Advanced Non-Clear Cell Kidney CancerPhase 2NCT02724878
Study of Atezolizumab + Bevacizumab in Patients With Advanced Non-Clear Cell Renal Cell Carcinoma
A Phase 2 study testing Bevacizumab and Atezolizumab in people with Advanced Non-Clear Cell Kidney Cancer, run by Dana-Farber Cancer Institute at 4 sites in United States.
Trial summary
This research study is studying the combination of Atezolizumab and Bevacizumab as a possible treatment for Advanced Non-Clear Cell Kidney Cancer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Advanced Non-Clear Cell Kidney Cancer
- What is being tested?
- Bevacizumab and Atezolizumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 65 participants
- Where
- 4 sitesUnited States
- Study dates
- 15 Jul 2016to 31 Dec 2024
- Phase
- Phase 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
- Age ≥ 18 years.
- Unresectable advanced or metastatic non-clear cell RCC to include but not limited to:
- Papillary RCC, any type
- Unclassified RCC
- Translocation RCC
- Chromophobe RCC
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- Collecting duct RCC
- Medulary RCC
- Clear cell RCC or any histology with > 20% sarcomatoid features will be eligible.
- Other non-clear cell histologies that are not included above need to be discussed with the PI.
- Request for formalin-fixed, paraffin-embedded (FFPE) archival tumor specimens if available and willingness of the participant to undergo mandatory fresh tumor biopsy unless determined medically unsafe or not feasible. A note from the study team should be provided documenting availability of tissue. If a target lesion is biopsied at screening, this lesion must be followed as non-target lesion after the biopsy unless it is the patient's only target lesion. If there is only one target lesion, it should be followed as a target lesion regardless.
- The archival specimen should contain adequate viable tumor tissue.
- The specimen may consist of a tissue block (preferred and should contain the highest grade of tumor) or at least 30 unstained serial sections. Fine-needle aspiration, brushings, cell pellet from pleural effusion, bone marrow aspirate/biopsy are not acceptable.
- Fresh tumor biopsy at progression will be required in cases where patients experience relapse after an initial response if medically safe.
- Measurable disease as defined by Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1.
- ECOG performance status ≤ 2 (See Appendix A).
- Adequate hematologic and end-organ function as defined by the following laboratory results obtained within 28 days prior to the first study treatment:
- Absolute neutrophil count (ANC) ≥ 1500 cells/uL.
- Lymphocyte count ≥ 500/uL.
- Platelet count ≥ 100,000/uL.
- Hemoglobin ≥ 9 g/dL (patients may be transfused to meet this criterion).
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x upper limit of normal (ULN) with the following exceptions: Patients with documented liver metastases should have AST and ALT ≤ 5 x ULN.
- Serum bilirubin ≤ 2.0 x ULN with the following exception: Patients with known Gilbert's disease should have a serum bilirubin ≤ 3 x ULN.
- Creatinine clearance ≥ 30 mL/min as calculated by Cockcroft-Gault equation.
- For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use highly effective forms of contraception and to continue its use 6 months after the last dose of atezolizumab or bevacizumab.
- Signed informed consent form.
- Ability and capacity to comply with study and follow-up procedures.
Who cannot join
- •Prior treatment with CD137 agonists, anti- cytotoxic T-lymphocyte-associated protein 4, anti-PD-1, or anti-PDL1 therapeutic antibody or pathway targeting agents.
- Prior IFNα or IL-2 is allowed following 4 week washout from treatment end date.
- Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitors) within 2 weeks of enrollment or receipt of any anti-cancer therapy (including investigational therapy, monoclonal antibodies, cytokine therapy) within 4 weeks of enrollment.
- Prior therapy with bevacizuamab.
- Thrombologic event within 3 weeks of treatment start date, unless stable on anticoagulation with LMWH or Factor Xa inhibitor for at least 2 weeks.
- Treatment with systemic immunosuppressive medications including but not limited to: prednisone, dexamethasone, cyclosporin, azathioprine, methotrexate, thalidomide, anti- tumor necrosis factor (TNF) agents, hydroxychloroquine within 2 weeks of first study dose.
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- Patients who have received acute, low-dose systemic immunosuppressant medications may be enrolled.
- Patients with adrenal insufficiency on physiologic replacement doses of steroids may be enrolled.
