Renal Cell Carcinoma Clinical Trial
Official title:
Molecular Determinants for Therapy Response on Renal Cell Carcinoma
Aim of the scientific analysis is to find biological factors (biomarkers) allowing a
prediction of disease progression and a better choice of therapy. After diagnosis the kidney
and the tumor will be removed by standard surgery followed by drug therapy. Within surgery
remaining tumor tissue will be used for the scientific analysis. In case of disease
progression during the drug treatment the drug therapy will be changed. Before therapy
change a small tissue sample will be collected for molecular diagnostics. This will be done
by puncture through the skin under local anesthesia. Blood samples taken before surgery and
at the time of first and second disease progression will also be used for
molecular-biological analysis. As there is no clear recommendation for drug therapy after
disease progression this study should serve to determine an individual therapy on the basis
of the molecular profile and the molecular changes. As the tumor disease changes and
developes resistance to drugs, analysis at the time of disease progression shall identify
biological factors which will predict a likelihood response to a specific drugs.
This shall allow to give the patient an individual therapy.
Aim of this study is to perform a profound molecular analysis of the tumor before beginning
therapy and after failure of the approved targeted first-and second line therapy (standard
therapy). The tumor sample will be analyzed by using profound molecular analysis to identify
target structures which will predict the efficacy of a specific therapy (substance group)and
therefore have a predictive value. The analysis of molecular biomarkers include the genomic
sequencing of targeted areas or of the entire DNA of the tumor tissue comparative to the DNA
of healthy cells, the measurement of DNA-regulatory elements (methylation, mi-RNA
expression, protein expression analytics, functional tumorcell analysis in-vitro, efficacy
analysis in cell culture or in animal model) who are supposed to inspect the biological
influence of the molecular biomarkers and measurements of free tumor DNA out of the blood.
The response to the established standard therapy in the first and second line will be
acquired due to all clinical and radiological established standard parameters. The
clinical-radiological response will be correlated with the molecular changes and their
changes in therapy process to allow predictive prognosis for a further therapy.
There is no approved clinical standard for third line therapy. However there are further
medications approved without any scientific evidence of their efficacy in this therapy
situation (third line treatment after failure of first and second line treatment) and for
which a response of under 6 weeks is expected.
For these patients the third line therapy will be adjusted to the molecular profiles of the
previous therapies. Therefore the oncological history of the noticed marker profiles and the
presence of target structures (from whom it is known that they are influenced by certain
substances) will be considered.
The therapy will use substances which are approved in general for the treatment of
metastatic renal cell cancer.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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