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Renal Cell CarcinomaPhase 1/2NCT01806064

Randomized Phase 2 Trial of Axitinib and TRC105 Versus Axitinib Alone in Patients Renal Cell Carcinoma

A Phase 1/2 study testing TRC105 and Axitinib and Axitinib in people with Renal Cell Carcinoma, run by Tracon Pharmaceuticals Inc. at 39 sites in 4 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

Phase 1b: To evaluate safety and tolerability and determine a recommended phase 2 dose for TRC105 when added to standard dose axitinib in patients with advanced renal cell carcinoma. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Renal Cell Carcinoma
What is being tested?
TRC105 and Axitinib and Axitinib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
173 participants
Where
39 sitesin 4 countries
Study dates
8 Mar 2013to 12 Jun 2019
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed advanced or metastatic renal cell carcinoma with a clear cell component that has progressed by investigator assessment following treatment with one and only one multi-targeted tyrosine kinase inhibitor (TKI) other than axitinib that targets the VEGF receptor (VEGFR) (e.g., sunitinib, pazopanib, sorafenib, tivozanib, cabozantinib). One prior immunotherapy (interleukin-2 or interferon-alpha or immune checkpoint inhibitor or tumor vaccine) and one prior mTOR inhibitor treatment are allowed.
  • No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission per investigators' clinical judgment.
  • Measurable disease by RECIST 1.1 criteria
  • Age of 18 years or older
  • ECOG performance status ≤ 1
  • Resolution of all acute adverse events resulting from prior cancer therapies to NCI CTCAE grade ≤ 1 or baseline (except alopecia)
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  • Adequate organ function as defined by the following criteria:
  • Willingness and ability to consent for self to participate in study
  • Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures

Who cannot join

  • Prior treatment with TRC105 or axitinib or any agent targeting the endoglin pathway (including a fusion protein that binds bone morphogenic protein)
  • Grade 3 or 4 toxicity related to prior VEGFR TKI that did not resolve to grade 1
  • Current treatment on another therapeutic clinical trial
  • Receipt of a small molecule anticancer agent, including an investigational anticancer small molecule, within 14 days of starting study treatment or receipt of a biologic anticancer agent (e.g., antibody) within 28 days of starting study treatment.
  • Prior radiation therapy within 28 days of starting the study treatment, except radiation therapy for bone metastases or radiosurgery is permitted up to 14 days of starting treatment
  • No major surgical procedure or significant traumatic injury within 6 weeks prior to study registration, and must have fully recovered from any such procedure; date of surgery (if applicable). Note: the following are not considered to be major procedures and are permitted up to 7 days before therapy initiation: Thoracentesis, paracentesis, port placement, laparoscopy, thorascopy, tube thoracostomy, bronchoscopy, endoscopic ultrasonographic procedures, mediastinoscopy, skin biopsies, incisional biopsies, imaging-guided biopsy for diagnostic purposes, and routine dental procedures
Show all 19Show fewer
  • Uncontrolled chronic hypertension defined as systolic > 150 or diastolic > 90 despite optimal therapy (initiation or adjustment of BP medication prior to study entry is allowed provided that the average of 3 BP readings at a visit prior to enrollment is < 150/90 mm Hg)
  • History of brain involvement with cancer, spinal cord compression, or carcinomatous meningitis, or new evidence of brain or leptomeningeal disease. Patients with radiated or resected lesions are permitted, provided the lesions are fully treated and inactive, patients are asymptomatic, and no steroids have been administered for at least 28 days.
  • Angina, MI, symptomatic congestive heart failure, cerebrovascular accident, transient ischemic attack, arterial embolism, pulmonary embolism, PTCA or CABG within the past 6 months. Deep venous thrombosis within 6 months unless the patient is anticoagulated without the use of warfarin for at least 2 weeks. In this situation, low molecular weight heparin is preferred.
  • Active bleeding or pathologic condition that carries a high risk of bleeding (e.g. hereditary hemorrhagic telangiectasia).
  • Thrombolytic use (except to maintain i.v. catheters) within 10 days prior to first day of study therapy
  • Known active viral or nonviral hepatitis or cirrhosis
  • History of hemorrhage or hemoptysis (> ½ teaspoon bright red blood) within 3 months of starting study treatment
  • History of peptic ulcer disease within 3 months of treatment, unless treated for the condition and complete resolution has been documented by esophagogastroduodenoscopy (EGD) within 28 days of starting study treatment
  • History of gastrointestinal perforation or fistula in the past 6 months, or while previously on antiangiogenic therapy, unless underlying risk has been resolved (e.g., through surgical resection or repair)
  • Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) related illness
  • Requirement for concomitant medications that strongly induce or inhibit CYP3A4/5
  • Pregnancy or breastfeeding. Female patients must be surgically sterile (i.e.: hysterectomy) or be postmenopausal, or must agree to use effective contraception during the study and for 3 months following last dose of TRC105. All female patients of reproductive potential must have a negative pregnancy test (serum or urine) within 7 days prior to first dose. Male patients must be surgically sterile or must agree to use effective contraception during the study and for 3 months following last dose of TRC105. The definition of effective contraception will be based on the judgment of the Principal Investigator or a designated associate.
  • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or may interfere with the interpretation of study results and, in the judgment of the Investigator, would make the patient inappropriate for this study

