Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma

Mass General Brigham

Status and phase

Withdrawn

Phase 2

Conditions

Renal Cell Carcinoma

Treatments

Drug: Bevacizumab

Drug: Sunitinib

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT00556205

07-202

Details and patient eligibility

About

The purpose of this research study is to further define an effective strategy for people with renal cell carcinoma and to learn the safety and effectiveness of two different types of sunitinib-refractory treatments: Bevacizumab alone or a combination of sunitinib and bevacizumab. Sunitinib is an FDA approved drug and is currently one of the standard treatments for advanced renal cell carcinoma. However, some people who receive this treatment do not respond to treatment or they stop responding to treatment. Bevacizumab is an FDA approved drug used for the treatment of several cancers however, is not yet approved for use in renal cell carcinoma.

Full description

Participants will receive one of two treatment possibilities. Since no one knows which of the study options is best, participants will be "randomized" to one fo the three treatment groups.
Group 1 will stop their current treatment with sunitinib and receive a dose of bevacizumab once every 2 weeks. Group 2 will receive the standard treatment of sunitinib with the addition of bevacizumab.
All study participants will undergo the same study procedures. These study procedures will include the following at intervals specified in the protocol: medical history review; vital signs; physical exam; urine analysis; EKG and CT scan.

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Histologically confirmed metastatic renal cell carcinoma with clear cell histology
Patients must be off sunitinib for 14 days prior to day 1 of treatment on protocol
Evidence of unidimensionally measurable disease based on RECIST criteria, with at least 1 measurable lesion
Radiographic evidence of disease progression defined by RECIST during or within 6 weeks of completion of sunitinib treatment
Participants must have received at least 14 doses of sunitinib therapy
Participants must enroll within 3 months of the last dose of sunitinib
Males or females, age of 18 years or older
ECOG Performance status 0-2
Resolution of all acute toxic effects of prior therapy, radiotherapy or surgical procedures to NCI CTCAE version 3.0 grade 1 or less
Laboratory values as defined in protocol
4 weeks or more must have elapsed from the time of major surgery and subjects must have recovered from the procedure prior to day 1 of randomization
No anticipated need for major surgical procedure during the course of the study
2 weeks or more must have elapsed from the time of minor surgery and subjects must have recovered from the procedure prior to day 1 of randomization
4 weeks of more must have elapsed from the time of major radiotherapy prior to day 1 of randomization

Exclusion criteria

Prior treatment with bevacizumab
Unacceptable toxicity on prior sunitinib therapy at 37.5mg or lower
Prior systemic therapy for RCC with > 2 regimens
Systemic therapy other than sunitinib within 4 weeks of starting the study treatment
Uncontrolled high blood pressure
Any prior history of hypertensive crisis or hypertensive encephalopathy
History of abdominal fistula, gastrointestinal perforation or intraabdominal abscess within 3 months prior to day 0
Any of the following within the 6 months prior to sudy drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, symptomatic congestive heart failure, or ejection fraction < 30%
Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range without medication
History of or known brain metastases or spinal cord compression
NCI CTCAE grade 2 or above hemorrhage within 4 weeks of starting study treatment
Significant vascular disease (e.g., aortic aneurysm, aortic dissection)
Symptomatic peripheral vascular disease
Grade 3 or higher cardiac dysrhythmia or QT prolongation
Concurrent use of proarrhythmic medications including terfenadine, quinidine, procainamide, disopyramide, sotalol, probucol, bepridil, haloperidol, risperidone, indapamide and flecainide
Pregnancy or breastfeeding or inadequate contraception
Significant thromboembolic event within 6 months
Evidence of bleeding diathesis or coagulopathy
Serious, non-healing wound, ulcer or bone fracture
Proteinuria at screening
Known hypersensitivity to any component of bevacizumab
Psychiatric illness/social situation that would limit compliance with study requirements
Previous or concurrent malignancy requiring active systemic therapy