Phase 2 Advanced Renal Cell Cancer Combination ImmunoThErapy Clinical Trial

Status: Recruiting
Location: See all (13) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This study is a randomized, open label, multicenter Phase II trial to evaluate the efficacy and safety of botensilimab (a novel Fc enhanced Tree depleting anti-CTLA4) and balstilimab (a novel anti-PD1) relative to ipilimumab and nivolumab in treatment naïve patients with metastatic ccRCC. The study will plan to enroll 120 eligible patients randomized in a 2:1 fashion to Arm A and Arm B. Patients in all IMDC Risk Groups are included. This study utilizes a Simon's two stage design which is described in the protocol. Patients randomized to Arm A will receive botensilimab in combination with balstilimab. Patients randomized to Arm B will receive ipilimumab in combination with nivolumab. Study treatment on both arms will continue until toxicity, disease progression or a maximum of 96 total weeks (12 weeks induction, 84 weeks maintenance).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Patient must have ECOG PS of ≤ 2 within 28 days of C1D1.

• Age ≥ 18 years old at the time of informed consent.

• Patient must have histological confirmation of renal carcinoma with clear cell component including advanced RCC (not amenable to curative surgery or radiation therapy) or metastatic RCC.

• Patient must have measurable disease by CT or MRI per RECIST 1.1 criteria. Radiated lesions cannot be used as measurable lesions unless there is clear evidence of progression.

• Patient must have defined IMDC risk categorization of either favorable, intermediate or poor based on clinical variables of increased risk (below).

‣ No risk factors (0) = favorable risk

⁃ 1-2 risk factors = intermediate risk

⁃ ≥ 3 risk factors = poor risk

• NOTE: Patients with all IMDC risk factors are eligible, but will be stratified according to IMDC risk, and initial analysis will be based on the IMDC intermediate and poor risk patients. IMDC Risks:

⁃ KPS less than 80%

⁃ Less than 1 year from diagnosis including original localized disease to randomization(if applicable)

⁃ Hemoglobin less than the lower limit of normal

⁃ Corrected calcium concentration greater than 10 mg/dL

⁃ ANC greater than the ULN

⁃ Platelet count greater than the ULN

• Patient must have either a formalin-fixed, paraffin-embedded (FFPE) tissue block or at least 10 (preferably 20) unstained tumor tissue sections, obtained from a metastatic lesion, preferably within 3 months or no more than 12 months with an associated pathology report. This tissue must be identified prior to registration. Confirmation of sufficient archival tissue must be obtained after informed consent and the tissue must be shipped to the appropriate lab by end of Cycle 2. Biopsies should be excisional, incisional, or core needle. Fine needle aspiration is unacceptable for submission. Biopsies of bone lesions that do not have a soft tissue component are also unacceptable for submission. This sample is required to be eligible for the trial. If a patient is having a standard of care biopsy, part of that sample may be utilized for eligibility.

• Demonstrate adequate organ function as defined below; all screening labs to be obtained within 28 days prior to registration.

‣ Hematological

⁃ White blood cell (WBC) ≥ 2,000/uL

⁃ Absolute Neutrophil Count (ANC) ≥ 1,000/uL; without growth factor support

⁃ Hemoglobin (Hgb) ≥ 8.0 g/dL; ≥ 7 days without PRBC transfusion.

⁃ Platelets ≥ 75,000/uL; without platelet transfusion

⁃ Renal

⁃ Calculated creatinine clearance (CrCl)1 ≥ 40 mL/min

⁃ Hepatic

⁃ Total Bilirubin ≤ 1.5 × upper limit of normal (ULN) \*EXCEPT participants with Gilbert Syndrome who must have a Total Bilirubin level of \< 3.0 x ULN

⁃ Aspartate aminotransferase (AST) ≤ 3.0 × ULN

⁃ Alanine aminotransferase (ALT) ≤ 3.0 × ULN

• HIV positive patients may be eligible if either:

‣ Patients with CD4 \> 200 cells/mm3 OR

⁃ Patients with HIV viral load undetectable.

• Active HBV or active HCV patients may be eligible if:

‣ Patients with HBV infection are eligible if hepatitis B surface antigen and HBV DNA are negative.

⁃ Patients with HCV infection are eligible if HCV RNA is negative.

⁃ WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin \[HCG\]) within 1 week prior to Cycle 1 Day 1.

⁃ WOCBP must agree to follow instructions for method(s) of contraception.

⁃ Males who are sexually active with WOCBP must agree to follow instructions for method(s) of contraception.

Locations
United States
California
University of California San Diego
RECRUITING
La Jolla
Connecticut
Yale University, Yale Cancer Center
RECRUITING
New Haven
Washington, D.c.
Georgetown University
RECRUITING
Washington D.c.
Georgia
Winship Cancer Institute of Emory University
RECRUITING
Atlanta
Indiana
Indiana University Melvin and Bren Simon Comprehensive Cancer Center
RECRUITING
Indianapolis
Massachusetts
Beth Israel Deaconess Medical Center
RECRUITING
Boston
Dana-Farber - Partners Cancer Care, Inc
RECRUITING
Boston
New Jersey
John Theurer Cancer Center
RECRUITING
Hackensack
New York
Cornell University
RECRUITING
Ithaca
Columbia University Irving Medical Center
RECRUITING
New York
Ohio
Ohio State University Comprehensive Cancer Center
RECRUITING
Columbus
Pennsylvania
Penn Medicine Abramson Cancer Center
RECRUITING
Philadelphia
Texas
University of Texas Southwestern Medical Center
RECRUITING
Dallas
Contact Information
Primary
Michael B Atkins, MD
mba41@georgetown.edu
202-687-2795
Backup
Rebecca Mottier
rmottier@hoosiercancer.org
317-634-5842
Time Frame
Start Date: 2023-09-25
Estimated Completion Date: 2026-10-12
Participants
Target number of participants: 120
Treatments
Experimental: Arm A (botensilimab and balstilimab)
Arm A subjects will receive 2 cycles of induction treatment with each cycle lasting 6 weeks. Cycle 1 will consist of botensilimab 75mg IV in combination with balstilimab 450mg IV on Day 1 and Day 22. Cycle 2 will consist of balstilimab 450mg IV ONLY on Day 1 and Day 22. Botensilimab will NOT be given in Cycle 2. Subjects will receive 7 cycles of maintenance treatment with each cycle lasting 12 weeks. Cycles 3 and 4 will consist of botensilimab 75mg IV on Day 1 in combination with balstilimab 450mg IV on Day 1, 22, 43 and 64. Cycles 5-9 will consist of balstilimab alone 450 mg IV on Day 1, 22, 43 and 64.
Active_comparator: Arm B (ipilimumab and nivolumab)
Arm B subjects will receive 2 cycles of induction treatment with each cycle lasting 6 weeks. Cycle 1 and 2 will consist of ipilimumab 1 mg/kg IV and nivolumab 3 mg/kg on Day 1 and 22. Subjects will receive 7 cycles of maintenance treatment with each cycle lasting 12 weeks. Nivolumab 480mg IV will be given on Day 1, 29 and 57 of each cycle (every 4 weeks).
Related Therapeutic Areas
Sponsors
Leads: Michael B. Atkins, MD
Collaborators: Georgetown University, Agenus Inc.

This content was sourced from clinicaltrials.gov

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