Renal Cell Carcinoma Clinical Trial
Official title:
A Phase II Trial of Avastin and Temsirolimus Following Tyrosine Kinase Inhibitor Failure in Patients With Advanced Renal Cell Carcinoma
This is a single-arm phase II trial evaluating the combination of avastin and temsirolimus in patients with metastatic renal cell cancer (RCC) including both histologically confirmed clear cell (cc) or non-clear cell (ncc) subtypes. Patients must have experienced disease progression or intolerable toxicity with a vascular endothelial growth factor (VEGF)-targeted tyrosine kinase inhibitor (TKI) (e.g. sorafenib, sunitinib, pazopanib). Only 2 prior VEGF therapies are allowed. The purpose of this research study is to evaluate efficacy of the combination against an historical control. Temsirolimus has been approved by the Food and Drug Administration (FDA) in the treatment of renal cell carcinoma. Avastin has been approved by the FDA for other types of cancers but not renal cell carcinoma.
Avastin, a humanized IgG1 monoclonal antibody (MAb), inhibits vascular endothelial growth
factor (VEGF). VEGF is one of the most potent and specific proangiogenic factors and has been
identified as a crucial regulator of both normal and pathological angiogenesis. Temsirolimus
specifically inhibits the mammalian target of rapamycin (mTOR), a highly conserved
serine/threonine kinase which regulates cell growth and metabolism in response to
environmental factors. The combination avastin and temsirolimus has already demonstrated
efficacy in the phase I setting
STATISTICAL CONSIDERATIONS:
The primary endpoint is 4-month PFS. The null and alternative hypotheses are 50% vs. 70%.
Assuming 2 ineligible patients, the target sample size is 41 patients (39 eligible patients).
The probability of concluding that the treatment is effective was >0.90 if the true rate is
at least 70%. The probability of concluding that the treatment is effective was ≤ 0.10 if the
true rate was 50% or less. If 24 or more patients are alive and progression-free at 4 months,
then this regimen would be considered for further study.
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