From date of first dose to date of documented disease progression or death due to any cause, whichever occurs first (assessed up to June 2017, approximately 31 months)

PFS was defined as the time between the date of randomization and the first date of documented progression, as determined by the IRRC (as per RECIST 1.1 criteria), or death due to any cause, whichever occurred first. Subsequent therapy included anticancer therapy, tumor directed radiotherapy, or tumor directed surgery. Subjects who died without a reported progression were considered to have progressed on the date of their death.

Investigator-assessed Objective Response Rate(ORR) in Any Risk Participants Per IRRC Using RECIST v1.1From first dose until date of documented disease progression or subsequent therapy, whichever occurs first (assessed up to June 2017, approximately 31 months)

ORR was defined as the proportion of randomized subjects who achieved a best response of complete response (CR) or partial response (PR) using the RECIST v1.1 criteria based on IRRC assessment. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), greater than or equal to 30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Trial Locations

Locations (189)

Local Institution - 0120

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Haifa, Israel

Local Institution - 0057

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La Jolla, California, United States

Local Institution - 0067

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Stanford, California, United States

Local Institution - 0042

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Iowa City, Iowa, United States

Local Institution - 0054

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Allentown, Pennsylvania, United States

Local Institution - 0097

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Caba, Argentina

Local Institution - 0138

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New Haven, Connecticut, United States

Local Institution - 0035

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Los Angeles, California, United States

Local Institution - 0005

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Philadelphia, Pennsylvania, United States

Local Institution - 0001

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New York, New York, United States

Local Institution - 0036

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Buffalo, New York, United States

Local Institution - 0008

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Charlotte, North Carolina, United States

Local Institution - 0163

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Fairway, Kansas, United States

Local Institution - 0048

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Baltimore, Maryland, United States

Local Institution - 0004

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Baltimore, Maryland, United States

Local Institution - 0006

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Duarte, California, United States

Local Institution - 0034

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Washington, District of Columbia, United States

Local Institution - 0056

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Dallas, Texas, United States

Local Institution - 0099

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Berazategui, Buenos Aires, Argentina

Local Institution - 0075

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Southport, Queensland, Australia

Local Institution - 0152

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Belo Horizonte, Minas Gerais, Brazil

Local Institution - 0161

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Boston, Massachusetts, United States

Local Institution - 0170

🇫🇷

Besançon, France

Local Institution - 0159

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Chattanooga, Tennessee, United States

Local Institution - 0172

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Toronto, Ontario, Canada

Local Institution - 0151

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Porto Alegre, Rio Grande Do Sul, Brazil

Local Institution - 0007

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Cleveland, Ohio, United States

Local Institution - 0156

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Sao Paulo, Brazil

Local Institution - 0053

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Brno, Czechia

Local Institution - 0070

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Westmead, New South Wales, Australia

Local Institution - 0157

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Rio de Janeiro, Brazil

Local Institution - 0123

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Heidelberg, Germany

Local Institution - 0148

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Toronto, Ontario, Canada

Local Institution - 0109

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Wien, Austria

Local Institution - 0062

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Bordeaux, France

Local Institution - 0169

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La Roche-Sur-Yon Cedex 9, France

Local Institution - 0065

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Strasbourg, France

Local Institution - 0058

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Villejuif, France

Local Institution - 0073

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Kogarah, New South Wales, Australia

Local Institution - 0052

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Olomouc, Czechia

Local Institution - 0060

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Marseille Cedex 9, France

Local Institution - 0108

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Linz, Austria

Local Institution - 0076

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Herston, Queensland, Australia

Local Institution - 0071

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Clayton, Victoria, Australia

Local Institution - 0050

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Liberec, Liberecký Kraj, Czechia

