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Phase 2, Randomized, Open Label, Multicenter Study of Intradermal IMA901 Plus GM-CSF With or Without Low Dose Cyclophosphamide Pre-treatment in Advanced Renal Cell Carcinoma Patients With Measurable Disease


Phase 2
18 Years
N/A
Not Enrolling
Both
Renal Cell Carcinoma

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Trial Information

Phase 2, Randomized, Open Label, Multicenter Study of Intradermal IMA901 Plus GM-CSF With or Without Low Dose Cyclophosphamide Pre-treatment in Advanced Renal Cell Carcinoma Patients With Measurable Disease


This is a multicenter, open label, randomized phase 2 study which investigated the effect of
a second-line systemic treatment with IMA901 plus GM-CSF in RCC patients. Randomization was
done according to a pre-treatment with low-dose cyclophosphamide (CY). Secondary endpoints
comprised tumor response parameters.

The study population consisted of HLA-A*02-positive men or women with advanced RCC of the
clear-cell type classified as having a favorable or intermediate risk after first-line
systemic therapy for. Patients had to be aged 18 years or older, had at least have one
measurable tumor lesion and had have received first-line tyrosine kinase inhibitor or
cytokine systemic therapy for advanced disease, during or after which the patient had
experienced disease progression.

Patients in both arms received a total of 17 vaccinations with GM-CSF followed by IMA901
during the 9 month treatment period.

At screening baseline tumor status was assessed by CT or MRI. During the study tumor
assessments were performed every 6 weeks.

Immunomonitoring (T-cell responses to peptides contained in IMA901 and analysis of other
immune cell populations that may influence T-cell responses), serum levels of antibodies and
molecules with suspected influence on immune response were assessed on several occasions
during the study.

Safety assessment comprised continuous adverse event reporting, regular physical
examinations and regular assessments of vital signs, hematology, blood chemistry and urine.
A 12-lead ECG was performed at screening and at the end of the study. Pregnancy testing was
performed according to applicable legislation in the country where the trial was performed.
At the very least, women of childbearing potential had have to undergo a pregnancy test
during screening for the study, before the first dose was applied and at the end of the
study.


Inclusion Criteria:



- Aged at least 18 years

- HLA type: HLA-A*02-positive

- Histologically documented advanced clear-cell RCC

- Patients who have received first-line tyrosine kinase inhibitor or cytokine systemic
therapy for advanced disease systematic therapy for advanced disease and must be
candidates for second-line therapy (NOTE: in Germany and Austria only patients after
first-line tyrosine kinase inhibitor failure will be included into the study)

- Patients having experienced documented tumor progression

- At least one unidimensional measurable target lesion

- Karnofsky Performance Status ≥ 80%

- Favorable or intermediate risk according to the 3-score MSKCC criteria.

- Able to understand the nature of the study and give written informed consent

- Willingness and ability to comply with the study protocol for the duration of the
study

Exclusion Criteria:

- Poor risk according to the 3-score MSKCC criteria

- Immunosuppressive therapy within 4 weeks before study entry, e.g. corticosteroid
treatment

- History of other malignant tumors, except non-melanoma-skin cancer or curatively
excised cervical carcinoma in situ

- Presence of brain metastases on MRI or CT scan

- Patients with a history or evidence of systemic autoimmune disease

- Any vaccination in the two weeks before study entry

- Any planned prophylactic vaccination from study entry until the end of the induction
period (5 weeks after the first vaccination)

- Known active hepatitis B or C infection

- Known HIV infection

- Any other infection with a biological agent that can cause a severe disease and poses
a severe danger to lab personnel working on patient tissues.

- Any of the following in the 4 weeks before study entry:

1. Major surgery

2. Anticancer treatments including (but not limited to) cytotoxic chemotherapy,
radiotherapy, immunotherapy, hormone therapy, tyrosine kinase inhibitors,
monoclonal antibodies

3. Unresolved toxicity from prior anticancer treatments including (but not limited
to) cytotoxic chemotherapy, hormone therapy, tyrosine kinase inhibitors,
monoclonal antibodies, radiotherapy, or immunotherapy

4. Received study drug within any clinical study

- Any of the following abnormal laboratory values:

1. Hematology: Hb < 9 g/dL; WBC < 3 x 109/L; neutrophils < 1.5 x 109/L; lymphocytes
< 1.0 x 109/L; platelets < 100 x 109/L

2. Liver function: serum bilirubin > 1.5 x upper normal limit (unless a history of
Gilbert's disease); ALAT or ASAT > 3 x upper normal limit (>5 x upper normal
limit if liver metastases are present)

3. Renal function: serum creatinine > 200 µmol/L

- Patients with other significant diseases currently uncontrolled by treatment which
might interfere with study completion, for example:

1. Heart failure or non compensated active heart disease

2. Severe coronary heart disease, cardiac arrhythmia requiring medication, or
uncontrolled hypertension

3. Symptomatic neurotoxicity (motor or sensory) ≥ grade 2 National Cancer Institute
- Common Toxicity Criteria (NCI-CTC).

4. Severe pulmonary dysfunction

- Psychiatric disabilities, seizures or central nervous system disorders that may
interfere with the ability to give informed consent or perform adequate follow-up in
the investigator's opinion

- Active infections requiring oral or intravenous antibiotics

- Women or men who decline to practice a medically approved method of contraception

- Pregnancy or breastfeeding

- Any condition which in the judgment of the investigator would place the patient at
undue risk or interfere with the results of the study

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Disease control rate

Outcome Time Frame:

after 26 weeks

Safety Issue:

No

Principal Investigator

Alexandra Kirner, PhD

Investigator Role:

Study Director

Investigator Affiliation:

immatics Biotechnologies GmbH

Authority:

Germany: Paul-Ehrlich-Institut

Study ID:

EudraCT Nr: 2006-006370-25

NCT ID:

NCT00523159

Start Date:

May 2007

Completion Date:

August 2009

Related Keywords:

  • Renal Cell Carcinoma
  • clear cell renal cell carcinoma
  • Carcinoma
  • Carcinoma, Renal Cell

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