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Tyrosine Kinase Inhibitor
Cabozantinib for Kidney Cancer
Phase 2
Recruiting
Led By Matthew Zibelman, MD
Research Sponsored by Fox Chase Cancer Center
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
Age > 18 years
ECOG performance status 0 - 2
Must not have
Active, symptomatic brain metastases or leptomeningeal metastases
Current use or anticipated need for treatment with drugs or foods that are known strong CYP3A4 inhibitors and inducers
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 2 years
Awards & highlights
All Individual Drugs Already Approved
Approved for 5 Other Conditions
No Placebo-Only Group
Summary
This trial is testing a new drug for kidney cancer patients who have not previously been treated with it.
Who is the study for?
Adults over 18 with advanced kidney cancer, either untreated or not previously treated with Cabozantinib. They must be in fairly good health, understand the study and consent to it, agree to use contraception, and have at least one measurable tumor. Excluded are those with uncontrolled illnesses, certain heart conditions, other active cancers needing treatment, significant bleeding history or major surgery recently.
What is being tested?
The trial is testing a different dosing schedule of Cabozantinib for patients with metastatic renal cell carcinoma (mRCC). It's open to all-risk frontline mRCC patients or any line mRCC patients who haven't tried Cabozantinib before.
What are the potential side effects?
Cabozantinib may cause high blood pressure, tiredness, loss of appetite, nausea/vomiting/diarrhea; hand-foot skin reactions; weight loss; changes in hair color; taste changes; new/worsening high blood pressure.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I am older than 18 years.
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I can take care of myself and am up and about more than half of the day.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
I have active brain or spinal cord cancer symptoms.
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I am not using, nor do I need, drugs or foods that strongly affect drug metabolism.
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I have not had major or minor surgery recently.
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I haven't had significant bleeding in the last 3 months.
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I am currently taking blood thinners.
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I have severe liver problems.
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I am HIV-positive and on antiretroviral therapy.
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I do not have any severe illnesses or mental health issues that would stop me from following the study's requirements.
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I have lung lesions or disease in my airways.
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My cancer is growing into or around major blood vessels.
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I have been treated with cabozantinib before.
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ 2 years
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~2 years
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Primary study objectives
Cohort A: Average daily dose of cabozantinib > 42.8 mg in at least 70% of patients
Cohort B: 75% of patients alive and progression free at 12 months
Cohort C: Decreased rate of grade ≥ 3 adverse events compared to 75% reported in CABINET trial
Secondary study objectives
Cohort A: Decreased grade ≥ 3 adverse events compared to historical controls (METEOR trial)
Cohort A: Improved median duration of time on drug compared to historical controls
Cohort A: Objective response rate per RECIST 1.1 criteria of all patients treated
+7 moreSide effects data
From 2022 Phase 2 trial • 45 Patients • NCT0210173695%
HYPOTHYROIDISM
73%
DIARRHEA
55%
WEIGHT LOSS
50%
FATIGUE
41%
ALANINE AMINOTRANSFERASE INCREASED
41%
Neutrophil Count Decreased
41%
ASPARTATE AMINOTRANSFERASE INCREASED
41%
VOMITING
41%
ANOREXIA
41%
NAUSEA
36%
HEADACHE
36%
