Upfront Toripalimab Plus Axitinib Combined With Deferred Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma
Overview
- Phase
- Phase 2
- Intervention
- Toripalimab
- Conditions
- Clear-cell Metastatic Renal Cell Carcinoma
- Sponsor
- RenJi Hospital
- Enrollment
- 20
- Primary Endpoint
- Pathological Major Response (MPR)
- Status
- Not yet recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Study Objective: To determine the efficacy of upfront immune checkpoint inhibitors combined with deferred cytoreductive nephrectomy in treating metastatic renal cell carcinoma.
Primary Endpoint: Pathological Major Response (MPR), defined as the percentage of residual tumor cells <10% in the primary tumor after nephrectomy.
Study Design:
Population: Participants meeting the diagnostic criteria with biopsy-proven clear cell renal cell carcinoma, IMDC score ≤3, or ≤5 metastatic lesions involving ≤3 organs.
Sample Size: 20 participants.
Patient Grouping: Non-randomized.
Interventions: Eligible participants will receive upfront treatment with a combination of Axitinib and Toripalimab for 4 cycles. After 2 cycles of treatment, radiological assessment will be conducted using RECIST 1.1 criteria. If disease progression is observed, the clinical trial will be terminated, and second-line treatment will be initiated according to guidelines. If disease progression is not observed, treatment will continue for 2 additional cycles followed by repeat radiological assessment before undergoing surgery.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Voluntary consent to participate in this study and signing of an informed consent form.
- •Male or female participants aged ≥18 years and \<80 years. Histologically diagnosed with clear cell carcinoma or predominantly clear cell renal cell carcinoma.
- •Clinical stage determined by CT or MRI: anyTN1M0 or anyTN0M1; IMDC score ≤3, or ≤5 metastatic lesions involving ≤3 organs; and the primary tumor (unilateral or bilateral) is resectable.
- •ECOG performance status: 0 or
- •No clinically significant cardiac, bone marrow, hepatic, or renal function abnormalities.
- •A willingness and ability to comply with testing and follow-up procedures.
Exclusion Criteria
- •Non-clear cell carcinoma. Severe liver or kidney dysfunction, or other severe diseases. Immune deficiency, organ transplantation, or autoimmune diseases. Severe central nervous system diseases. Other malignant tumors within the past 5 years, except for cured basal cell carcinoma of the skin and cervical carcinoma in situ.
- •Unable to comply with regular follow-up visits due to psychological, social, family, or geographical reasons.
Arms & Interventions
Experimental
Experimental arm
Intervention: Toripalimab
Experimental
Experimental arm
Intervention: Cytoreductive Nephrectomy
Experimental
Experimental arm
Intervention: Axitinib
Outcomes
Primary Outcomes
Pathological Major Response (MPR)
Time Frame: through study completion, an average of 1 year
The percentage of residual tumor cells in the primary tumor after surgery, with MPR defined as less than 10% of residual tumor cells in the pathology report.