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临床试验/NCT04987203
NCT04987203已完成3 期

TiNivo-2: A Phase 3, Randomized, Controlled, Multicenter, Open-label Study to Compare Tivozanib in Combination With Nivolumab to Tivozanib Monotherapy in Subjects With Renal Cell Carcinoma Who Have Progressed Following One or Two Lines of Therapy Where One Line Has an Immune Checkpoint Inhibitor

AVEO Pharmaceuticals, Inc.278 个研究点 分布在 6 个国家目标入组 343 人开始时间: 2021年9月9日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
状态
已完成
入组人数
343
试验地点
278
主要终点
Progression free survival

研究概览

简要总结

This study will be comparing tivozanib in combination with nivolumab to tivozanib alone in subjects with advanced Renal Cell Carcinoma (RCC) who have had 1 or 2 prior lines of therapy, one of which was an Immune Checkpoint Inhibitor (ICI).

详细描述

This will be an open-label, randomized, controlled, multicenter, multi-national, parallel-arm study. The study is designed to compare the progression free survival (PFS), overall survival (OS), Objective response rate (ORR), duration of response (DoR), and safety of tivozanib and the combination of tivozanib with nivolumab.

Approximately 326 subjects with refractory advanced RCC at approximately 190 sites will be randomized in a 1:1 ratio to treatment with tivozanib plus nivolumab (163 subjects) or tivozanib (163 subjects). Subjects will be randomly assigned to a treatment.

Subjects will receive 1.34 mg/day (monotherapy arm) or 0.89mg/day (combination arm) of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug. One cycle will be defined as 4 weeks: 3 weeks on treatment and 1 week off treatment. Subjects who receive nivolumab will be infused with 1 treatment of nivolumab at specified dose on specified days of each Cycle.

Subjects with documented stable disease or an objective response may continue to receive both tivozanib and nivolumab therapy at the same dose and schedule until progression as long as the tolerability is acceptable. Nivolumab will be discontinued in all subjects after 2 years; Tivozanib may be continued after discontinuation of nivolumab until other withdrawal criteria are met. A Safety Follow-up Visit will be performed 30 days (± 7 days) after the last dose of study drug.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 130 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Radiographic disease progression during or following at least 6 weeks of treatment with ICI for locally advanced or metastatic RCC with a clear cell component either in first- or second-line treatment.
  • Subjects must have recovered from the adverse events of prior therapy to grade ≤ 1 or baseline.
  • Histologically or cytologically confirmed RCC with a clear cell component.
  • Measurable disease per RECIST criteria Version 1.
  • Eastern Cooperative Oncology Group performance status of 0 or
  • All participants must follow protocol defined contraceptive measures.

排除标准

  • Subjects who received: a. A single agent tyrosine kinase inhibitor (TKI) in the first line setting followed by a single agent immune checkpoint inhibitor (ICI) in the second line setting; b. More than 2 prior lines of therapy in the advanced or metastatic setting.
  • History of life-threatening toxicity related to prior immune therapy.
  • Active autoimmune disease as well as those that required discontinuation of prior immuno-oncological (IO) therapy due to immune mediated AEs.
  • Uncontrolled hypertension.
  • More than 1 prior line of therapy with a checkpoint inhibitor in the metastatic setting.
  • Subjects on immune suppressive therapy for organ transplant or subjects with a history of genetic or acquired immune suppression disease such as human immunodeficiency virus (HIV) [Patients with HIV who have CD4+ T-cell counts >350 cells/µL, without a history of acquired immune deficiency syndrome (AIDS)-defining opportunistic infections, and are on established antiretroviral therapy which does not include a cytochrome P450 (CYP)3A4 inducer, for at least 4 weeks and have an HIV viral load less than 400 copies/mL, are eligible].
  • History of clinically significant interstitial lung disease or current non-infectious pneumonitis.

