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Sorafenib and Interferon Alfa in Treating Patients With Locally Advanced or Metastatic Kidney Cancer

Phase 2
Terminated
Conditions
Clear Cell Renal Cell Carcinoma
Papillary Renal Cell Carcinoma
Recurrent Renal Cell Cancer
Stage III Renal Cell Cancer
Stage IV Renal Cell Cancer
Interventions
Biological: recombinant interferon alfa
Other: laboratory biomarker analysis
Registration Number
NCT00098618
Lead Sponsor
National Cancer Institute (NCI)
Brief Summary

Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for their growth or by blocking blood flow to the tumor. Interferon alfa may interfere with the growth of tumor cells and slow the growth of kidney cancer. Sorafenib may help interferon alfa kill more tumor cells by making tumor cells more sensitive to the drug. Giving sorafenib together with interferon alfa may kill more tumor cells. This phase II trial is studying how well giving sorafenib with interferon alfa works in treating patients with locally advanced or metastatic kidney cancer.

Detailed Description

PRIMARY OBJECTIVES:

I. Determine the feasibility and tolerability of sorafenib and interferon alfa in patients with locally advanced or metastatic renal cell carcinoma.

II. Determine the response rate (complete response and partial response) in patients treated with this regimen.

SECONDARY OBJECTIVES:

I. Determine the progression-free survival and response duration of patients treated with this regimen.

II. Correlate changes in laboratory parameters with response in patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients receive oral sorafenib twice daily and interferon alfa subcutaneously three times a week for 8 weeks. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity.

Patients with stable or responding disease are followed every 3 months for 2 years, every 6 months for 2 years, and then annually for 1 year or until disease progression.

PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study within 10 months.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Histologically or cytologically confirmed renal cell carcinoma

    • Locally advanced or metastatic disease
    • All histologic subtypes allowed
  • Measurable disease

    • At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
  • No known brain metastases or leptomeningeal disease

  • Performance status - ECOG 0-2

  • WBC ≥ 3,000/mm^3

  • Absolute neutrophil count ≥ 1,500/mm^3

  • Platelet count ≥ 100,000/mm^3

  • No bleeding diathesis

  • Bilirubin normal

  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)

  • Creatinine ≤ 1.5 times ULN

  • Creatinine clearance ≥ 60 mL/min

  • No uncontrolled hypertension

  • No symptomatic congestive heart failure

  • No unstable angina pectoris

  • No cardiac arrhythmia

  • Not pregnant or nursing

  • Negative pregnancy test

  • Fertile patients must use effective contraception

  • No history of sensitivity to E. coli-derived products

  • No history of severe depression

  • No active infection requiring antibiotics

  • No seizure disorder requiring antiepileptic medication

  • No medical condition likely to require systemic corticosteroids

  • No autoimmune disorder that could result in life-threatening complications

  • No other uncontrolled illness

  • No psychiatric illness or social situation that would preclude study compliance

  • No more than 1 prior biologic response modifier regimen

  • At least 4 weeks since prior biologic response modifiers

  • No prior interferon alfa

  • No prior chemotherapy

  • At least 4 weeks since prior radiotherapy to non-index lesions

    • Prior radiotherapy to index lesion allowed provided irradiated lesion progressed ≥ 20% in diameter
  • At least 2 weeks since prior major surgery

  • No concurrent combination antiretroviral therapy for HIV-positive patients

  • No concurrent therapeutic anticoagulation therapy

    • Concurrent prophylactic anticoagulation, such as low-dose warfarin, for venous or arterial access device allowed provided PT, PTT, and INR are normal
  • No other concurrent investigational agents

  • No other concurrent anticancer therapy

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment (sorafenib tosylate and recombinant interferon alfa)sorafenib tosylatePatients receive oral sorafenib twice daily and interferon alfa subcutaneously three times a week for 8 weeks. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity
Treatment (sorafenib tosylate and recombinant interferon alfa)recombinant interferon alfaPatients receive oral sorafenib twice daily and interferon alfa subcutaneously three times a week for 8 weeks. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity
Treatment (sorafenib tosylate and recombinant interferon alfa)laboratory biomarker analysisPatients receive oral sorafenib twice daily and interferon alfa subcutaneously three times a week for 8 weeks. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity
Primary Outcome Measures
NameTimeMethod
Overall response rate (CR+PR) using RECIST criteriaUp to 5 years

CR+PR rate will be calculated with exact 90% confidence intervals.

Grade 3+ toxicities assessed using NCI CTCAE version 3.0Up to 5 years

Toxicities will be tabulated by type and grade. Toxicity rates will be calculated with exact 90% confidence intervals.

Progression-free survivalUp to 5 years

Kaplan-Meier curves will be used.

Overall survivalUp to 5 years

Kaplan-Meier curves will be used.

Duration of responseFrom the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented , assessed up to 5 years

Kaplan-Meier curves will be used.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

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