Local Institution - 0125

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Aachen, Germany

Local Institution - 0143

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Magdeburg, Germany

Local Institution - 0074

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Murdoch, Australia

Local Institution - 0147

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Hamburg, Germany

Local Institution - 0059

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Toulouse Cedex 9, France

Local Institution - 0051

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Hradec Kralove, Czechia

Local Institution - 0142

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Hannover, Germany

Local Institution - 0127

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Homburg, Germany

Local Institution - 0126

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Erlangen, Germany

Local Institution - 0130

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Ulm, Germany

Local Institution - 0015

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Wilton, Cork, Ireland

Local Institution - 0088

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Barcelona, Spain

Local Institution - 0141

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Frankfurt, Germany

Local Institution - 0146

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Muenster, Germany

Local Institution - 0129

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Jena, Germany

Local Institution - 0086

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Madrid, Spain

Local Institution - 0206

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Kobe, Hyogo, Japan

Local Institution - 0175

🇲🇽

Queretaro, Querétaro, Mexico

Local Institution - 0089

🇪🇸

Barcelona, Spain

Local Institution - 0090

🇪🇸

Sevilla, Spain

Local Institution - 0111

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Oviedo, Spain

Local Institution - 0012

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Swansea, United Kingdom

Local Institution - 0085

🇪🇸

Madrid, Spain

Local Institution - 0087

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Madrid, Spain

Local Institution - 0134

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Solna, Sweden

Local Institution - 0009

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Glasgow, Lanarkshire, United Kingdom

Local Institution - 0021

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Manchester, United Kingdom

Local Institution - 0077

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London, United Kingdom

Local Institution - 0176

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Seoul, Korea, Republic of

Local Institution - 0135

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Boston, Massachusetts, United States

Local Institution - 0041

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Seattle, Washington, United States

Local Institution - 0044

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Los Angeles, California, United States

Local Institution - 0068

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Atlanta, Georgia, United States

Local Institution - 0038

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Indianapolis, Indiana, United States

Local Institution - 0164

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Columbus, Ohio, United States

Local Institution - 0031

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Pittsburgh, Pennsylvania, United States

Local Institution - 0003

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Houston, Texas, United States

Local Institution - 0032

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Dallas, Texas, United States

Local Institution - 0140

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Elizabeth Vale, South Australia, Australia

Local Institution - 0155

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Sao Paulo, Brazil

Local Institution - 0162

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Medellin, Colombia

Local Institution - 0063

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Saint Herblain, France

Local Institution - 0124

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Muenchen, Germany

Local Institution - 0184

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Gyula, Békés, Hungary

Local Institution - 0121

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Petach Tikva, Israel

Local Institution - 0187

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Chiba-shi, Chiba, Japan

Local Institution - 0183

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Sapporo-shi, Hokkaido, Japan

Local Institution - 0205

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Tsukuba-shi, Ibaraki, Japan

Local Institution - 0186

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Yokohama-shi, Kanagawa, Japan

Local Institution - 0191

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Kyoto-shi, Kyoto, Japan

Local Institution - 0194

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Tokushima-shi, Tokushima, Japan

Local Institution - 0197

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Bunkyo-ku, Tokyo, Japan

Local Institution - 0207

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Koto-ku, Tokyo, Japan

Local Institution - 0193

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Shinjuku-ku, Tokyo, Japan

Local Institution - 0178

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Seoul, Korea, Republic of

Local Institution - 0203

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Yamagata, Japan

Local Institution - 0177

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Seoul, Korea, Republic of

Local Institution - 0010

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London, Greater London, United Kingdom

Local Institution - 0150

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Porto Alegre, RIO Grande DO SUL, Brazil

Local Institution - 0061

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Paris, Île-de-France, France

Local Institution - 0018

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Dublin 7, Dublin, Ireland

Local Institution - 0104

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Nedlands, Western Australia, Australia

Local Institution - 0017

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Dublin 7, Dublin, Ireland

Local Institution - 0043

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Detroit, Michigan, United States

Local Institution - 0045

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Durham, North Carolina, United States

Local Institution - 0066

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Nashville, Tennessee, United States

Local Institution - 0136

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Aarhus N, Denmark

Local Institution - 0158

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Herlev, Denmark

Local Institution - 0137

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Odense, Denmark

Local Institution - 0022

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Arezzo, Italy

Local Institution - 0024

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Meldola (fc), Italy

Local Institution - 0023

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Milano, Italy

Local Institution - 0064

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Napoli, Italy

Local Institution - 0026

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Roma, Italy

Local Institution - 0079

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Padova, Italy

Local Institution - 0025

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Pavia, Italy

Local Institution - 0055

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Charleston, South Carolina, United States

Local Institution - 0139

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Ciudad Autonoma De Buenos Aire, Buenos Aires, Argentina

