Condition or disease | Intervention/treatment | Phase |
---|---|---|
Metastatic Renal Cell Carcinoma | Drug: Cabozantinib | Phase 2 |
Cabozantinib is a small molecule inhibitor of tyrosine kinases which include MET (hepatocyte growth factor receptor protein), VEGFR (vascular endothelial growth factor receptors), AXL, RET (Rearranged during transfection), FLT3 (Fms-like tyrosine kinase-3), KIT (mast/stem cell factor receptor), ROS1, MER, TYRO3, TRKB (Tropomyosin receptor kinase B) and TIE-2 (angiopoietins receptor). Similar to other TKIs, cabozantinib is a reversible, ATP-competitive inhibitor. Cabozantinib has thus demonstrated significant activity in metastatic clear cell renal cell carcinoma after failure of one or 2 tyrosine kinase inhibitors and is now approved in the second line setting in Europe. Some efficacy was also demonstrated in patients in first line treatment when compared to sunitinib.
Brain metastasis in renal cancer are difficult to treat and cytotoxic systemic therapies are still not used, given by the more or less impermeable blood-brain barrier. The interest of cabozantinib in brain renal cell carcinoma metastases is encouraged by 3 recent cases reports of significant responses of brain metastases including a complete response of brain metastases in one case. Moreover MET receptor surexpression appear more frequent in brain metastases than in other renal cell carcinoma tumor sites. Cabozantinib as multitarget inhibitor including VEGF and MET receptors suggest that it could be a good option. Its efficacy in brain metastases from renal cell carcinoma requires further evaluation.
On this basis, the investigators propose to conduct an open-label exploratory single arm, multicenter prospective phase II trial to assess the efficacy of cabozantinib on brain metastases in metastatic renal cell carcinoma patients.
Ancillary studies:
The relationship between serum markers and efficacy data will be investigated. Serum and plasma sample will be collected at Baseline. MET expression and MET sequencing will be also performed on available tumor tissues.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 77 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | CABRAMET: A Phase 2 Study of Cabozantinib in Metastatic Renal Cell Carcinoma (mRCC) With Brain Metastases |
Actual Study Start Date : | November 29, 2019 |
Estimated Primary Completion Date : | September 2022 |
Estimated Study Completion Date : | March 2024 |
Arm | Intervention/treatment |
---|---|
Experimental: Cabozantinib treatment
All participants will be treated by 60 mg of cabozantinib once daily.
|
Drug: Cabozantinib
All participants will be treated by 60 mg of cabozantinib once daily. Temporary or permanent discontinuation and/or dose reduction of cabozantinib therapy may be required for the management of some adverse reactions. When dose reduction is necessary, it is recommended to reduce to 40 mg daily, and then to 20 mg daily.
|
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
I1. Age ≥ 18 years. I2. Histologically proven metastatic Renal Cell Carcinoma. I3. Brain metastases not requiring corticosteroids at dose > 40 mg/day. I4.At least 1 locally untreated brain lesion ≥8mm in longest diameter or >5mm if > 1 lesion.
I5.Not previously treated by cabozantinib. I6.Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≤ 1. I7.Life expectancy ≥ 3 months
I8.Adequate organ function as defined by the following criteria:
I11. Signed and dated IRB/ICE approved informed consent form. I12. Accepting to use effective contraception (barrier contraceptives) during study treatment and within at least 4 months after final dose of study therapy. Oral contraceptives are not acceptable.
Exclusion Criteria:
E1. Any local previous treatment of current brain metastases. E2. Any anti-coagulation therapy (except preventive treatment at low dose). E3. Contra-indication of Magnetic Resonance Imaging (MRI) (i.e. : pace-maker). E4. Uncontrolled seizures. E5. Any symptoms of intracranial hypertension. E6. Any of the following within 12 months prior to treatment initiation: severe/unstable angina, myocardial infarction, coronary artery bypass graft, symptomatic congestive heart failure, ischemic or hemorrhagic stroke including transient ischemic attack.
E7. Uncontrolled hypertension defined as systolic blood pressure >150 mmHg or diastolic pressure >90 mmHg, despite optimal medical treatment.
E8. Ongoing cardiac dysrhythmia of grade ≥ 2, atrial fibrillation of any grade, QTc interval > 0.43.
E9. Pregnant or breast feeding woman (mandatory negative serum or urinary pregnancy test at study entry for all women of childbearing potential).
E10. Any acute or chronic medical or psychiatric condition or laboratory abnormality that would make the patient unsuited to study participation.
E11. Any second malignancy within the last 3 years with the exception of basal cell carcinoma, in situ cervical cancer and pT1/a bladder cancer with no evidence of recurrent disease for 12 months.
E12. Patients receiving strong inhibitor or inducer of CYP3A4 especially some anti-epileptic drugs.
E13. Psychological, familial, sociological, geographical conditions that would limit compliance with study protocol requirements.
E14. Participation to another clinical trial that might interfere with the evaluation of the main criterion.
E15. Known hypersensitivity to the active substance or to any of the excipients of cabozantinib.
E16. Patient requiring tutorship or curatorship.
