This is an open label, randomized phase II trial. Eligible subjects will be randomized in a 1:1 ratio and stratified for known prognostics variables to one of two first-line medication treatment arms. Once disease progression has been documented, and following a required inter-line washout period, subjects will receive either second-line medication treatment or discontinue treatment, per discretion of treating investigator.
OUTLINE: This is a multi-center trial. Eligible subjects will be randomized and stratified to one of two arms: FIRST-LINE INVESTIGATIONAL TREATMENT ARM A: * Avelumab 10mg/kg intravenously (IV) on Day 1 (D1) and Day 15 (D15) of every 28 day cycle until documented disease progression per Immune-related Response Evaluation Criteria In Solid Tumors (irRECIST) 1.1 SECOND-LINE INVESTIGATIONAL TREATMENT ARM A: * Following completion of an inter-line washout period of a minimum of 2 weeks up to a maximum of 60 days (or at the discretion of treating investigator) subjects will receive: * Sunitinib 50 mg by mouth (po) once daily from D1 to D14 of every 21 day cycle until documented disease progression per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 OR * Discontinue treatment FIRST-LINE INVESTIGATIONAL TREATMENT ARM B: * Sunitinib 50 mg po once daily from D1 to D14 of every 21 day cycle until documented disease progression per RECIST 1.1 SECOND-LINE INVESTIGATIONAL TREATMENT ARM B: * Following completion of an inter-line washout period of a minimum of 2 weeks up to a maximum of 60 days (or at the discretion of treating investigator) subjects will receive: * Avelumab 10mg/kg IV on D1 and D15 every 28 day cycle until documented disease progression per irRECIST 1.1 OR * Discontinue treatment NOTE: Subjects who do not experience disease progression at end of first-line treatment and are removed from first-line treatment due to toxicities or personal decision, may also either receive second-line therapy or be monitored during the inter-line period until progression (which may be longer than 60 days) per discretion of treating investigator. Radiological disease evaluation assessments will be completed every 12 weeks. To demonstrate adequate organ function, all screening labs must be obtained within 14 days prior to registration: Hematological: * Absolute Neutrophil Count (ANC) ≥ 1.5 K/mm3 * Hemoglobin (Hgb) ≥ 9 g/dL * Platelets ≥ 100 K/ mm3 Renal: * Calculated creatinine clearance by Cockcroft-Gault formula ≥ 40 ml/min Hepatic: * Bilirubin ≤ 1.5 × upper limit of normal (ULN) * Aspartate aminotransferase (AST) ≤ 2.5 × ULN * Alanine aminotransferase (ALT) ≤ 2.5 × ULN Miscellaneous: * Urine/serum pregnancy test - Negative
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
University of Alabama Hematology Oncology Clinic at Medical West
Birmingham, Alabama, United States
Overall Progression-Free Survival (PFS)
Compare PFS1 + PFS2 rates for overall PFS
Time frame: up to 24 months
Overall Failure-Free Survival (FFS)
Compare FFS1 rates for first-line therapy on each arm
Time frame: up to 24 months
Overall Survival (OS)
Compare OS rates for subjects on each arm
Time frame: up to 36 months
Overall Response Rate (RR)
Compare RR and PFS1 of sunitinib vs. avelumab as first-line therapy and PFS2 as second-line therapy
Time frame: 2 years
Overall Toxicities
Describe toxicities of sunitinib and avelumab
Time frame: up to 36 months
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