Trial locations and contacts

39 sites in 4 countries.

39 sites in 4 countries

United States28 sites
  • University of Michigan

    Ann Arbor, Michigan, 48109

  • Johns Hopkins University

    Baltimore, Maryland, 21287

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35294

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02215

  • Massachusetts General Hospital

    Boston, Massachusetts, 220071

  • Gabrail Cancer Center Research

    Canton, Ohio, 44718

  • Ohio State University

    Columbus, Ohio, 43210

  • City of Hope

    Duarte, California, 91010

  • St. Joseph Heritage Healthcare

    Fullerton, California, 92805

  • University of Florida

    Gainesville, Florida, 32611

  • Indiana Univeristy

    Indianapolis, Indiana, 47405

  • University of Iowa

    Iowa City, Iowa, 52242

  • University of California, Irvine

    Irvine, California, 92697

  • University of Kentucky

    Lexington, Kentucky, 40526

  • Cedars-Sinai Medical Center

    Los Angeles, California, 90048

  • Joe Arrington Cancer Research & Treatment Center

    Lubbock, Texas, 79410

  • University of Miami

    Miami, Florida, 33124

  • Atlantic Health System

    Morristown, New Jersey, 07960

  • Vanderbilt University

    Nashville, Tennessee, 37232

  • Nebraska Cancer Specialists

    Omaha, Nebraska, 68124

  • Illinois CancerCare

    Peoria, Illinois, 61615

  • Oregon Health & Science University

    Portland, Oregon, 97239

  • University of California, Davis

    Sacramento, California, 95616

  • University of Utah

    Salt Lake City, Utah, 84132

  • Mayo Clinic Arizona

    Scottsdale, Arizona, 85054

  • Washington University in St. Louis

    St Louis, Missouri, 63110

  • Moffitt Cancer Center

    Tampa, Florida, 100271

Other trials in United States

Czechia5 sites
  • Masaryk Institute

    Brno

  • St. Anne's

    Brno

  • University Hospital Brno

    Brno

  • Na Bulovce Hospital

    Prague

  • Thomayer Hospital

    Prague

Other trials in Czechia

Hungary5 sites
  • Integrated Szent Istvan and Szent Laszlo Hospital

    Budapest

  • National Institute of Oncology

    Budapest

  • University of Debrecen Medical Center Institute of Oncology

    Debrecen

  • Kaposi Mor Teaching Hospital

    Kaposvár

  • Medical Center of the University of Pecs

    Pécs

Other trials in Hungary

United Kingdom1 site
  • Sussex Cancer Center, Royal Sussex County Hospital

    Brighton, East Sussex

Other trials in United Kingdom

About this study

Official title: A Randomized Phase 2 Trial of Axitinib and TRC105 Versus Axitinib Alone (Including a lead-in Phase 1B Dose Escalation Portion) in Patients With Advanced or Metastatic Renal Cell Carcinoma

Phase 1b: To evaluate safety and tolerability and determine a recommended phase 2 dose for TRC105 when added to standard dose axitinib in patients with advanced renal cell carcinoma.

Phase 2: To estimate the PFS of patients with advanced or metastatic RCC by RECIST 1.1 criteria in patients treated with axitinib and TRC105 compared to those treated with axitinib alone, following failure of one prior VEGF TKI