Contact: Sylvie NEGRIER, MD, PhD | 0478782751 ext +33 | sylvie.negrier@lyon.unicancer.fr |
France | |
Institut de Cancérologie de l'Ouest-Site Paul Papin | Not yet recruiting |
Angers, France, 49005 | |
Contact: Remy DELVA, MD +332.41.35.27.00 remy.delva@ico.unicancer.fr | |
CHU Besancon | Recruiting |
Besançon, France, 25030 | |
Contact: Fabien CALCAGNO, MD +33381668705 f.calcagno@chu-besancon.fr | |
Centre Georges François Leclerc | Not yet recruiting |
Dijon, France, 21079 | |
Contact: Sylvain LADOIRE, MD +333 80 73 75 28 sladoire@cgfl.fr | |
Centre Leon Berard | Recruiting |
Lyon, France, 69373 | |
Contact: Sylvie NEGRIER, MD, PhD +334 78 78 27 51 sylvie.negrier@lyon.unicancer.fr | |
Centre Val d'Aurelle | Not yet recruiting |
Montpellier, France, 34928 | |
Contact: Diego TOSI, MD +334.67.61.23.04 diego.tosi@icm.unicancer.fr | |
Institut de Cancérologie de la Lorraine | Recruiting |
Nancy, France, 54519 | |
Contact: Lionnel GEOFFROIS, MD +333 83 59 83 31 l.geoffrois@nancy.unicancer.fr | |
Institut de Cancérologie de l'Ouest-site René Gauducheau | Recruiting |
Saint-Herblain, France, 44805 | |
Contact: Frédéric ROLLAND, MD +332.40.67.99.76 frederic.rolland@ico.unicancer.fr | |
IUCT-Institut Claudius Regaud | Recruiting |
Toulouse, France, 31059 | |
Contact: Christine CHEVREAU, MD +335 31 15 51 51 chevreau.christine@iuct-oncopole.fr | |
Institut Gustave Roussy | Not yet recruiting |
Villejuif, France, 94805 | |
Contact: Laurence ALBIGES, MD +331 42 11 62 64 laurence.albiges@gustaveroussy.fr |
Principal Investigator: | Sylvie NEGRIER, MD,PhD | Centre Leon Berard |
Tracking Information | |||||
---|---|---|---|---|---|
First Submitted Date ICMJE | May 27, 2019 | ||||
First Posted Date ICMJE | May 30, 2019 | ||||
Last Update Posted Date | February 8, 2021 | ||||
Actual Study Start Date ICMJE | November 29, 2019 | ||||
Estimated Primary Completion Date | September 2022 (Final data collection date for primary outcome measure) | ||||
Current Primary Outcome Measures ICMJE |
The non progression rate in brain metastases at 3 months [ Time Frame: At 3 months for each patient ] Tumor assessment in brain will be performed by cerebral MRI at baseline, 1.5 months and 3 months. These cerebral MRI will be reviewed by central review according to the RANO-BM criteria.
|
||||
Original Primary Outcome Measures ICMJE | Same as current | ||||
Change History | |||||
Current Secondary Outcome Measures ICMJE |
|
||||
Original Secondary Outcome Measures ICMJE | Same as current | ||||
Current Other Pre-specified Outcome Measures | Not Provided | ||||
Original Other Pre-specified Outcome Measures | Not Provided | ||||
Descriptive Information | |||||
Brief Title ICMJE | Evaluation of Cabozantinib in Metastatic Renal Cell Carcinoma (mRCC) With Brain Metastases | ||||
Official Title ICMJE | CABRAMET: A Phase 2 Study of Cabozantinib in Metastatic Renal Cell Carcinoma (mRCC) With Brain Metastases | ||||
Brief Summary | This is a multicenter, open-label, exploratory, single-arm, prospective phase II study to assess the efficacy and safety profile of cabozantinib in patients with brain metastases from metastatic renal cell carcinoma (mRCC). | ||||
Detailed Description |
Cabozantinib is a small molecule inhibitor of tyrosine kinases which include MET (hepatocyte growth factor receptor protein), VEGFR (vascular endothelial growth factor receptors), AXL, RET (Rearranged during transfection), FLT3 (Fms-like tyrosine kinase-3), KIT (mast/stem cell factor receptor), ROS1, MER, TYRO3, TRKB (Tropomyosin receptor kinase B) and TIE-2 (angiopoietins receptor). Similar to other TKIs, cabozantinib is a reversible, ATP-competitive inhibitor. Cabozantinib has thus demonstrated significant activity in metastatic clear cell renal cell carcinoma after failure of one or 2 tyrosine kinase inhibitors and is now approved in the second line setting in Europe. Some efficacy was also demonstrated in patients in first line treatment when compared to sunitinib. Brain metastasis in renal cancer are difficult to treat and cytotoxic systemic therapies are still not used, given by the more or less impermeable blood-brain barrier. The interest of cabozantinib in brain renal cell carcinoma metastases is encouraged by 3 recent cases reports of significant responses of brain metastases including a complete response of brain metastases in one case. Moreover MET receptor surexpression appear more frequent in brain metastases than in other renal cell carcinoma tumor sites. Cabozantinib as multitarget inhibitor including VEGF and MET receptors suggest that it could be a good option. Its efficacy in brain metastases from renal cell carcinoma requires further evaluation. On this basis, the investigators propose to conduct an open-label exploratory single arm, multicenter prospective phase II trial to assess the efficacy of cabozantinib on brain metastases in metastatic renal cell carcinoma patients. Ancillary studies: The relationship between serum markers and efficacy data will be investigated. Serum and plasma sample will be collected at Baseline. MET expression and MET sequencing will be also performed on available tumor tissues. |
||||
Study Type ICMJE | Interventional | ||||
Study Phase ICMJE | Phase 2 | ||||
Study Design ICMJE | Allocation: N/A Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment |
||||
Condition ICMJE | Metastatic Renal Cell Carcinoma | ||||
Intervention ICMJE | Drug: Cabozantinib
All participants will be treated by 60 mg of cabozantinib once daily. Temporary or permanent discontinuation and/or dose reduction of cabozantinib therapy may be required for the management of some adverse reactions. When dose reduction is necessary, it is recommended to reduce to 40 mg daily, and then to 20 mg daily.
