Clinical Trial to Assess the Importance of Nephrectomy - Full Text View

Purpose

The study compare the standard treatment with nephrectomy + sunitinib to treatment with sunitinib alone without nephrectomy. This study will be the first trial on this competitive context

Condition	Intervention	Phase
Metastatic Renal Cell Carcinoma	Procedure: Nephrectomy Other: Sunitinib alone	Phase 3

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Randomized Phase III Trial Evaluating the Importance of Nephrectomy in Patients Presenting With Metastatic Renal Cell Carcinoma Treated With Sunitinib

Resource links provided by NLM:

Drug Information available for: Sunitinib malate Sunitinib

U.S. FDA Resources

Further study details as provided by Assistance Publique - Hôpitaux de Paris:

Primary Outcome Measures:

The primary endpoint is overall survival. [ Time Frame: starting at 4 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

Objective Response (complete or partial) is evaluated according to RECIST 1.1 criteria [ Time Frame: Starting at 4 months ] [ Designated as safety issue: Yes ]
Clinical benefit (complete response, partial or stable for at least 12 weeks). [ Time Frame: Starting at 4 months ] [ Designated as safety issue: Yes ]
Progression-Free Survival [ Time Frame: Starting at 4 months ] [ Designated as safety issue: Yes ]
Non-compliance to Sunitinib treatment is evaluated in arm A (nephrectomy + sunitinib) as the percentage of patients not starting sunitinib treatment within 6 weeks after nephrectomy [ Time Frame: Starting at 4 months ] [ Designated as safety issue: Yes ]
Non-compliance to sunitinib treatment is evaluated in arm B (sunitinib alone) as the percentage of patients needing nephrectomy [ Time Frame: Starting at 4 months ] [ Designated as safety issue: Yes ]
Post operative morbidity is evaluated as the percentage of deaths within 30 days following nephrectomy [ Time Frame: Starting at 4 months ] [ Designated as safety issue: Yes ]

Estimated Enrollment:	576
Study Start Date:	September 2009
Estimated Study Completion Date:	May 2016
Estimated Primary Completion Date:	September 2015 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: A Nephrectomy + sunitinib	Procedure: Nephrectomy Current surgery Other Name: Nephrectomy
Experimental: B Sunitinib alone	Other: Sunitinib alone Sunitinib alone without nephrectomy Other Name: Sunitinib alone without nephrectomy

Detailed Description:

The 2 previous studies on the impact of nephrectomy (EORTC, SWOG) in metastatic renal cell carcinoma have justified recommendation to initial nephrectomy for patients presenting with metastatic renal cell carcinoma. But these studies were performed at the time of immunotherapy.

The objective is Evaluation of the importance of nephrectomy in patients with metastatic renal cell carcinoma treated with sunitinib (AA) Arm A : Nephrectomy followed by Sunitinib Arm B : Sunitinib alone Sunitinib will be administrated orally daily for 4 weeks followed by a 2 week rest( schedule 4/2), 6 weeks are considered as a cycle The starting dose will be 50 mg daily with provision for dose reduction based on tolerability Patient will be treated until disease progression or unacceptable toxicity occurrence or withdraw.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

age ≥ 18 years
ECOG Performance Status 0 - 1
Biopsy (primary tumour or metastases) confirming the diagnosis of clear cell carcinoma
Documented metastatic disease
Absence of prior systemic treatment for kidney cancer including AA
Tumour amenable to nephrectomy (partial or total) in the opinion of the patient's urologist. Patients presenting with an inferior vena cava thrombosis can be included.
Patients for which the indication of Sunitinib is considered according to the recommendations rules given by national health authorities of participating countries. The prescription of Sunitinib in the circumstances of the study is considered as a standard treatment.
Platelets > or = 100 x 109/L, haemoglobin >or = 9 g/dl, neutrophils >or = 1.5 x 109/L;
Bilirubin < or = 2 mg/dL, aspartate transaminase (ASAT) and alanine transaminase (ALAT)< or = 2.5 times the upper normal limit (UNL) or < or = 5 times UNL for patients with liver metastases
Patients of child bearing age should use contraceptive methods
Patient able to follow the procedures outlined in the protocol as far as the planning of visits and examinations are concerned.
Life expectancy ≥ 3 months
Written informed consent

Exclusion Criteria:

Prior systemic treatment for kidney cancer (including Anti Angiogenic)
Bilateral kidney cancer
Pregnant or breast feeding women
Acute coronary syndrome or episode of myocardial infarction or severe or unstable angina within the last 6 months as well as severe diabetes with severe peripheral arteriopathy or deep phlebitis not treated with low molecular weight heparin or arterial thrombosis within the last 3 months
Patients being treated with antivitamin K (please note that patients being treated with low molecular weight heparin can be included)
Medical, general or psychiatric difficulties which, in the opinion of the Investigator, would make it inappropriate for trial entry
Symptomatic or untreated brain metastases (patients with brain metastases that have been treated by radiotherapy or surgery and have stable disease within 6 weeks, and are not requiring treatment with corticosteroids can be included)
Previous history of gastric disease or malabsorption, syndrome compromising the absorption of Sunitinib
Experimental treatment within the 28 days preceding inclusion
Other cancer within the previous 5 years (except for insitu skin carcinoma and treated localised prostate cancer with undetectable PSA)
Patient has received treatment with IV biphosphonate

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00930033

Contacts

Contact: Arnaud Mejean, MD, PhD	+33(0)1 44 49 53 36	arnaud.mejean@nck.aphp.fr
Contact: Raphael Serreau, MD, PhD	+33(0)1 58 41 11 80	raphael.serreau@cch.aphp.fr

Locations

France
Hopital Necker	Recruiting
Paris, France, 75015
Principal Investigator: Arnaud Mejean, MD, PhD

Sponsors and Collaborators

Assistance Publique - Hôpitaux de Paris

Pfizer

Investigators

Principal Investigator:

Arnaud Mejean, MD PhD

Assistance Publique - Hôpitaux de Paris

More Information

No publications provided

Responsible Party:	Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier:	NCT00930033 History of Changes
Other Study ID Numbers:	P070144
Study First Received:	June 29, 2009
Last Updated:	November 16, 2012
Health Authority:	France: Ministry of Health

Keywords provided by Assistance Publique - Hôpitaux de Paris:

Nephrectomy,
metastatic renal cell carcinoma,
sunitinib

Additional relevant MeSH terms:

Carcinoma
Carcinoma, Renal Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Adenocarcinoma
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases

Urologic Diseases
Sunitinib
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors

ClinicalTrials.gov processed this record on May 16, 2013

Clinical Trial to Assess the Importance of Nephrectomy (CARMENA)