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A Randomized Phase II Study to Determine the Effect of 2 Different Doses AVE0005 (VEGF Trap) in Patients With Metastatic Renal Cell Carcinoma


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Clear Cell Renal Cell Carcinoma, Recurrent Renal Cell Cancer, Stage III Renal Cell Cancer, Stage IV Renal Cell Cancer

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Trial Information

A Randomized Phase II Study to Determine the Effect of 2 Different Doses AVE0005 (VEGF Trap) in Patients With Metastatic Renal Cell Carcinoma


PRIMARY OBJECTIVES:

I. Compare the effect of two different doses of AVE0005 (vascular endothelial growth factor
[VEGF] Trap) treatment on the progression-free proportion at 8 weeks in patients with
metastatic renal cell carcinoma who had previous treatment with a tyrosine kinase inhibitor
(TKI).

SECONDARY OBJECTIVES:

I. Determine the effect of AVE0005 (VEGF Trap) treatment on objective response rate in
patients with metastatic renal cell carcinoma who have had previous TKI treatment.

II. Describe progression-free survival among patients who undergo dose escalation after
progression on low-dose AVE0005 (VEGF Trap).

III. Evaluate the safety and tolerability of AVE0005 (VEGF Trap) in patients with
metastatic renal cell carcinoma who have had previous treatment with a TKI.

IV. Determine the circulating levels of VEGF AVE0005 (VEGF-Trap) complex and correlate it
with clinical activity.

V. Evaluate the modulation of specific angiogenesis-related protein expression by AVE0005
(VEGF Trap).

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior
cytokine therapy (yes vs no) and Memorial Sloan Kettering Cancer Center (MSKCC) risk (low vs
medium vs high). Patients are randomized to 1 of 2 treatment arms.

ARM A: Patients receive a higher dose of VEGF Trap intervenously (IV) over 1 hour on day 1.

ARM B: Patients receive a lower dose of VEGF Trap IV over 1 hour on day 1.

In both arms, courses repeat every 14 days in the absence of disease progression or
unacceptable toxicity. Patients receiving treatment on arm I may crossover and receive
treatment on arm II if disease progression is evident after 4 courses of treatment.

After completion of study treatment, patients are followed every 3 months for 3 years.


Inclusion Criteria:



- Patient must have histologically confirmed metastatic or unresectable renal cell
carcinoma; disease must be conventional clear cell carcinoma or have a component of
clear cell carcinoma

- Patients with true papillary, sarcomatoid features without any clear cell component,
chromophobe, oncocytoma, collecting duct tumors and transitional cell carcinoma are
NOT eligible

- Patient must have measurable lesions according to the Response Evaluation Criteria In
Solid Tumors (RECIST) criteria; baseline measurements must be performed =< 4 weeks
prior to randomization; all sites of disease, both measurable and nonmeasurable, must
be evaluated =< 4 weeks prior to randomization

- Patient must have evidence of progressive disease following treatment with a tyrosine
kinase inhibitor (TKI) as assessed by the site investigator on the basis of computed
tomography (CT) scans and other appropriate clinical documentation

- Patient must have received at least one prior treatment with a VEGF receptor tyrosine
kinase inhibitor for at least 12 weeks; prior treatment with either temsirolimus or
everolimus is allowed; prior immunotherapy is limited to cytokine therapy with
interleukin 2 and interferon alpha only; no other prior immunotherapy is allowed; no
prior treatment with bevacizumab is allowed

- No prior cellular therapy, vaccine, hormonal or chemotherapy for renal cell carcinoma
is allowed; prior therapy for other cancers is allowable if therapy ended at least 5
years prior to enrollment

- Previous radiotherapy (RT) is permissible provided the measurable disease is outside
the RT port; RT must be completed >= 3 weeks prior to randomization

- Eastern Cooperative Oncology Group (ECOG) performance status 0-2

- Patient must have recovered from any toxic effects of prior radiotherapy or surgical
procedures within 4 weeks prior to randomization

- Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) and
serum glutamic pyruvate transaminase (SGPT)(alanine aminotransferase [ALT] =< 3 times
upper limit of normal (ULN)

- Total serum bilirubin =< 1.5 times ULN

- Absolute neutrophil count (ANC) >= 1 x 10^9/L

- Platelet count >= 100 x 10^9/L

- Hemoglobin >= 8.0 g/dL

- Serum calcium =< 12.0 mg/dL

- Calculated creatinine clearance (CrCl) >= 60 mL/min, and either proteinuria =< 500
mg/24 hours or urine protein: creatinine ratio (UPCR) =< 1

- International normalized ratio (INR) within normal limits (or =< 1.5 x ULN if on
prophylactic anticoagulation) and activated partial thromboplastin time (aPTT) within
normal limits