PALMAR-PLANTAR ERYTHRODYSESTHESIA SYNDROME
36%
PAIN IN EXTREMITY
36%
HYPERTENSION
32%
PROTEINURIA
32%
PAIN
27%
White Blood Cell Count Decreased
27%
ABDOMINAL PAIN
23%
PLATELET COUNT DECREASE
23%
HYPONATREMIA
23%
Decreased Platelet Count
23%
Platelet Count Decreased
23%
Skin Hypopigmentation
23%
Renal & Urinary Disorders - Other, Ketonuria
23%
HAIR COLOR CHANGE
18%
Upper Respiratory Infection
18%
HEMOGLOBIN INCREASED
18%
HYPOKALEMIA
18%
HYPOPHOSPHATEMIA
18%
Alopecia
18%
Hyperkalemia
14%
Pruritis
14%
HYPOGLYCEMIA
14%
Rash Acneiform
14%
HYPERGLYCEMIA
14%
Rash Maculopapular
14%
BILIRUBIN INCREASED
14%
ACNEIFORM RASH
14%
Cough
14%
Blood Bilirubin Increased
14%
DIZZINESS
14%
Skin And Subcutaneous Disorders - Other, Achromotricia
14%
CONSTIPATION
14%
Fever
9%
TUMOR PAIN
9%
Papulopustular Rash
9%
ALKALINE PHOSPHATASE INCREASED
9%
LIPASE INCREASED
9%
Creatinine Increased
9%
Back Pain
9%
ABSOLUTE NEUTROPHIL COUNT DECREASED
9%
Paresthesia
9%
Skin And Subcutaneous Tissue Disorders- Other, Rash Unspecified
9%
ORAL PAIN
9%
LYMPHOCYTE COUNT DECREASED
9%
NASAL CONGESTION
9%
WEIGHT GAIN
9%
HYPOCALCEMIA
9%
DRY SKIN
5%
Hypotension
5%
Hypertension
5%
SERUM AMYLASE INCREASED
5%
Investigations - Other, Eosinophilia
5%
Sore Throat
5%
Allergic Rhinitis
5%
Muscle Weakness Lower Limb
5%
ANXIETY
5%
Hypermagnesemia
5%
Rash Ezcematoid
5%
Musculoskeletal And Connective Tissue Disorders - Other, Extremity Cramps
5%
Skin And Subcutaneous Tissue Disorders - Other, Skin Color Change
5%
Skin And Subcutaneous Tissue Disorders - Other: Blue Lips (Not Cyanosis)
5%
Behaviour Disturbance
5%
Scalp Pain
5%
Neuropathy
5%
Psychiatric Disorders - Other, Mood Swings
5%
URINARY URGENCY
5%
Sinus Tachycardia
5%
Periodontal Disease
5%
Peripheral Sensory Neuropathy
5%
Myalgia
5%
Tooth Infection
5%
RASH
5%
Peripheral Motor Neuropathy
5%
Tachycardia
5%
URINARY FREQUENCY
5%
Conjunctivitis
5%
Sinusitis
5%
Syncope
5%
Activated Partial Thromboplastin Time Prolonged
5%
Breast Pain
5%
JOINT RANGE OF MOTION DECREASED
5%
INSOMNIA
5%
Gastrointestinal Disorders - Other, Buccal Cyst
5%
Skin And Subcutaneous Disorders - Other, Dry Skin Patches
5%
HEMATURIA
5%
Investigations - Other, International Normalized Ration Increased
5%
Joint Range Of Motion Decreased
5%
Infections And Infestations - Other, Gi Viral Infection
5%
Gastrointestinal Disorders - Other, Dental Pain
5%
Scalp Lesion
5%
Stomach Pain
5%
SKIN INFECTION
5%
HYPOMAGNESEMIA
5%
Muscle Weakness Upper Limb
5%
DIFFICULTY WALKING, BACK PAIN, BOWEL/BLADDER URGENCY, LEGS GAVE OUT, AND PARESTHESIAS
5%
Skin And Subcutaneous Tissue Disorders- Other, Blister/Bug Bite On Finger
5%
Surgical & Medical Procedures - Other, Dental Extractions
5%
Skin And Subcutaneous Tissue Disorders- Other, Erythema
5%
Infections And Infestations - Other, Covid-19
5%
Investigations - Other, Increased Mean Corpuscular Volume
5%
TENDONITIS
5%
SINUS BRADYCARDIA
5%
HYPERTHYROIDISM
5%
Creatine Phosphokinase Increased
5%
SUBJECT WAS ADMITTED TO THE HOSPITAL ON 10/24/20 WITH GRADE 2 WEIGHT LOSS THAT THE PHYSICIAN FELT NE
5%
Injury, Poisoning And Procedural Complications - Other, Ankle Injury
5%
Injury, Poisoning And Procedural Complications- Other, Scalp Laceration
5%
Musculoskeletal And Connective Tissue Disorder - Other, Tendinitis
5%
Skin And Subcutaneous Tissue Disorders- Other, New Freckles/Moles
5%
Skin And Subcutaneous Tissue Disorders- Other, Sore On Lips
5%
Skin And Subcutaneous Tissue Disorders- Other, Transient Erythema
5%
Urine Discoloration
5%
SPINAL CORD COMPRESSION
5%
ANEMIA
5%
PARONYCHIA
5%
BRUISING
5%
HYPOALBUMINEMIA
5%
Ear And Labyrinth Disorders - Other, Impacted Cerumen
5%
Ear Pain
5%
Elevated Amylase
5%
Facial Pain
5%
Gastrointestinal Disorders - Other, Stomatitis
5%
Hoarseness
5%
Laryngitis
5%
Leg Pain
5%
Localized Edema
5%
Lung Infection
5%
Metabolism And Nutrition Disorders - Other, Decreased Oral Intake
5%
Metabolism Other - Decreased Vitamin D
5%
Metbolism And Nutrition Disorders - Other, Hyperchloremia
5%
Mucositis Oral
100%
80%
60%
40%
20%
0%
Study treatment Arm
Cohort B
Cohort A
Awards & Highlights
All Individual Drugs Already Approved
Therapies where all constituent drugs have already been approved are likely to have better-understood side effect profiles.
