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Study Summary
No. 2007-0248:.......Kidney......Nizar M. Tannir......Genitourinary Medical Oncology
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Study Summary Title
Study Summary
Number:
2007-0248
Study Title:A Randomized, Double Blinded, Multi-Center Phase 2 Study to Estimate the Efficacy and Evaluate the Safety and Tolerability of Sorafenib in Combination with AMG 386 or Placebo In Subjects with Metastatic Clear Cell Carcinoma of the Kidney
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Physician New Patient Referral
Name:Nizar M. TannirPatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:Genitourinary Medical OncologyReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-792-2830
Contact us about clinical trials
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General Information
Disease Group:KidneySupported By:Amgen, Inc.
Phase of Study:Phase IIReturn
Visit:
Participants will be required to return to the clinic weekly for therapy and
evaluation.
Treatment
Agents:
AMG 386
Sorafenib
Home Care:N/A
Treatment Loc:Both at MDACC & outside MDACC at one or more Collaborating Sites or Institutions
Estimated
Length of Stay
in Houston:
N/A
Description/
Intervention:
The goal of this clinical research study is to compare NexavarŽ (sorafenib), in
combination with 2 different doses of AMG 386, with sorafenib alone in the
treatment of clear cell cancer of the kidney. The safety of this drug
combination will also be studied.
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Study Objectives / Outcomes
Primary Objective:
  • To estimate the efficacy as measured by progression free survival (PFS) of subjects receiving AMG 386 (either 3mg/kg or 10mg/kg IV QW) in combination with sorafenib (400mg PO BID) compared to subjects receiving sorafenib (400mg PO BID) plus placebo.

Secondary Objective(s):
  • To evaluate the safety and tolerability of the combination regimen of AMG 386 and sorafenib.
    • To estimate the efficacy (by parameters other than PFS) of subjects receiving AMG 386 (either 3 mg/kg or 10 mg/kg IV QW) in combination with sorafenib (400 mg PO BID) compared to the subjects receiving sorafenib (400 mg PO BID) plus placebo
  • To evaluate the pharmacokinetics (pK) of AMG 386 and sorafenib when used in combination
  • To determine the incidence of occurrence of anti-AMG386 antibody formation
    • To evaluate patient reported outcomes (PRO) using the Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-15) and EQ-5D
    • To evaluate the efficacy of subjects receiving AMG 386 10.0 mg/kg QW in combination with sorafenib after treatment failure with sorafenib plus placebo

    Exploratory Objective(s):
    • To explore the associations between progression free survival and other measures of efficacy
    • To explore the pharmacodynamic (PD) response as assessed by changes in blood levels of angiogenic cytokines, tumor apoptosis and other markers in subjects receiving AMG 386 (either 3 mg/kg or 10 mg/kg IV QW) in combination with sorafenib (400 mg PO BID) compared to the PD response in subjects receiving sorafenib (400 mg PO BID) plus placebo
    • To explore the association of histological features and selected immunologic, biochemical, pharmacogenomic or angiogenic markers in tumor biopsies or serum samples with safety and/or efficacy outcomes
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    Study Status Information
    Study Activation / Registration Date:03/25/2008
    IRB Review and Approval Date:10/01/2007
    Study Type:Phase Ii Or Phase I/Ii
    Recruitment Status:Closed
    Projected Accrual:150
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    Enrollment Eligibility
    If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

    Inclusion Criteria:1) Subjects must have a histologically confirmed metastatic RCC with a clear cell component.

    2) Low or intermediate risk according to the Memorial Sloan Kettering Cancer Center (MSKCC) prognostic risk classification defined as meeting between 0 and 2 of the following risk factors:(1) Karnofsky performance status < 80%; (2) Serum lactate dehydrogenase > 1.5 x upper limit of normal (ULN); (3) Serum hemoglobin < lower limit of normal (LLN) for their institutions; (4) Serum calcium (corrected) > 10 mg/dL; (5) Time from diagnosis of RCC to first systemic treatment < 1 year

    3) Measurable disease with at least one unidimensionally measurable lesion per RECIST.

    4) Complete radiology and tumor measurement within 28 days prior to randomization: a.) Chest: CT / MRI scan with intravenous contrast if the contrast is not medically contraindicated; b.) Abdomen: CT / MRI scan with intravenous contrast if the contrast is not medically contraindicated; c.) Pelvis: CT / MRI scan with intravenous contrast if the contrast is not medically contraindicated; d.) Brain or Head: CT / MRI scan; e.) Bone: Whole body Bone Scintigraphy

    5) Men or women >/= 18 years old

    6) Adequate organ and hematological function as evidenced by the following laboratory studies within 14 days of randomization: (1) Hematological function, as follows: (a) Absolute neutrophil count (ANC) >/= 1.5 x 10^9/L, (b) Platelet count >/= 100 x 10^9/L, (c) Hemoglobin >/= 9 g/dL;

    7) Renal function, as follows: a.) Calculated creatinine clearance > 50 mL/min according to the Cockcroft-Gault formula; b.) Urinary protein quantitative value of </= 30 mg in urinalysis or </= 1+ on dipstick, unless quantitative protein is < 1000 mg in a 24 hour urine sample

