Testing the Addition of the Anti-Cancer Drug Tivozanib to Immunotherapy (Pembrolizumab) After Surgery to Remove All Known Sites of Kidney Cancer
Launched by ALLIANCE FOR CLINICAL TRIALS IN ONCOLOGY · Oct 25, 2024
Trial Information
Current as of May 28, 2025
Recruiting
Keywords
ClinConnect Summary
This clinical trial is studying whether adding a drug called tivozanib to the standard treatment, pembrolizumab, can improve outcomes for patients with certain types of kidney cancer, specifically high-risk renal cell carcinoma (RCC). Pembrolizumab is an immunotherapy that helps the body’s immune system fight cancer, while tivozanib works by blocking signals that help tumor cells grow. The trial aims to see if using these two treatments together after surgery to remove cancer can be more effective than using pembrolizumab alone.
To be eligible for this trial, participants must be at least 18 years old and have a confirmed diagnosis of RCC with specific characteristics, like having had surgery to remove the cancer. They should also have no signs of disease at the time of joining the study and meet certain health criteria. Participants will receive either the combination of tivozanib and pembrolizumab or pembrolizumab alone and will be monitored closely for their response to treatment. It’s important to know that women who can become pregnant will need to take a pregnancy test before joining, and there are some health conditions that could prevent someone from participating in the trial.
Gender
ALL
Eligibility criteria
- Inclusion Criteria:
- • • Histologically confirmed diagnosis of RCC with clear cell component with or without sarcomatoid features following complete resection of the primary tumor (radical or partial nephrectomy)
- • Note: Patients with microscopically positive soft tissue or vascular margins without gross residual disease are permitted
- * Intermediate-high risk RCC:
- • pT2 grade 4 or sarcomatoid features, N0M0
- • pT3 any grade N0, M0
- • High-risk RCC
- • pT4, any grade, N0, M0
- • pT, any stage., any grade, N+, M0
- • cM1 no evidence of disease (NED) RCC
- • Participants who have had resection of primary tumor (radical or partical nephrectomy) and resection or definitive radiation or ablation of solid, isolated, soft tissue metastases (excluding brain and bone lesions) at the time of primary tumor removal (synchronous) or ≤1 year from primary tumor removal (metachronous)
- • Surgery (radical or partial nephrectomy or metastasectomy or ablation) \> 4 weeks but =\< 16 weeks prior to study registration with no ongoing complications from surgery
- • No evidence of disease at time of randomization as assessed by investigator by either CT or MRI scan of the brain and chest, abdomen and pelvis
- • No prior systemic treatment for RCC
- • Age \>= 18 years
- • Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 (or Karnofsky \>= 60%)
- • Absolute neutrophil count (ANC) \>= 1,000/mm\^3
- • Platelet count \>= 100,000/mm\^3
- • Hemoglobin \>= 8 g/dL
- • Total bilirubin =\< 3 x upper limit of normal (ULN)
- • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3 x upper limit of normal (ULN)
- • Calculated (calc.) creatinine clearance \>= 30 mL/min (using Cockcroft Gault equation or the estimated glomerular filtration rate from the modification of diet in renal disease trial)
- • Urine protein =\< 1+ on urine analysis (UA) or urine protein creatinine ration (UPCR) \< 2mg/mg
- • Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative pregnancy test is required =\< 14 days prior to registration
- • HIV status: HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
- • Hepatitis
- • Hepatitis B: For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. Patients with resolved HBV infection, defined as positive hepatitis B core antibody (anti-HBc) and negative hepatitis B surface antigen (HbsAg), are eligible
- • Hepatitis C: Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
- • Cardiac Disease: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class IIB or better
- • No history of myocarditis
- • No history of clinically significant pneumonitis
- • No uncontrolled hypertension (systolic blood pressure \[BP\] \> 150 mm Hg or diastolic BP \> 90 mm Hg) documented on 2 consecutive measurements taken at least 2 hours apart
- • No serious non-healing wound, ulcer or bone fracture within 28 days prior to registration
- • No serious/active infection requiring parenteral antibiotics
- • No moderate or severe hepatic impairment (child-Pugh B or C)
- * No significant bleeding disorders within 1 month prior to registration, for example:
- • Hematemesis, hematochezia or other gastrointestinal bleeding grade 3 or higher
- • Hemoptysis of pulmonary bleeding grade 3 or higher
- • Hematuria or other genitourinary bleeding grade 3 or higher