Read the detailed description

Axitinib is an oral inhibitor of multiple receptor tyrosine kinases including vascular endothelial growth factor receptor VEGFR-1, VEGFR-2, and VEGFR-3 at therapeutic plasma concentrations. These receptors are implicated in pathologic angiogenesis, tumor growth, and cancer progression. Axitinib is approved for the treatment of advanced renal cell carcinoma, following progression on one prior systemic therapy. TRC105 is an antibody to CD105, an important angiogenic target on vascular endothelial cells that is distinct from VEGFR. TRC105 inhibits angiogenesis, tumor growth and metastases in preclinical models and complements the activity of bevacizumab and multi-kinase inhibitors that target VEGFR. In a phase 1 study of advanced solid tumors,TRC105 therapy caused a global reduction in angiogenic biomarkers and reduced tumor burden at doses that were well-tolerated. By targeting a non-VEGF pathway that is upregulated following VEGF inhibition, TRC105 has the potential to complement VEGF inhibitors and could represent a major advance in cancer therapy. TRC105 potentiates bevacizumab and VEGFR tyrosine kinases (VEGFR TKI) in preclinical models. In a phase 1b study, the combination of TRC105 and bevacizumab produced radiographic reductions in tumor volume in bevacizumab refractory patients. Together, the use of TRC105 with axitinib may result in more effective angiogenesis inhibition and improved clinical efficacy over that seen with axitinib alone.

Being tested
TRC105 and Axitinib, Axitinib
Keywords
TRC105, CD105, RCC, Renal Cell Carcinoma, Axitinib, INLYTA, Advanced Renal Cell Carcinoma
Medical subject headings
Carcinoma, Renal Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TRC105 and AxitinibDrug

    Also called Chimeric Antibody (TRC105) to CD105, Inlyta

  • AxitinibDrug

    Also called Inlyta

Study groups in NCT01806064
Study groupRoleWhat they receive
TRC105 and AxitinibExperimentalPatients randomized to receive TRC105 at 3 mg/kg on day 1, 7 mg/kg on day 4, and 10 mg/kg on day 8 and weekly thereafter in combination with axitinib 5 mg twice daily
Receives: Drug: TRC105 and Axitinib
AxitinibActive comparatorPatients randomized to receive axitinib 5 mg twice daily
Receives: Drug: Axitinib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase 1b: Number of Patients With DLT

    Phase 1b: For dose limiting toxicity (DLT) evaluation, severity (grade) was classified according to common terminology criteria for adverse events version 4.0 (CTCAE v4.0).

    Measured: 12 Months

  2. Phase 2: Progression Free Survival (PFS) of Patients With RCC

    Median progression free survival (PFS) of patients with advanced or metastatic RCC by RECIST 1.1. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

    Measured: 15 Months

Secondary outcomes (4)
  1. Phase 1b & 2: Response Rate of Patients With RCC

    Number of patients with partial response (PR) or complete response (CR) by RECIST 1.1 criteria. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

    Measured: 15 Months

  2. Phase 2: Overall Response Rate of Patients With RCC by Choi

    Overall response (OR) rate is the number of patients with partial response (PR) or complete response (CR) by Choi Criteria. Per Choi criteria for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), A decrease in size ≥ 10% or a decrease in tumor attenuation (Houndsfield units) ≥ 15% on CT and no new lesions; Overall Response (OR) = CR + PR.

    Measured: 15 Months

  3. Phase 1b & 2: Trough Concentrations of TRC105 by Dose Level in Phase 1b

    Trough Serum TRC105 concentrations at steady state (cycle 2 day 15) were measured using validated ELISA methods.

    Measured: 2.5 months (cycle 2 day 15)

  4. Phase 1b & 2: Number of Patients With Development of Immunogenicity Antibodies.

    Anti-product antibody concentration were measured using validated ELISA methods.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Mar 2013 (estimated)
  2. Study start8 Mar 2013
  3. Primary completion21 Dec 2018
  4. Study completion12 Jun 2019

Why it stopped: The study did not meet endpoint.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
173 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01806064
Sponsor's protocol ID
105RC101
Status last verified
Oct 2020
First submitted
26 Feb 2013
Last updated
19 Oct 2020
Data monitoring committee
Yes

Publications

  • Choueiri TK, Michaelson MD, Posadas EM, Sonpavde GP, McDermott DF, Nixon AB, Liu Y, Yuan Z, Seon BK, Walsh M, Jivani MA, Adams BJ, Theuer CP. An Open Label Phase Ib Dose Escalation Study of TRC105 (Anti-Endoglin Antibody) with Axitinib in Patients with Metastatic Renal Cell Carcinoma. Oncologist. 2019 Feb;24(2):202-210. doi: 10.1634/theoncologist.2018-0299. Epub 2018 Sep 6.

    PubMed 30190302

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing TRC105 and Axitinib and Axitinib in people with Renal Cell Carcinoma, run by Tracon Pharmaceuticals Inc. at 39 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 19 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 39 sites in United States, Czechia, Hungary, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Oct 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1b: Number of Patients With DLT (time frame: 12 Months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01806064, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Oct 2020.

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