Local Institution - 0081

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Medellin, Colombia

Local Institution - 0192

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Akita-shi, Akita, Japan

Local Institution - 0204

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Okayama-shi, Okayama, Japan

Local Institution - 0029

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Amsterdam, Netherlands

Local Institution - 0040

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Groningen, Netherlands

Local Institution - 0093

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Krakow, Poland

Local Institution - 0122

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Istanbul, Turkey

Local Institution - 0149

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Calgary, Alberta, Canada

Local Institution - 0110

🇺🇸

Boston, Massachusetts, United States

Local Institution - 0095

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San Miguel De Tucuman, Tucuman, Argentina

Local Institution - 0096

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San Miguel de Tucuman, Tucuman, Argentina

Local Institution - 0020

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Gent, Belgium

Local Institution - 0072

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Box Hill, Victoria, Australia

Local Institution - 0173

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Boston, Massachusetts, United States

Local Institution - 0019

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Leuven, Belgium

Local Institution - 0080

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Bogota, Colombia

Local Institution - 0016

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Dublin, Ireland

Local Institution - 0182

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Kelowna, British Columbia, Canada

Local Institution - 0100

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Cordoba, Argentina

Local Institution - 0101

🇨🇱

Santiago, Metropolitana, Chile

Local Institution - 0103

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Vina del Mar, Chile

Local Institution - 0084

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Pecs, Hungary

Local Institution - 0196

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Fukuoka-shi, Fukuoka, Japan

Local Institution - 0133

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Edmonton, Alberta, Canada

Local Institution - 0098

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Capital Federal, Buenos Aires, Argentina

Local Institution - 0027

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Helsinki, Uusimaa, Finland

Local Institution - 0107

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Wels, Austria

Local Institution - 0102

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Santiago, Metropolitana, Chile

Local Institution - 0144

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Santiago, Metropolitana, Chile

Local Institution - 0028

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Tampere, Finland

Local Institution - 0117

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Kfar Saba, Israel

Local Institution - 0119

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Zerifin, Israel

Local Institution - 0132

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Montreal, Quebec, Canada

Local Institution - 0131

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Moncton, New Brunswick, Canada

Local Institution - 0082

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Debrecen, Hungary

Local Institution - 0118

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Ramat-gan, Israel

Local Institution - 0190

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Osaka-sayama, Osaka, Japan

Local Institution - 0201

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Suita-shi, Osaka, Japan

Local Institution - 0195

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Bunkyo-ku, Tokyo, Japan

Local Institution - 0198

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Tokyo, Japan

Local Institution - 0167

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Oaxaca, Mexico

Local Institution - 0114

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Antalya, Turkey

Local Institution - 0153

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Sao Paulo, São Paulo, Brazil

Local Institution - 0083

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Budapest, Hungary

Local Institution - 0180

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Taipei, Taiwan

Local Institution - 0209

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Hirosaki-shi, Aomori, Japan

Local Institution - 0200

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Morioka-shi, Iwate, Japan

Local Institution - 0189

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Kumamoto-shi, Kumamoto, Japan

Local Institution - 0199

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Niigata-shi, Niigata, Japan

Local Institution - 0168

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Mexico D.f., Distrito Federal, Mexico

Local Institution - 0030

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Nijmegen, Netherlands

Local Institution - 0106

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Wroclaw, Poland

Local Institution - 0188

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Sapporo-shi, Hokai-do, Japan

Local Institution - 0208

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Hamamatsu-shi, Shizuoka, Japan

Local Institution - 0202

🇯🇵

Bunkyo-ku, Tokyo, Japan

Local Institution - 0115

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Ankara, Turkey

Local Institution - 0185

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Shinjuku-Ku, Tokyo, Japan

Local Institution - 0171

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Monterrey, Nuevo Leon, Mexico

Local Institution - 0112

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Poznan, Poland

Local Institution - 0181

🇨🇳

Taoyuan, Taiwan

Local Institution - 0179

🇨🇳

Taipei, Taiwan

Local Institution - 0011

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Northwood, United Kingdom

Local Institution - 0049

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Tampa, Florida, United States

Local Institution - 0046

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Ann Arbor, Michigan, United States

Local Institution - 0039

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Portland, Oregon, United States

Local Institution - 0128

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Vancouver, British Columbia, Canada

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