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Phase I/II Trial of Stereotactic Body Radiotherapy With Concurrent Fixed Dose Tyrosine Kinase Inhibitors in Metastatic Renal Cell Carcinoma: Dose Limiting Toxicity and Abscopal Effect.

Phase 1
Completed
Conditions
Carcinoma, Renal Cell
Interventions
Radiation: Stereotactic body radiotherapy
Registration Number
NCT02334709
Lead Sponsor
University Hospital, Ghent
Brief Summary

Tyrosine kinase inhibitors (TKIs) are often used in the standard treatment for patients with metastasized renal cell carcinoma. In addition to their ability to specifically inhibit tumor growth, TKIs also interfere with the vascularisation of the tumor. Unfortunately, most patients do not obtain long-lasting clinical benefit from this treatment. The goal of the current study is to enhance the effect of TKIs by combining them with stereotactic radiotherapy treatment of one of the metastases. This type of radiotherapy allows us to precisely irradiate the tumor with minimal effect on the surrounding healthy tissue. Recently it has been demonstrated that this type of radiotherapy stimulates the immune system to attack the tumor. By combining stereotactic radiotherapy with TKIs we expect to observe a reduction of metastases in a bigger population of patients.

In the first part of our study we focus on the safety of the combination therapy. In the second part we will evaluate the combined treatment response.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
13
Inclusion Criteria
  • signed informed consent
  • diagnosis of RCC with clear-cell component histology
  • at least 3 extracranial measurable metastatic lesions per RECIST
  • Karnofsky Performance score >60
  • patients should have undergone cytoreductive treatment of their RCC at least 6 weeks prior to inclusion
  • patients should have adequate organ function for TKI treatment.
Exclusion Criteria
  • prior systemic treatment for RCC
  • uncontrolled central nervous metastases
  • prior radiotherapy interfering with SBRT
  • any disorder precluding understanding of trial information.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
SBRT + fixed dose Tyrosine Kinase InhibitorStereotactic body radiotherapySingle arm phase I trial with 3 dose-escalation arms
Primary Outcome Measures
NameTimeMethod
Dose limiting toxicity2 years

Dose limiting toxicity will be assessed before start of TKI, before SBRT, at the end of SBRT and at each follow-up visit

Secondary Outcome Measures
NameTimeMethod
Immunomonitoring4 years

Immunomonitoring before start of TKI, before SBRT and 2 weeks after SBRT.

Response rate4 years

Response rate will be evaluated at 12 weeks following the start of TKI.

Trial Locations

Locations (1)

Dept. of Radiotherapy, Ghent University Hospital

🇧🇪

Ghent, Oost-Vlaanderen, Belgium

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