- Patients must not have history of metastatic central nervous system (CNS) disease

- Female patients MUST NOT be pregnant or breastfeeding; due to the unknown teratogenic
properties of AVE0005 (AVE0005 (VEGF Trap), its use in pregnant or breastfeeding
patients is INADVISABLE; for women of childbearing potential, a negative serum
pregnancy test is required within 1 week prior to randomization

- Women of childbearing potential and sexually active males must agree to use an
accepted and effective method of contraception while on this study, and for 6 months
after the completion of the study; if a woman becomes pregnant while she is on this
study or within 6 months after the last dose of protocol therapy, she must inform her
treating physician immediately; if a man impregnates a woman while he is on this
study or within 6 months after the last dose of protocol therapy, he must inform his
treating physician immediately

- Patients who have had basal cell skin cancer, squamous cell skin cancer, in situ
cervical cancer, ductal carcinoma in situ of the breast, or lobular carcinoma in situ
of the breast within the past five years are eligible only if treated with curative
intent

- Patients with other malignancies are eligible only if they have been
continuously disease-free for > 5 years prior to the time of randomization

- Patient must not have any of the following conditions within 24 weeks prior to
randomization:

- Myocardial infarction, severe/unstable angina pectoris, coronary/peripheral
artery bypass graft, New York Heart Association (NYHA) class III or IV
congestive heart failure, cerebrovascular accident or transient ischemic attack

- No prior pulmonary embolism, deep vein thrombosis, or other thromboembolic event

- Patient must not have a history of uncontrolled or labile hypertension, with or
without antihypertensive drug treatment, within 12 weeks prior to drug
administration; this is defined as blood pressure > 150/100 mm Hg or systolic blood
pressure > 180 mm Hg on at least 2 repeated determinations on separate days

- Patient must not have known active infection, evidence of bleeding or intratumoral
bleeding, or underlying bleeding disorder

- Patient must not have a known history of hypersensitivity to any Trap agents or
recombinant proteins

- Human immunodeficiency virus (HIV)-positive patients receiving combination
anti-retroviral therapy are excluded from this study because of possible
pharmacokinetic interactions with AVE0005 (VEGF Trap)

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-free survival rate as assessed by Response Evaluation Criteria in Solid Tumors (RECIST)

Outcome Description:

A two-stage design will be used within each arm.

Outcome Time Frame:

Time from randomization to the earlier of documentation of progression or death, assessed at 8 weeks

Safety Issue:

No

Principal Investigator

Roberto Pili

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00559

NCT ID:

NCT00357760

Start Date:

December 2007

Completion Date:

Related Keywords:

  • Clear Cell Renal Cell Carcinoma
  • Recurrent Renal Cell Cancer
  • Stage III Renal Cell Cancer
  • Stage IV Renal Cell Cancer
  • Carcinoma
  • Carcinoma, Renal Cell