- The use of inhaled, topical intraocular, or intra articular corticosteroids or, mineralocorticoids are allowed.
- Radiotherapy for RCC within 14 days of first study treatment with the exception of a single fraction of radiation administered for palliation of symptoms.
- Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy, radiosurgery, or surgery and stable for at least 4 weeks prior to the initiation of study treatment. Stability must be confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) imaging and/or treating investigator determination.
- Malignancies other than RCC within 2 years of first study treatment with the exception of those with negligible risk of metastases or death (included but not limited to carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer, ductal carcinoma in situ of the breast, non-muscle invasive urothelial carcinoma, or other malignancy not deemed to impact that patients 5-year life expectancy).
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion protein.
- Known hypersensitivity to any component of the atezolizumab product.
- History of autoimmune disease including: myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with anti-phospholipid syndrome, Wegner's granulomatosis, Sjogren's syndrome, Guillain-Barre syndrome, multiple sclerosis, type I diabetes mellitus, vasculitis, or glomerulonephritis. Patients with a history of autoimmune-related hypothyroidism on thyroid replacement hormone or those with autoimmune dermatologic conditions not requiring the use of prednisone > 10 mg or equivalent are eligible.
- History of idiopathic pulmonary fibrosis, organized pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening imaging CT of the chest. History of radiation pneumonitis in the radiation field is permitted.
- Positive test for HIV (test to be performed within 28 days of first treatment start).
- Patients with active or chronic hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening). Patients with past/resolved HBV infection (defined as having negative HBsAg test and a positive antibody to hepatitis B core antigen [anti-HBc] antibody test) are eligible. A negative HBA DNA test must be obtained in patients with positive hepatitis B core antibody prior to Cycle 1 Day 1.
- Active hepatitis C infection. Patients positive hepatitis C antibody test are eligible if PCR is negative for hepatitis C viral DNA.
- Infection requiring receipt of therapeutic oral or IV anti-microbials within 2 weeks of first study treatment. Patients receiving routine anti-microbial prophylaxis (for dental extractions/procedures) are eligible.
- Significant cardiovascular disease such as New York Heart Association (NYHA) class II or greater, myocardial infarction within the previous 3 months of first study treatment, unstable arrhythmias, unstable angina. Patients with known coronary artery disease, congestive heart failure not meeting the above criteria, or left ventricular ejection fraction < 50% must be on a stable regimen that is optimized in the opinion of the treating physician, in consultation with a cardiologist when appropriate.
- Inadequately controlled hypertension (defined as systolic blood pressure > 150 mmHg and/or diastolic blood pressure > 100 mmHg). Anti-hypertensive therapy to achieve these parameters is allowed.
- Prior history of hypertensive crisis or hypertensive encephalopathy within the previous 3 months of first study treatment.
- History of stroke or transient ischemic attack within 3 months of first study dose.
- Significant vascular disease (such as aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis) within 6 months of first study dose. Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation).
- Current or recent use of dipyramidole, ticlopidine, clopidogrel, cilostazol is excluded. Aspirin (≤ 325 mg per day) is allowed. Prophylactic anticoagulation with oral or parenteral anticoagulants for the patency of venous access devices or other indications is allowed. Therapeutic use of low-molecular weight heparin (such as enoxaparin), and factor Xa inhibitors are allowed. Use of warfarin is prohibited.
- Use of plaquenil must be discontinued two weeks prior to first study treatment.
- History of abdominal or tracheoesophageal fistula or GI perforation within 6 months of first study treatment.
- Clinical signs or symptoms of active GI obstruction or requirement of routine parenteral nutrition or tube feedings.
- Evidence of abdominal free air not explained by paracentesis or recent surgical procedure.
- Serious, non-healing or dehiscing wound or active ulcer.
- Proteinuria, as demonstrated by > 1.5 gram of protein in a 24-hour urine collection. All patients with ≥ 2+ protein on dipstick urinalysis at baseline must undergo 24-hour urine collection for protein.
- Major surgical procedure within 21 days of first study treatment.
- Prior allogenic stem cell or solid organ transplant.
- Administration of a live, attenuated vaccine within 4 weeks for first study treatment.
- Pregnant or lactating women.
Trial locations and contacts
4 sites in 1 country.