研究组 & 干预措施

Tivozanib in Combination with Nivolumab

Experimental

Subjects with advanced RCC will receive 0.89 mg of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug and nivolumab every 4 weeks on Day 1 of each Cycle, until disease progression or unacceptable toxicities occur, other withdrawal criteria are met, or completion of 2 years of treatment [for nivolumab] whichever occurs first.

干预措施: Tivozanib (Drug)

Tivozanib

Experimental

Subjects with advanced RCC will receive 1.34 mg of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug until disease progression or unacceptable toxicities occur, or other withdrawal criteria are met.

干预措施: Tivozanib (Drug)

Tivozanib in Combination with Nivolumab

Experimental

Subjects with advanced RCC will receive 0.89 mg of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug and nivolumab every 4 weeks on Day 1 of each Cycle, until disease progression or unacceptable toxicities occur, other withdrawal criteria are met, or completion of 2 years of treatment [for nivolumab] whichever occurs first.

干预措施: Nivolumab (Drug)

结局指标

主要结局

Progression free survival

时间窗: Until progressive disease [PD] (Approximately 30 months)

Comparison of the PFS of tivozanib in combination with nivolumab to tivozanib in subjects with RCC who have progressed following 1 or 2 lines of therapy. PFS is defined as the time from randomization to first documentation of objective tumor progression (progressive disease \[PD\], radiological) according to Response Evaluation Criteria In Solid Tumors (RECIST), or death due to any reasons whichever comes first.

次要结局

  • Number of subjects with serious and non-serious adverse events(From Screening (Day -28 to Day -1) to Follow-up visit (30 days after last dose of study drug ± 7 days))
  • Overall Survival(From Screening (Days -28 to -1) until death (Approximately 42 months))
  • Progression free survival(Until progressive disease [PD] (Approximately 30 months))
  • Duration of Response(From Screening (Days -28 to -1) until PD or death (Approximately 30 months))
  • Objective Response Rate(From Screening (Days -28 to -1) until PD (Approximately 30 months))

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (278)

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相关资讯

TiNivo-2 Trial Highlights Challenges in ICI Retreatment for Advanced RCCThe phase 3 TiNivo-2 trial reveals that combining tivozanib with nivolumab does not improve clinical outcomes over tivozanib monotherapy in advanced renal cell carcinoma patients previously treated with immune checkpoint inhibitors, underscoring the challenges of ICI rechallenge.last yearTrials Needed to Optimize Checkpoint Inhibitor Sequencing in Bladder Cancer- The optimal strategy for rechallenging patients with checkpoint inhibitors after prior use in localized bladder cancer remains unclear, necessitating further clinical trials. - Sequencing challenges persist, particularly regarding therapies following pembrolizumab plus enfortumab vedotin and the integration of erdafitinib in patients with FGFR alterations. - Emerging research highlights the importance of germline mutation testing in urothelial carcinoma, benefiting both patients and their families through cancer prevention screening. - Data from kidney cancer trials suggest limited benefit from checkpoint inhibitor rechallenge, but dedicated bladder cancer trials are needed to confirm these findings.last yearTivozanib Monotherapy Shows Superiority Over Tivozanib Plus Nivolumab in Metastatic RCC After ICI Progression- The phase 3 TiNivo-2 trial revealed that tivozanib monotherapy demonstrated superior progression-free survival (PFS) compared to the combination of tivozanib and nivolumab in metastatic renal cell carcinoma (RCC). - Median PFS was 7.4 months with tivozanib alone versus 5.7 months with the combination, indicating that immune checkpoint inhibitor (ICI) rechallenge may not be beneficial in this setting. - The study suggests that tivozanib monotherapy at 1.34 mg can be considered a second-line treatment option for patients with RCC who have progressed after prior ICI therapy. - The reduced dose of tivozanib in the combination arm (0.89 mg) may have impacted the efficacy, highlighting the importance of optimal dosing in VEGFR TKI therapy.2 years ago