Name

Location

Johns Hopkins University Baltimore, Maryland  21205
Fox Chase Cancer Center Philadelphia, Pennsylvania  19111
Hurley Medical Center Flint, Michigan  48503
Boulder Community Hospital Boulder, Colorado  80301-9019
Porter Adventist Hospital Denver, Colorado  80210
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
North Suburban Medical Center Thornton, Colorado  80229
Genesys Hurley Cancer Institute Flint, Michigan  48503
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Fairview Ridges Hospital Burnsville, Minnesota  55337
Hutchinson Area Health Care Hutchinson, Minnesota  55350
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Avera Cancer Institute Sioux Falls, South Dakota  57105
Methodist Medical Center of Illinois Peoria, Illinois  61636
Beth Israel Medical Center New York, New York  10003
Via Christi Regional Medical Center Wichita, Kansas  67214
Scott and White Memorial Hospital Temple, Texas  76508
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
MetroHealth Medical Center Cleveland, Ohio  44109
Sibley Memorial Hospital Washington, District of Columbia  20016
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Adena Regional Medical Center Chillicothe, Ohio  54601
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Avera McKennan Hospital and University Health Center Sioux Falls, South Dakota  57105
Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
Memorial Hospital Carthage, Illinois  62321
Galesburg Cottage Hospital Galesburg, Illinois  61401
Galesburg Clinic Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Creighton University Medical Center Omaha, Nebraska  68131-2197
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Graham Hospital Association Canton, Illinois  61520
Saint Joseph Medical Center Joliet, Illinois  60435
Pekin Hospital Pekin, Illinois  61554
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Ottumwa Regional Health Center Ottumwa, Iowa  52501
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Fairview-Southdale Hospital Edina, Minnesota  55435
Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
Regions Hospital Saint Paul, Minnesota  55101
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Mary Imogene Bassett Hospital Cooperstown, New York  13326
Geisinger Medical Group State College, Pennsylvania  16801
Swedish American Hospital Rockford, Illinois  61104
Eastern Connecticut Hematology and Oncology Associates Norwich, Connecticut  06360
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Mary Rutan Hospital Bellefontaine, Ohio  43311
Knox Community Hospital Mount Vernon, Ohio  43050
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Longmont United Hospital Longmont, Colorado  80501
Manchester Memorial Hospital Manchester, Connecticut  06040-4188
University of Pittsburgh Pittsburgh, Pennsylvania  15261
Hennepin County Medical Center Minneapolis, Minnesota  
University of Florida Gainesville, Florida  32610-0277
Saint Alphonsus Regional Medical Center Boise, Idaho  83706
Emory University Atlanta, Georgia  30322
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Cancer Center of Kansas - McPherson McPherson, Kansas  67460
Columbus CCOP Columbus, Ohio  43206
Indiana University Medical Center Indianapolis, Indiana  46202
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Wichita CCOP Wichita, Kansas  67214-3882
Alegent Health Immanuel Medical Center Omaha, Nebraska  68122
Alegent Health Bergan Mercy Medical Center Omaha, Nebraska  68124
Metro-Minnesota CCOP St. Louis Park, Minnesota  
Lakeview Hospital Stillwater, Minnesota  55082
Lankenau Hospital Wynnewood, Pennsylvania  19096
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
New Ulm Medical Center New Ulm, Minnesota  56073
OSF Saint Francis Medical Center Peoria, Illinois  61637
The Medical Center of Aurora Aurora, Colorado  80012
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
Saint Anthony Central Hospital Denver, Colorado  80204
Exempla Saint Joseph Hospital Denver, Colorado  80218
Colorado Cancer Research Program CCOP Denver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical Center Grand Junction, Colorado  81502
Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Saint Joseph's-Candler Health System Savannah, Georgia  31405
Rush - Copley Medical Center Aurora, Illinois  60504
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Community Cancer Center Foundation Normal, Illinois  61761
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Wishard Hospital Indianapolis, Indiana  46202
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
McFarland Clinic Ames, Iowa  50010
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Mercy Hospital Cedar Rapids, Iowa  52403
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Mercy Medical Center - North Iowa Mason City, Iowa  50401
Mercy Medical Center-Sioux City Sioux City, Iowa  51104
Saint Luke's Regional Medical Center Sioux City, Iowa  51104
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Miller-Dwan Hospital Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Saint John's Hospital - Healtheast Maplewood, Minnesota  55109
Minnesota Oncology Hematology PA-Maplewood Maplewood, Minnesota  55109
North Memorial Medical Health Center Robbinsdale, Minnesota  55422
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Lincoln Medical Education Foundation Cancer Resource Center Lincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOP Omaha, Nebraska  68106
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Veterans Adminstration New Jersey Health Care System East Orange, New Jersey  07018-1095
The North Division of Montefiore Medical Center Bronx, New York  10466
Aultman Health Foundation Canton, Ohio  44710
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Saint Rita's Medical Center Lima, Ohio  45801
Marietta Memorial Hospital Marietta, Ohio  45750
Genesis HealthCare System Zanesville, Ohio  43701
Natalie W Bryant Cancer Center Tulsa, Oklahoma  74136
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Mainline Health CCOP Wynnewood, Pennsylvania  19096
Saint Vincent Hospital Green Bay, Wisconsin  54301
Dean Hematology and Oncology Clinic Madison, Wisconsin  53717
Bay Area Medical Center Marinette, Wisconsin  54143
Roger Maris Cancer Center Fargo, North Dakota  58122
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
West Virginia University Charleston Charleston, West Virginia  25304
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Hinsdale Hematology Oncology Associates Incorporated Hinsdale, Illinois  60521
Southern Ohio Medical Center Portsmouth, Ohio  45662
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
Alegent Health Lakeside Hospital Omaha, Nebraska  68130
New York Oncology Hematology PC -Albany Medical Center Albany, New York  12208
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
Oncology Associates at Mercy Medical Center Cedar Rapids, Iowa  52403
Sanford Clinic North-Fargo Fargo, North Dakota  58102
Sanford Medical Center-Fargo Fargo, North Dakota  58122
Summa Akron City Hospital Akron, Ohio  44304
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Sanford Clinic North-Bemidgi Bemidji, Minnesota  56601
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Essentia Health Saint Mary's Medical Center Duluth, Minnesota  55805
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
Springfield Regional Medical Center Springfield, Ohio  45505
Lake Region Healthcare Corporation-Cancer Care Fergus Falls, Minnesota  56537
Nevada Cancer Institute-Summerlin Campus Las Vegas, Nevada  89135
Cancer Center of Western Wisconsin New Richmond, Wisconsin  54017