United States4 sites
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02115
Dana Farber Cancer Institute
Boston, Massachusetts, 02115
Karmanos Cancer Institute
Detroit, Michigan, 48201
University of California, San Diego Moores Cancer Center
La Jolla, California, 92037
About this study
Official title: Phase II Study of Atezolizumab + Bevacizumab in Patients With Advanced Non-Clear Cell Renal Cell Carcinoma
This research study is studying the combination of Atezolizumab and Bevacizumab as a possible treatment for Advanced Non-Clear Cell Kidney Cancer.
Read the detailed description
This research study is a Phase II clinical trial. In this research the investigators are studying the combination of Atezolizumab with Bevacizumab. Participants will receive both vascular endothelial targeted therapy and immunotherapy.
The FDA (the U.S. Food and Drug Administration) has not approved Atezolizumab for Advanced Non-Clear Cell Kidney Cancer, but it has been approved for other uses.
The FDA has approved Bevacizumab with Interferon (IFNα) as a treatment option for Advanced Kidney Cancer.
- Conditions
- Advanced Non-Clear Cell Kidney Cancer
- Being tested
- Bevacizumab, Atezolizumab
- Keywords
- Kidney Cancer
- Medical subject headings
- Kidney Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BevacizumabDrug
Also called Avastin
AtezolizumabDrug
Also called RG-7446
| Study group | Role | What they receive |
|---|---|---|
| Bevacizumab And Atezolizumab Combination | Experimental | 1200 mg of Atezolizumab intravenously x 3 weeks
15 mg/kg of Bevacizumab intravenously x 3 weeks.
One cycle will be 3 weeks in duration. Receives: Drug: Bevacizumab; Drug: Atezolizumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Best Overall Response Rate
The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria.
CR and PR must meet the following lesion criteria without having any new lesions as well:
Target Lesion:
(CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
(PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
Non-Target Lesion:
(CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis).
Non-CR/Non-Progressive Disease: Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion.
Measured: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
Secondary outcomes (19)
Best Overall Response Rate by Histological Subtypes
The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria. Please see the primary endpoint "Best Overall Response Rate" description for the definition of CR and PR.
Non-clear cell renal cell carcinoma includes different histologic and genetic subtypes to include: papillary, chromophobe, collecting duct, unclassified, translocation, and medullary carcinoma. These subtypes are measured using established methods.
Measured: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months
Percentage of Participants With Treatment-related Adverse Events
Assessed by -Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. All treatment-related all-grade adverse events occurring in >10% of participants.
Treatment Related is discerned as follows:
- Yes: There is a plausible temporal relationship between the onset of the AE and administration of atezolizumab or bevacizumab, and the AE cannot be readily explained by the patient's clinical state, intercurrent illness, or concomitant therapies; and/or the AE follows a known pattern of response to atezolizumab or bevacizumab or with similar treatments; and/or the AE resolves upon discontinuation of the study drugs or dose reduction and, if applicable, reappears upon re-challenge.
- No: Evidence exists that the AE has an etiology other than the study drugs (e.g., pre existing medical condition, underlying disease, intercurrent illness, or concomitant medication); and/or the AE has no plausible temporal relationship to the study drugs administration.
Measured: Adverse events are measured continuously on treatment and up to thirty days after going off treatment (up to ~32 months).
Duration of Response
The duration of overall response (based on RECIST 1.1) is measured from the time measurement criteria are met for CR and PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented taking as reference for progressive disease the smallest measurements recorded since the treatment started or death due to any cause. Participants without events reported are censored at the last disease evaluation.
Measured: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months.
Immune Related Best Overall Response Rate
The best overall Immune-Related Complete Response (irCR) or Immune-Related Partial Response (irPR) is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started).
irCR: Complete disappearance of all target lesions in two consecutive observations not less than 4 weeks apart. This category encompasses exactly the same subjects as complete response (CR).
irPR: Decrease, relative to baseline, of 50% or greater in the sum of the products of the two largest perpendicular diameters (SPD) of all target and all new measurable lesions in two consecutive observations not less than 4 weeks apart. Note: the appearance of new measurable lesions is factored into the overall tumor burden, but does not automatically qualify as progressive disease until the SPD increases by > 25% when compared to SPD at nadir.
Measured: Measured every 6 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months.
Median Progression Free Survival
Progression free survival (PFS) is defined as the time from start of treatment to disease progression (PD) or death from any cause as estimated by Kaplan Meier methods. Patients who have not progressed and are alive are censored at the date the patient is known to be progression-free. Progression is defined by Response Evaluation Criteria In Solid Tumors Criteria 1.1 (RECIST) as follows:
- >20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (including baseline if it's the smallest). The sum must also demonstrate an increase of >5 mm.
OR
-Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment.
Measured: Participants followed for up to 32 months.
1-Year Overall Survival
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Measured: 1 year
Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score
The Function Assessment of Cancer Therapy-Kidney Symptom Index-19 (FKSI-19) is a 19 item questionnaire with each item scored on a scale of 0-4 for a total score of 0-76 with higher scores indicating fewer symptom.
Measured: Assessed at baseline, week 3, week 5, week 7, week 9, and end of therapy.
Brief Fatigue Inventory Score - Items 1-3
The Brief Fatigue Inventory Score (BFI) is a 9 item questionnaire with each items 1-3 scored on a scale of 0-10 Scores are categorized is mild (1-3), moderate (4-6), or severe (7-10). A global fatigue score can be found by averaging the score obtained on each test item completed. Items 1-3 of the 9 are reported here.
Measured: Assessed at baseline, week 9, week 15, week 21, week 27, and end of therapy.
6-Month Progression-Free Survival by Histological Subgroups
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows:
- >20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of >5 mm.
OR
-Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment.
Histological subgroups are categorized using established methods.
Measured: 6 months
1-Year Overall Survival by Histological Subgroup
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Measured: 1 year
6-Month Progression-Free Survival by Sarcomatoid Differentiation
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows:
- >20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of >5 mm.
OR
-Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment.
Sarcomatoid Differentiation are categorized using established methods
Measured: 6 months
1-Year Overall Survival by Sarcomatoid Differentiation
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Measured: 1 year
Objective Response Rate by Sarcomatoid Differentiation
The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1).
CR and PR must meet the following criteria without having any new lesions as well:
Target Lesion:
(CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
(PR): >=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter.
Non-Target Lesion:
(CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (<10 mm short axis) Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion Sarcomatoid Differentiation are categorized using established methods
Measured: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows:
- >20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum. The sum must also demonstrate an increase of >5 mm.
OR
-Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at next assessment at investigator discretion if patient is benefiting from treatment.
International Metastatic Renal Cell Carcinoma Risk Group determined by established methods
Measured: 6 months
1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Measured: 1 year
Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group
The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using RECIST 1.1.
CR and PR must meet the following criteria without having any new lesions as well:
Target Lesion:
(CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
(PR): >=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter.
Non-Target Lesion:
(CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (<10 mm short axis).
Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion.
International Metastatic Renal Cell Carcinoma Risk Group are categorized using established methods
Measured: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
6-Month Progression-Free Survival by Prior Systemic Therapy
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows:
- >20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of >5 mm.
OR
-Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment.
Prior systemic therapy group determined by established methods,
Measured: 6 months
1-Year Overall Survival by Prior Systemic Therapy
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Measured: 1 year
Objective Response Rate by Prior Systemic Therapy
The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using RECIST 1.1.
CR and PR must meet the following criteria without having any new lesions as well:
Target Lesion:
(CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
(PR): >=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter.
Non-Target Lesion:
(CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (<10 mm short axis).
Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion.
Measured: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Mar 2016 (estimated)
- Study start15 Jul 2016
- Primary completion13 Nov 2019
- Study completion31 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Advanced Non-Clear Cell Kidney CancerStudies of the same condition, open and under way.
- More trials run by Dana-Farber Cancer InstituteThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 65 participants (actual)
Sponsor and investigators
- Lead sponsor
- Dana-Farber Cancer Institute
- Sponsor type
- University, hospital or other
- Collaborators
- Genentech, Inc.
- Responsible party
- Principal investigator, Toni Choueiri, MD, Dana-Farber Cancer Institute
- Investigators
- Toni Choueiri, MD, Principal investigator, Dana-Farber Cancer Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02724878
- Sponsor's protocol ID
- 15-592
- Status last verified
- Jan 2025
- First submitted
- 16 Mar 2016
- Last updated
- 13 Feb 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: Available upon request.
Publications
Saliby RM, El Zarif T, Bakouny Z, Shah V, Xie W, Flippot R, Denize T, Kane MH, Madsen KN, Ficial M, Hirsch L, Wei XX, Steinharter JA, Harshman LC, Vaishampayan UN, Severgnini M, McDermott DF, Lee GM, Xu W, Van Allen EM, McGregor BA, Signoretti S, Choueiri TK, McKay RR, Braun DA. Circulating and Intratumoral Immune Determinants of Response to Atezolizumab plus Bevacizumab in Patients with Variant Histology or Sarcomatoid Renal Cell Carcinoma. Cancer Immunol Res. 2023 Aug 3;11(8):1114-1124. doi: 10.1158/2326-6066.CIR-22-0996.
PubMed 37279009McGregor BA, McKay RR, Braun DA, Werner L, Gray K, Flaifel A, Signoretti S, Hirsch MS, Steinharter JA, Bakouny Z, Flippot R, Wei XX, Choudhury A, Kilbridge K, Freeman GJ, Van Allen EM, Harshman LC, McDermott DF, Vaishampayan U, Choueiri TK. Results of a Multicenter Phase II Study of Atezolizumab and Bevacizumab for Patients With Metastatic Renal Cell Carcinoma With Variant Histology and/or Sarcomatoid Features. J Clin Oncol. 2020 Jan 1;38(1):63-70. doi: 10.1200/JCO.19.01882. Epub 2019 Nov 13.
PubMed 31721643
Study at a glance
From the registry record, last updated by the sponsor on 13 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Study of Atezolizumab + Bevacizumab in Patients With Advanced Non-Clear Cell Renal Cell Carcinoma
- ClinicalTrials.gov ID
- NCT02724878
- Acronym / sponsor ID
- 15-592
- Conditions
- Advanced Non-Clear Cell Kidney Cancer
- Keywords
- Kidney Cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 65 participants (actual)
- Lead sponsor
- Dana-Farber Cancer InstituteUniversity, hospital or other
- Collaborators
- Genentech, Inc.
- Study start
- 15 Jul 2016 (actual)
- Primary completion
- 13 Nov 2019 (actual)
- Study completion
- 31 Dec 2024 (actual)
- First posted
- 31 Mar 2016 (estimated)
- Results
- Posted 21 Apr 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This research study is studying the combination of Atezolizumab and Bevacizumab as a possible treatment for Advanced Non-Clear Cell Kidney Cancer.
Detailed description
This research study is a Phase II clinical trial. In this research the investigators are studying the combination of Atezolizumab with Bevacizumab. Participants will receive both vascular endothelial targeted therapy and immunotherapy.
The FDA (the U.S. Food and Drug Administration) has not approved Atezolizumab for Advanced Non-Clear Cell Kidney Cancer, but it has been approved for other uses.
The FDA has approved Bevacizumab with Interferon (IFNα) as a treatment option for Advanced Kidney Cancer.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Bevacizumab And Atezolizumab Combination | Experimental | Drug: Bevacizumab, Drug: Atezolizumab1200 mg of Atezolizumab intravenously x 3 weeks 15 mg/kg of Bevacizumab intravenously x 3 weeks. One cycle will be 3 weeks in duration. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (27 listed)
- Age ≥ 18 years.
- Unresectable advanced or metastatic non-clear cell RCC to include but not limited to:
- Request for formalin-fixed, paraffin-embedded (FFPE) archival tumor specimens if available and willingness of the participant to undergo mandatory fresh tumor biopsy unless determined medically unsafe or not feasible. A note from the study team should be provided documenting availability of tissue. If a target lesion is biopsied at screening, this lesion must be followed as non-target lesion after the biopsy unless it is the patient's only target lesion. If there is only one target lesion, it should be followed as a target lesion regardless.
- Measurable disease as defined by Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1.
- ECOG performance status ≤ 2 (See Appendix A).
Key exclusion criteria (36 listed)
- •Prior treatment with CD137 agonists, anti- cytotoxic T-lymphocyte-associated protein 4, anti-PD-1, or anti-PDL1 therapeutic antibody or pathway targeting agents.
- Prior IFNα or IL-2 is allowed following 4 week washout from treatment end date.
- Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitors) within 2 weeks of enrollment or receipt of any anti-cancer therapy (including investigational therapy, monoclonal antibodies, cytokine therapy) within 4 weeks of enrollment.
- Prior therapy with bevacizuamab.
- Thrombologic event within 3 weeks of treatment start date, unless stable on anticoagulation with LMWH or Factor Xa inhibitor for at least 2 weeks.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| BevacizumabAlso: Avastin | Drug | Bevacizumab And Atezolizumab Combination |
| AtezolizumabAlso: RG-7446 | Drug | Bevacizumab And Atezolizumab Combination |
Primary outcome
Best Overall Response Rate
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria. CR and PR must meet the following lesion criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion.
19 secondary outcomes
Best Overall Response Rate by Histological Subtypes
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months
Percentage of Participants With Treatment-related Adverse Events
Time frame: Adverse events are measured continuously on treatment and up to thirty days after going off treatment (up to ~32 months).
Duration of Response
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months.
Immune Related Best Overall Response Rate
Time frame: Measured every 6 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months.
Median Progression Free Survival
Time frame: Participants followed for up to 32 months.
1-Year Overall Survival
Time frame: 1 year
Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score
Time frame: Assessed at baseline, week 3, week 5, week 7, week 9, and end of therapy.
Brief Fatigue Inventory Score - Items 1-3
Time frame: Assessed at baseline, week 9, week 15, week 21, week 27, and end of therapy.
6-Month Progression-Free Survival by Histological Subgroups
Time frame: 6 months
1-Year Overall Survival by Histological Subgroup
Time frame: 1 year
6-Month Progression-Free Survival by Sarcomatoid Differentiation
Time frame: 6 months
1-Year Overall Survival by Sarcomatoid Differentiation
Time frame: 1 year
Objective Response Rate by Sarcomatoid Differentiation
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group
Time frame: 6 months
1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group
Time frame: 1 year
Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
6-Month Progression-Free Survival by Prior Systemic Therapy
Time frame: 6 months
1-Year Overall Survival by Prior Systemic Therapy
Time frame: 1 year
Objective Response Rate by Prior Systemic Therapy
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Feb 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 37279009Saliby RM, El Zarif T, Bakouny Z, Shah V, Xie W, Flippot R, Denize T, Kane MH, Madsen KN, Ficial M, Hirsch L, Wei XX, Steinharter JA, Harshman LC, Vaishampayan UN, Severgnini M, McDermott DF, Lee GM, Xu W, Van Allen EM, McGregor BA, Signoretti S, Choueiri TK, McKay RR, Braun DA. Circulating and Intratumoral Immune Determinants of Response to Atezolizumab plus Bevacizumab in Patients with Variant Histology or Sarcomatoid Renal Cell Carcinoma. Cancer Immunol Res. 2023 Aug 3;11(8):1114-1124. doi: 10.1158/2326-6066.CIR-22-0996.
- Results publication: PubMed 31721643McGregor BA, McKay RR, Braun DA, Werner L, Gray K, Flaifel A, Signoretti S, Hirsch MS, Steinharter JA, Bakouny Z, Flippot R, Wei XX, Choudhury A, Kilbridge K, Freeman GJ, Van Allen EM, Harshman LC, McDermott DF, Vaishampayan U, Choueiri TK. Results of a Multicenter Phase II Study of Atezolizumab and Bevacizumab for Patients With Metastatic Renal Cell Carcinoma With Variant Histology and/or Sarcomatoid Features. J Clin Oncol. 2020 Jan 1;38(1):63-70. doi: 10.1200/JCO.19.01882. Epub 2019 Nov 13.
- Individual participant dataSharing planned: Yes. Available upon request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Toni Choueiri, MD principal investigator
Dana-Farber Cancer Institute
4 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Bevacizumab and Atezolizumab in people with Advanced Non-Clear Cell Kidney Cancer, run by Dana-Farber Cancer Institute at 4 sites in United States.
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 27 inclusion and 36 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: finished, as of the sponsor's last update on 13 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 4 sites in United States. 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 phase mean?
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 21 Apr 2021). 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?
Best Overall Response Rate (time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .). 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 NCT02724878, which also lists 2 linked publications.
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 13 Feb 2025.