    8) Hepatic function, as follows: a.) Aspartate aminotransferase (AST) </= 2.5 x upper limit of normal (ULN) (if liver metastases are present, </= 5 x ULN); b.) Alanine aminotransferase (ALT) </= 2.5 x ULN (if liver metastases are present, </= 5 x ULN); c.) Alkaline phosphatase </= 2.0 x ULN (if bone or liver metastases are present, </= 5 x ULN); d.) Bilirubin </= 2.0 x ULN

    9) Hemostatic function, as follows: a.) International Normalized Ratio (INR) </= 1.5 per institutional laboratory range; b.) Partial thromboplastin time (PTT) or activated partial thromboplastin (aPTT) </= 1.5 x ULN per institutional laboratory range

    10) Able to tolerate infusions and self-administer oral medications

    11) Competent to comprehend, sign, and date an institutional review board (IRB) or Independent Ethics Committee (IEC) - approved informed consent form

    12) ECOG of 0 or 1

    13) Subject plans to begin protocol directed therapy within 7 days of randomization

    Exclusion Criteria:1) Primary tumor in situ: Subjects must have their primary tumor resected to be eligible for this study

    2) Known history of central nervous system metastases. An MRI or CT scan of the brain or head will be performed within 28 days of randomization.

    3) History of arterial or venous thrombosis within 6 months prior to randomization

    4) History of bleeding diathesis or clinically significant bleeding within 14 days of randomization

    5) Previous treatment (excluding surgery and palliative radiotherapy) for advanced or metastatic renal cell carcinoma

    6) Focal radiation therapy for palliation of pain from bony metastases within 14 days of randomization.

    7) Subjects who received radiation therapy must have recovered from all radiation induced toxicities prior to randomization

    8) Currently or previously treated with sorafenib or other small molecule inhibitors of VEGF including, but not limited to AMG 706 (motesanib), SU11248 (sunitinib), PTK787 (vatalinib), AZD 2171, AEE-788. Currently or previously treated with bevacizumab

    9) Currently or previously treated with AMG 386, or other molecules that inhibit the angiopoietins or Tie2 receptor including but not limited to, AZD-5180, XL-820, CEP 11981/SSR-106462, BSF-466,895, CGI-1842, LOC-590, XL-184, or CP- 8681596

    10) Concomitant or use within 30 days prior to randomization of any strong inducer of CYP3A4 including, but not limited to, rifampin, St. John's wort, phenytoin, carbamazepine, phenobarbital and dexamethasone

    11) Known ongoing pancreatits

    12) Myocardial infarction, cerebrovascular accident, transient ischemic attack, percutaneous transluminal coronary angioplasty/stent, congestive heart failure, grade 2 or greater peripheral vascular disease, arrhythmias not controlled by outpatient medication, or unstable angina within 1 year prior to randomization

    13) Major surgery within 30 days before randomization or still recovering from prior surgery

    14) History of allergic reactions to bacterially produced proteins

    15) Pregnant (i.e., positive beta-human chorionic gonadotropin test) or is breast feeding

    16) Exclude subjects with a history of prior malignancy, except: a.) Malignancy treated with curative intent and with no known active disease present for = 3 years before enrollment and felt to be at low risk for recurrence by treating physician; b.) Adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease; c.) Adequately treated cervical carcinoma in situ without evidence of disease; d.) Prostatic intraepithelial neoplasia without evidence of prostate cancer

    17) Minor surgical procedures, placement of access device, or fine needle aspiration within 7 days of first dose.

    18) Uncontrolled hypertension as defined as diastolic > 90 mmHg OR systolic >140 mmHg. Anti-hypertensive medications are permitted.

    19) Known active or ongoing infection within 14 days before randomization

    20) Subject known to have tested positive for HIV

    21) Subject known to have chronic hepatitis

    22) Any condition which in the investigator's opinion makes the subject unsuitable for study participation

    23) History of pulmonary hemorrhage or gross hemoptysis (1/2 teaspoon or more of bright red blood) within 6 months before randomization

    24) Concurrent or prior (within 1 week before randomization) anticoagulation therapy, excluding aspirin and anti-platelet agents. The concurrent use of low molecular weight heparin or low dose warfarin (ie, </= 1 mg daily) for prophylaxis against thrombosis is acceptable while on study.

    25) Other investigational procedures are excluded.

    26) Subject not consenting to the use of highly effective contraceptive, e.g. double barrier method (i.e. condom plus diaphragm) precautions during the course of the study and for 6 months after administration of the last study medication

    27) Subject currently is enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(s), or subject is receiving other investigational agent(s)

    28) Subject has known sensitivity to any of the products to be administered during dosing

    29) Subject has previously been randomized onto this study

    30) Subject will not be available for follow-up assessment

    31) Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures

    32) Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures

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    Links
    Registration Number: NCT00467025
    Study Information on Clinical Trials Registry (clinicaltrials.gov)

    Other Links:
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    Results


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