Renal Cell Carcinoma Clinical Trial
Official title:
Phase II Study of Sintilimab, a PD-1 Inhibitor, as Second-line Treatment in FH-deficient Renal Cell Carcinoma
This is a single-arm phase II clinical trial to evaluate the initial efficacy and safety of Sintilimab, a PD-1 Inhibitor, as Second-line Treatment in FH-deficient Renal Cell Carcinoma.
Fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) is a rare subtype of RCC
characterized by germline/somatic mutation of the fumarate hydratase (FH) gene, and is an
extremely aggressive tumor, with a propensity to disseminate early even in the setting of a
small primary tumor.
Loss-of-function mutation of FH results in the accumulation of fumarate, impairment of
oxidative phosphorylation, alteration of the metabolic state, and stabilization of
hypoxia-inducible factor (HIF)-1α, thus activating angiogenic and oxidative stress response
pathways. Unlike the robust response of clear cell RCC (ccRCC) to antiangiogenic agents,
blocking the antiangiogenic pathway does not lead to better outcomes in FH-deficient RCC.
Anti-mTOR agents are also ineffective.
Although the National Comprehensive Cancer Network (NCCN) guideline recommends the
combination of bevacizumab plus erlotinib or everolimus for metastatic FH-deficient RCC,
high-level evidence for standardized systematic therapy remains scarce.
In the present study, the investigators plan to assess the efficacy and safety of
immunotherapy with Sintilimab as second-line treatment in FH-deficient RCC, and to explore
potential biomarkers related to the treatment efficacy by means of detection, including but
not limited to the next-generation sequencing, flow cytometry, etc.
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