- • No history of allogeneic organ transplantation
- • No history of allergy of hypersensitivity to study drugs or components
- • No condition requiring systemic treatment with either corticosteroid (\> 10 mg daily or prednisone equivalent) within 14 days of treatment initiation or other immunosuppressive medications within 30 days of randomization. Inhaled or topical steroids and adrenal replacement doses ≤10 mg daily prednisone equivalent are permitted in absence of active autoimmune disease
- • No active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis or other gastrointestinal condition associated with increased risk of perforation; history of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 4 weeks prior to registration
- • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
- * No patients with a history of autoimmune disease that has required systemic treatment in the past 2 years (i.e., with use of disease modifying agents, corticosteroids \> 10 mg/day, or immunosuppressive drugs) with the following exceptions:
- • Replacement therapy (e.g., thyroxine, insulin, physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed
- • Brief (\<7 days) use of systemic corticosteroids is allowed when use is considered standard of care
- • Patients with vitiligo, psoriasis, type 1 diabetes mellitus, hypothyroidism, or resolved childhood asthma/atopy will not be excluded
- • Patients requiring intermittent use of bronchodilators, inhaled steroids, or local steroid injections will not be excluded
- • Patients with hypothyroidism that is stable with hormone replacement or Sjögren's syndrome will not be excluded • Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients must discontinue the drug 14 days prior to the start of study treatment
About Alliance For Clinical Trials In Oncology
The Alliance for Clinical Trials in Oncology is a prominent cooperative group dedicated to conducting high-quality, innovative clinical research aimed at improving cancer treatment and patient outcomes. Comprising a diverse network of institutions and investigators, the Alliance focuses on developing and implementing clinical trials that evaluate new therapies, treatment combinations, and prevention strategies across various cancer types. By fostering collaboration among oncologists, researchers, and healthcare professionals, the Alliance aims to accelerate the translation of scientific discoveries into effective clinical practices, ultimately enhancing the standard of care for cancer patients.
Contacts
Jennifer Cobb
Immunology at National Institute of Allergy and Infectious Diseases (NIAID)
Locations
Saint Louis, Missouri, United States
Flint, Michigan, United States
Effingham, Illinois, United States
Springfield, Illinois, United States
Saint Louis, Missouri, United States
Cape Girardeau, Missouri, United States
Decatur, Illinois, United States
Ottawa, Illinois, United States
Peoria, Illinois, United States
Cedar Rapids, Iowa, United States
Cedar Rapids, Iowa, United States
Galesburg, Illinois, United States
Billings, Montana, United States
Burlington, Massachusetts, United States
Livonia, Michigan, United States
Charleston, West Virginia, United States
Canton, Illinois, United States
Carthage, Illinois, United States
Eureka, Illinois, United States
Kewanee, Illinois, United States
Macomb, Illinois, United States
Peru, Illinois, United States
Princeton, Illinois, United States
Post Falls, Idaho, United States
Bloomington, Illinois, United States
Pekin, Illinois, United States
Saint Louis, Missouri, United States
Springfield, Illinois, United States
Saint Peters, Missouri, United States
Great Falls, Montana, United States
Newark, Delaware, United States
Newark, Delaware, United States
Rehoboth Beach, Delaware, United States
Coeur D'alene, Idaho, United States
Flint, Michigan, United States
Decatur, Illinois, United States
Brighton, Michigan, United States
Canton, Michigan, United States
Chelsea, Michigan, United States
Ypsilanti, Michigan, United States
Sainte Genevieve, Missouri, United States
Sullivan, Missouri, United States
Ames, Iowa, United States
Creve Coeur, Missouri, United States
Saint Louis, Missouri, United States
Dixon, Illinois, United States
Washington, Illinois, United States
Farmington, Missouri, United States
Peabody, Massachusetts, United States
Bozeman, Montana, United States
Missoula, Montana, United States
Springfield, Illinois, United States
Shiloh, Illinois, United States
Boone, Iowa, United States
Fort Dodge, Iowa, United States
Jefferson, Iowa, United States
Marshalltown, Iowa, United States
Ames, Iowa, United States
Sunset Hills, Missouri, United States
Sandpoint, Idaho, United States
Millville, Delaware, United States
Flint, Michigan, United States
Patients applied
Timeline
First submit
Trial launched
Trial updated
Estimated completion
Not reported