Approved for 5 Other Conditions
This treatment demonstrated efficacy for 5 other conditions.
No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Trial Design
2Treatment groups
Experimental Treatment
Group I: Cabozantinib and nivolumabExperimental Treatment2 Interventions
Cabozantinib treatment will receive monthly fix-dosed nivolumab infusions, and start at 40 mg of cabozantinib daily and dose escalate or de-escalate based on pre-specified criteria and at set dosing schedules to allow for smaller median dose changes between adjustments. The de-escalation would be fine-tuned and adjustments would be made in 10 mg average daily dosing increments by utilizing alternate day dosing schedules (e.g 60 mg/40 mg every other day) rather than decreasing by 20 mg. The maximum dose of cabozantinib is 60 mg daily. Cycles would be 28 days, with weekly follow-up for cycle 1 and bi-weekly follow-up for cycle 2 to allow for prompt dose adjustments, and then monthly. At each check-in, patients that have met established protocol criteria and were not yet at the maximum dose of 60 mg daily would be eligible for dose-escalation. Patients would also be dose de-escalated as determined by the investigator. Patients who de-escalate may be allowed to re-escalate in the future.
Group II: CabozantinibExperimental Treatment1 Intervention
Cabozantinib treatment will start at 40 mg of cabozantinib daily and dose escalate or de-escalate based on pre-specified criteria and at set dosing schedules to allow for smaller median dose changes between adjustments. The de-escalation would be fine-tuned and adjustments would be made in 10 mg average daily dosing increments by utilizing alternate day dosing schedules (e.g 60 mg/40 mg every other day) rather than decreasing by 20 mg. The maximum dose of cabozantinib is 60 mg daily. Cycles would be 28 days, with weekly follow-up for cycle 1 and bi-weekly follow-up for cycle 2 to allow for prompt dose adjustments, and then monthly. At each check-in, patients that have met the established protocol criteria and were not yet at the maximum dose of 60 mg daily would be eligible for dose-escalation. Patients would also be dose de-escalated as determined by the investigator. Patients who de-escalate may be allowed to re-escalate in the future.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Cabozantinib
FDA approved
Nivolumab
2015
Completed Phase 3
~4010
Find a Location
Who is running the clinical trial?
Fox Chase Cancer CenterLead Sponsor
234 Previous Clinical Trials
39,262 Total Patients Enrolled
2 Trials studying Neuroendocrine Tumors
111 Patients Enrolled for Neuroendocrine Tumors
ExelixisIndustry Sponsor
121 Previous Clinical Trials
20,059 Total Patients Enrolled
3 Trials studying Neuroendocrine Tumors
73 Patients Enrolled for Neuroendocrine Tumors
Matthew Zibelman, MDPrincipal InvestigatorFox Chase Cancer Center
1 Previous Clinical Trials
26 Total Patients Enrolled
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- You have at least one clearly measurable tumor according to specific guidelines.I have had multiple treatments for my condition.I have active brain or spinal cord cancer symptoms.I am either at low risk according to IMDC or cannot receive immunotherapy as my first treatment.I am not using, nor do I need, drugs or foods that strongly affect drug metabolism.I have issues with my digestive system.My blood pressure is under control without unmanaged high blood pressure.I have not had major or minor surgery recently.I haven't had significant bleeding in the last 3 months.My kidney cancer is confirmed and can be clear cell, non-clear cell, or sarcomatoid.I am currently taking blood thinners.I have another cancer that doesn't need active treatment.I have severe liver problems.I am HIV-positive and on antiretroviral therapy.I do not have any severe illnesses or mental health issues that would stop me from following the study's requirements.I do not have any other major health issues.I am older than 18 years.I can take care of myself and am up and about more than half of the day.My organ and bone marrow functions are normal.I have lung lesions or disease in my airways.I do not have serious heart, stomach, or listed medical conditions.My cancer is growing into or around major blood vessels.I haven't had cancer treatment or radiation recently.I have been treated with cabozantinib before.You have had allergic reactions to similar drugs in the past.
Research Study Groups:
This trial has the following groups:- Group 1: Cabozantinib
- Group 2: Cabozantinib and nivolumab
Awards:
This trial has 3 awards, including:- All Individual Drugs Already Approved - Therapies where all constituent drugs have already been approved are likely to have better-understood side effect profiles.
- Approved for 5 Other Conditions - This treatment demonstrated efficacy for 5 other conditions.
- No Placebo-Only Group - All patients enrolled in this study will receive some form of active treatment.
Timeline:
This trial has the following timeline:- Screening: It may take up to 3 Weeks to process to see if you qualify in this trial.
- Treatment: The duration you will receive the treatment varies.
- Follow Ups: You may be asked to continue sharing information regarding the trial for 6 Months after you stop receiving the treatment.
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