This is a phase II study of an investigational agent, brivanib, in patients with refractory metastatic renal cell carcinoma. This study will evaluate the safety and effectiveness of brivanib in renal cell carcinoma, and explore the activity of this drug in this population to determine whether imaging and molecular features of the tumors can be used to predict response. Approximately 30 people with advanced kidney cancer will be enrolled on this study at the University of Pennsylvania.
The primary objective of this clinical trial is to determine the efficacy of brivanib in the treatment of metastatic renal cell carcinoma in terms of progression-free survival (PFS) in patients who have progressed on treatment with sunitinib, sorafenib, bevacizumab, or pazopanib. The primary endpoint of the trial will be PFS at 16 weeks. The secondary objectives are to further examine the safety and tolerability profile of brivanib, to examine the efficacy of brivanib in this population in terms of best overall response, response rate, progression-free survival, and overall survival, to describe baseline and changes in I-cG250 PET/CT in relation to observed therapeutic effects, to describe novel baseline histologic features of these tumors in relation to observed therapeutic effects. Modalities will include Von Hippel-Lindau gene (VHL) and hypoxia-inducible factor 1 gene (HIF-1) expression assessment and a novel histo-cytometric assessment of the tumor microenvironment in terms of p-STAT3, p-ERK, Ki67, VEGFR2, FGFR1 expression, to describe changes in circulating collagen IV on brivanib in relation to therapeutic effects, to explore the relationship between single nucleotide polymorphisms in angiogenesis-related genes and the activity of brivanib in the treatment of these patients.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Brivanib by mouth daily at a dose of 800mg.
Undergo 1241-cG250 PET/CT imaging (correlative studies)
Undergo 124I-cG250 PET/CT imaging (correlative studies)
Abramson Cancer Center of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Progression Free Survival (PFS)
All patients will be followed through the entire 16-week period and will be given a binary outcome assignment: progressive disease or not.
Time frame: 16 weeks
Best Overall Response Rated for Each Patients as Assessed by RECIST 1.1 Guidelines
The best overall radiographic response to therapy as measured and assessed using RECIST 1.1 guidelines will be captured for each research subject.
Time frame: Every 8 weeks
Overall Survival
Will record deaths on study, and, to the extent possible, after the study follow-up period is completed for each patient, will be captured. Reason for death will be identified and recorded where possible.
Time frame: Every 8 weeks
Change in Total Antibody Binding as Assessed by 124I-cG250 PET/CT Imaging (Correlative Studies)
Will determine the baseline and change in total antibody binding in lesions from baseline to the time on treatment that patients are assessed. The analysis dataset will be quantitated radiotracer uptake data obtained via I-cG250 PET/CT for all evaluable patients who complete the trial.
Time frame: At baseline and 8 weeks
Response Rate for All Patients
Response Rate for all patients as assessed by RECIST 1.1 guidelines
Time frame: Every 8 weeks
Molecular Markers
Molecular markers expressed in patient tumor specimens as assessed by IHC and histocytometry (e.g., VHL, HIF, p-STAT3, p-ERK, and Ki67, VEGFR2, and FGFR1) (correlative studies)
Time frame: At baseline
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Undergo 1241-cG250 PET/CT imaging (correlative studies)
Correlative studies
correlative studies
Changes in Collagen IV Levels
Changes in collagen IV levels for each patient (correlative studies)
Time frame: At baseline and week 3
Germline Polymorphisms and Assessment of Relationship to Toxicity and Clinical Outcome
Germline polymorphisms and assessment of relationship to toxicity and clinical outcome (correlative studies)
Time frame: At baseline and week 3
Blood Pressure Data
Blood pressure data
Time frame: At baseline, day 1 weeks 3,6,8,12,16 and every 6-8 weeks thereafter
Toxicity as Assessed by NCI CTCAE Version 4.0
Toxicity as assessed by NCI CTCAE version 4.0
Time frame: Day 1, weeks 3,6,9,12,16, and every 6-8 weeks thereafter