|
||||
Study Arms ICMJE | Experimental: Cabozantinib treatment
All participants will be treated by 60 mg of cabozantinib once daily.
Intervention: Drug: Cabozantinib
|
||||
Publications * | Not Provided | ||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||
Recruitment Status ICMJE | Recruiting | ||||
Estimated Enrollment ICMJE |
77 | ||||
Original Estimated Enrollment ICMJE | Same as current | ||||
Estimated Study Completion Date ICMJE | March 2024 | ||||
Estimated Primary Completion Date | September 2022 (Final data collection date for primary outcome measure) | ||||
Eligibility Criteria ICMJE |
Inclusion Criteria: I1. Age ≥ 18 years. I2. Histologically proven metastatic Renal Cell Carcinoma. I3. Brain metastases not requiring corticosteroids at dose > 40 mg/day. I4.At least 1 locally untreated brain lesion ≥8mm in longest diameter or >5mm if > 1 lesion. I5.Not previously treated by cabozantinib. I6.Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≤ 1. I7.Life expectancy ≥ 3 months I8.Adequate organ function as defined by the following criteria:
I11. Signed and dated IRB/ICE approved informed consent form. I12. Accepting to use effective contraception (barrier contraceptives) during study treatment and within at least 4 months after final dose of study therapy. Oral contraceptives are not acceptable. Exclusion Criteria: E1. Any local previous treatment of current brain metastases. E2. Any anti-coagulation therapy (except preventive treatment at low dose). E3. Contra-indication of Magnetic Resonance Imaging (MRI) (i.e. : pace-maker). E4. Uncontrolled seizures. E5. Any symptoms of intracranial hypertension. E6. Any of the following within 12 months prior to treatment initiation: severe/unstable angina, myocardial infarction, coronary artery bypass graft, symptomatic congestive heart failure, ischemic or hemorrhagic stroke including transient ischemic attack. E7. Uncontrolled hypertension defined as systolic blood pressure >150 mmHg or diastolic pressure >90 mmHg, despite optimal medical treatment. E8. Ongoing cardiac dysrhythmia of grade ≥ 2, atrial fibrillation of any grade, QTc interval > 0.43. E9. Pregnant or breast feeding woman (mandatory negative serum or urinary pregnancy test at study entry for all women of childbearing potential). E10. Any acute or chronic medical or psychiatric condition or laboratory abnormality that would make the patient unsuited to study participation. E11. Any second malignancy within the last 3 years with the exception of basal cell carcinoma, in situ cervical cancer and pT1/a bladder cancer with no evidence of recurrent disease for 12 months. E12. Patients receiving strong inhibitor or inducer of CYP3A4 especially some anti-epileptic drugs. E13. Psychological, familial, sociological, geographical conditions that would limit compliance with study protocol requirements. E14. Participation to another clinical trial that might interfere with the evaluation of the main criterion. E15. Known hypersensitivity to the active substance or to any of the excipients of cabozantinib. E16. Patient requiring tutorship or curatorship. |
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Sex/Gender ICMJE |
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Ages ICMJE | 18 Years and older (Adult, Older Adult) | ||||
Accepts Healthy Volunteers ICMJE | No | ||||
Contacts ICMJE |
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Listed Location Countries ICMJE | France | ||||
Removed Location Countries | |||||
Administrative Information | |||||
NCT Number ICMJE | NCT03967522 | ||||
Other Study ID Numbers ICMJE | CABRAMET (ET19-006) | ||||
Has Data Monitoring Committee | No | ||||
U.S. FDA-regulated Product |
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IPD Sharing Statement ICMJE | Not Provided | ||||
Responsible Party | Centre Leon Berard | ||||
Study Sponsor ICMJE | Centre Leon Berard | ||||
Collaborators ICMJE | Not Provided | ||||
Investigators ICMJE |
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PRS Account | Centre Leon Berard | ||||
Verification Date | February 2021 | ||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |