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Metastatic Renal Cell CarcinomaPhase 2INDIGONCT04644432

Individualized Treatment Strategy for Patients With Metastatic Non-clear Cell Renal Cell Carcinoma

A Phase 2 study testing Medication (A specification is listed under each arm) and Patient reported outcomes measurement in people with Metastatic Renal Cell Carcinoma and Kidney Neoplasm, run by Herlev and Gentofte Hospital at 1 site in Denmark.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of the open-label INDIGO-study is to examine whether a first line individualized treatment strategy based on DNA and RNA analyses from the patient's tumor is feasible. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Medication (A specification is listed under each arm) and Patient reported outcomes measurement
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteDenmark
Study dates
6 Mar 2020to 6 Sep 2022
Phase
Phase 2
Are there results?
None posted in the registry

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

  • Signed informed consent form must be obtained before any study-related procedures start.
  • The patient must be willing and able to follow the protocol.
  • Age ≥ 18 years
  • Histological biopsy-confirmed inoperable, locally advanced or metastatic non-cc RCC or 100% sarcomatoid tumour arising from the kidney found unsuited for surgery with a curative intent. Nephrectomy is not mandatory.
  • If the primary disease was diagnosed more than 1 year ago, a fresh medium needle biopsy must be collected to confirm the diagnosis and tissue must be collected for DNA and RNA analyses.
  • If a patient with inoperable relapse had a nephrectomy less than 1 year ago, and no tissue samples are stored in Dansk CancerBiobank, a fresh medium needle biopsy must be collected for DNA and RNA analyses.
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  • In cases where metastatic disease was confirmed by biopsy more than 1 year ago without initiated treatment, the patient is offered a fresh medium needle biopsy, but this is not mandatory for inclusion.
  • If the patient had a nephrectomy using tissue from Dansk CancerBiobank and has been diagnosed with metastases within 1 year, the patient must be offered a fresh medium needle biopsy from a metastasis if the metastasis is easily accessible for biopsy, but a fresh biopsy is not mandatory for inclusion.
  • A medium needle biopsy is mainly taken from a metastasis, but biopsy from a renal tumour is allowed.
  • A biopsy may not be taken from bones as it cannot be used for molecular analysis.
  • If the primary tumour is a proven clear cell RCC, but the biopsy from a metastasis shows non-cc RCC, the patient can be included in the study.
  • Sufficient tissue for DNA analyses, corresponding to 10 slides and RNA analyses corresponding to 1000 tumour cells.
  • Females with a negative pregnancy test or of non-childbearing potential (menopausal, hysterectomy or ovariectomy) and non-breastfeeding.
  • Females of childbearing potential (<2 years after last menstrual period) and males must use effective contraception (pills, intrauterine device, diaphragm or condom with spermicide or sterilisation).
  • Measurable disease (according to RECIST 1.1 criteria)
  • Karnofsky Performance status ≥ 70% / ECOG Performance status 0-2.
  • Life expectancy more than 3 months.
  • At baseline, the laboratory values must be: Haematology: Leukocytes ≥ 3.0 x 109/l, thrombocytes ≥ 100 x 109/l, haemoglobin ≥ 6.2 mmol/l.
  • Biochemistry: International Normalized Ratio (INR) ≤ 1.5, APTT ≤ 1.5 x upper limit of normal (ULN) Total bilirubin ≤ 1.5 x ULN, aspartate transaminase, alanine aminotransferase ≤ 2.5 x ULN for patients without liver metastases, ≤ 5 x ULN for patients with liver metastases. Estimated glomerular filtration rate (eGFR) > 30.

Who cannot join

  • Previous systemic treatment for metastatic RCC (including neoadjuvant treatment).
  • Former adjuvant treatment with immune checkpoint inhibitors.
  • Major surgical procedure, open surgical biopsy or significant trauma within 28 days prior to initiation.
  • Serious non-healing wound, ulcer or bone fracture.
  • Auto-immune disease or other condition requiring systemic treatment with either corticosteroids (prednisolone > 10 mg/day or similar) or other immunosuppressive drugs
  • Metastases in the central nervous system (CNS). The patient must have an MRI scan (preferred) or CT scan of the brain (using contrast agent if possible) within 28 prior to initiation.
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  • Seizures which cannot be managed with standard medical treatment.
  • If urine dipstick with protein ≥ 3+, urine must be collected over a period of 24 hours which must be < 3.5 grams/day. If degree 2 proteinuria, urine must be collected over a period of 24 hours prior to each prescription.
  • Other malignancy within 5 years (except for curatively treated basal cell carcinoma of the skin and/or cervix carcinoma in situ).
  • Uncontrolled hypertension (≥ 150 mm Hg systolic and/or ≥ 100 mm Hg diastolic) despite maximum antihypertensive medical treatment.
  • Clinically significant (i.e. active) cardiovascular disease, such as cerebrovascular conditions (≤ 6 months), myocardial infarction (≤ 6 months), unstable angina, New York Heart Association (NYHA) congestive heart failure ≥ degree III or serious cardiac arrhythmia requiring medical treatment. Patients with well-managed Atrial fibrillation/ atrial flutter may be included.
  • Treatment using other investigational drugs or participation in other studies.
  • Previous or current other diseases, metabolic dysfunction, clinical findings on physical examination or clinical laboratory findings that give suspicion of a disease or condition that would contraindicate the use of an investigational drug or a patient with a high risk of treatment complications.
  • Patients where the investigator finds that patient compliance prevents safe completion of the treatment.

Trial locations and contacts

1 site in 1 country.

Anne Kirstine H Moeller, MD, PhD contact

+4538681083

anne.kirstine.hundahl.moeller@regionh.dk

Jesper A Palshof, MD, PhD contact

+4538686161

jesper.andreas.palshof@regionh.dk

Denmark1 site, 1 recruiting
  • Department of Oncology, Herlev and Gentofte Hospital

    Herlev, 2730

    Anne Kirstine H Moeller, MD, PhD, +4538681083, anne.kirstine.hundahl.moeller@regionh.dk

    Jesper A Palshof, MD, PhD, +4538686161, jesper.andreas.palshof@regionh.dk

    Recruiting

Other trials in Denmark

About this study

Official title: A Phase II Study of an Individualized Treatment Strategy for Patients With Metastatic Non-clear Cell Renal Cell Carcinoma

The purpose of the open-label INDIGO-study is to examine whether a first line individualized treatment strategy based on DNA and RNA analyses from the patient's tumor is feasible. Moreover, to involve the patient further in their treatment via patient-reported outcomes (PRO) measurements in a value-based healthcare setup with simultaneous analyses of the financial costs of this strategy.

The patients are assigned into 4 treatment arms according to the results of their DNA and RNA analyses. All patients receive electronic questionnaires regarding symptoms and side effects weekly and questionnaires regarding quality of life monthly. Based on each patient's answers of the questionnaires the patient receives advices in the app to reduce the symptoms and side effects or the patient is instructed to contact the hospital.

The hypothesis: Basing the choice of first-line treatment for DNA mutations and RNA profiles in a heterogeneous patient population increases the overall response rate for the total population to 30% compared to 10% for historical cohorts.

Being tested
Medication (A specification is listed under each arm), Patient reported outcomes measurement
Keywords
non-clear cell renal cell carcinoma, liquid biopsy, patient reported outcomes, gene expression
Medical subject headings
Carcinoma, Renal Cell, Kidney Neoplasms, Urologic Neoplasms, Urogenital Neoplasms

What participants receive

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

  • Medication (A specification is listed under each arm)Drug

    Study drugs and dosages are listed in the description of arms.

  • Patient reported outcomes measurementOther

    Also called PRO

    PRO questionnaires regarding symptoms and side effects with questions selected from the Nation Cancer Institute Patient Reported Outcomes-Common Terminology Criteria for Adverse Events.

    The patient receive individual advices according to the patient's answers to reduce the symptoms and side effects or is instructed to contact the hospital.

    For monitoring quality of life the EORTC QLQ-C30 is used. All questionnaires are in Danish.

Study groups in NCT04644432
Study groupRoleWhat they receive
A - for patients with a DNA mutation that match a targeted treatmentExperimentalListed below are the possible study drugs and dosages: Erlotinib 150 mg once a day for 4 weeks. Osimertinib 80 mg once a day for 4 weeks. Alectinib 600 mg twice a day for 4 weeks Dabrafenib 150 mg twice a day combined with Trametinib 2 mg once a day for 4 weeks Trastuzumab-emtansin iv infusion 3.6 mg/kg every 3rd week Olaparib 400 mg twice a day for 4 weeks Pembrolizumab iv infusion 2 mg/kg every 3rd week Cabozantinib 60 mg once a day for 4 weeks Crizotinib 250 mg twice a day for 4 weeks Palbociclib 125 mg once a day in3 weeks, hereafter pause for one week Imatinib 400 mg once a day for 4 weeks If the patient can fit in several arms, arm A or the arm closest to arm A is chosen.
Receives: Drug: Medication (A specification is listed under each arm); Other: Patient reported outcomes measurement
B - for patients with an angiogen profileExperimentalStudy drug: Sunitinib peroral tablet 50 mg once a day for 4 weeks, hereafter pause for 2 weeks (4/2 schedule or 2/1 schedule). If the patient can fit in several arms, arm A or the arm closest to arm A is chosen.
Receives: Drug: Medication (A specification is listed under each arm); Other: Patient reported outcomes measurement
C - for patients with an immune profileExperimentalStudy drug: Nivolumab iv infusion 6 mg/kg (max 480 mg) every 4th week. If the patient can fit in several arms, arm A or the arm closest to arm A is chosen.
Receives: Drug: Medication (A specification is listed under each arm); Other: Patient reported outcomes measurement
D - for patients that have neither mutations nor an immune- or angiogen profileExperimentalStudy drug: Nivolumab iv infusion 6 mg/kg (max 480 mg) every 4th week. If the patient can fit in several arms, arm A or the arm closest to arm A is chosen.
Receives: Drug: Medication (A specification is listed under each arm); Other: Patient reported outcomes measurement

What is being measured

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

  1. Overall response rate (ORR)

    The total share of patients who have received treatment with complete and partial response assessed radiologically based on RECIST v.1.1.

    Measured: 30 months

  2. Time to treatment failure (TTF)

    The time from start up day 1 until discontinuation of treatment, regardless of the reason.

    Measured: 30 months

Secondary outcomes (8)
  1. Overall Survival (OS)

    Overall survival for the total population

    Measured: 30 months

  2. Progression-Free Survival (PFS)

    Progression-free survival for the total population

    Measured: 30 months

  3. Disease Control Rate (DCR)

    Disease control rate (complete response + partial response + stabile disease) for the total population based on RECIST v1.1 criteria

    Measured: 30 months

  4. Response duration

    Response duration for the total population.

    Measured: 30 months

  5. Use of PRO tools

    The patients' use of PRO tools during treatment assessed with the validated Patient Feedback Form

    Measured: 30 months

  6. PRO and PRO-CTCAE

    Number of and changes in Patient-reported outcomes according to PRO-CTCAE from baseline.

    Measured: 30 months

  7. NCI-CTCAE

    Number of and types of adverse events according to NCI-CTCAE

    Measured: 30 months

  8. Hospital admissions

    Number of hospital admissions

    Measured: 30 months

Timeline

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

  1. First posted25 Nov 2020
  2. Study start6 Mar 2020
  3. Primary completion6 Sep 2022 (estimated)
  4. Study completion6 Sep 2022 (estimated)

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 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04644432
Sponsor's protocol ID
UR1909
Other IDs
2019-001316-38, PACTIUS, GCP, 2019
Acronym
INDIGO
Status last verified
Nov 2020
First submitted
30 Oct 2020
Last updated
25 Nov 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Rasmussen IML, Soerensen AV, Moller AK, Persson GF, Palshof JA, Taarnhoj GA, Pappot H. Individualizing the Oncological Treatment of Patients With Metastatic Non-Clear Cell Renal Cell Carcinoma by Using Gene Sequencing and Patient-Reported Outcomes: Protocol for the INDIGO Study. JMIR Res Protoc. 2022 Sep 15;11(9):e36632. doi: 10.2196/36632.

    PubMed 36107483

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Medication (A specification is listed under each arm) and Patient reported outcomes measurement in people with Metastatic Renal Cell Carcinoma and Kidney Neoplasm, run by Herlev and Gentofte Hospital at 1 site in Denmark.

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 19 inclusion and 14 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: status not confirmed, as of the sponsor's last update on 25 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. 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?

Results are not available in the source record.

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

Contact Anne Kirstine H Moeller, MD, PhD (+4538681083, anne.kirstine.hundahl.moeller@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall response rate (ORR) (time frame: 30 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 NCT04644432, 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 25 Nov 2020.

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