This research study will assess whether abemaciclib alone or in combination with MK-6482 are safe and effective in slowing down the growth of clear cell renal cell carcinoma (ccRCC). The names of the study drugs in this investigational combination are: * Abemaciclib * MK-6482
This a two-arm, non-randomized phase 1/1B trial aiming at assessing the safety and activity of abemaciclib alone (arm 1), and abemaciclib plus MK-6482 (arm 2) in patients with advanced refractory clear-cell renal cell carcinoma (croc). A Phase I clinical trial tests the safety of an investigational drug or drug combination and also tries to define the appropriate dose of the investigational drug or drug combination to use for further studies. "Investigational" means that the drug is being studied.The U.S. Food and Drug Administration (FDA) has not approved either abemaciclib or MK-6482 for renal (kidney) cancer but abemaciclib has been approved to treat other forms of cancer. Abemaciclib is in a class of drugs known as CDK4 \& 6 inhibitors. These proteins control how fast cells grow and divide and are found on both normal and cancer cells. They become overactive in cancer cells causing cells to grow and divide uncontrollably. Abemaciclib blocks these proteins just as the cells start to grow and divide and in other cancers has been shown to slow down cancer cell growth and division, causing cancer cells to become inactive or even die. MK-6482 is an oral, first-in-class selective small-molecule inhibitor that targets hypoxia-inducible factor (HIF)-2a, which promotes the growth of new vessels that fuel kidney cancer. This study is looking at two different treatments: * Arm 1 - abemaciclib alone: * To determine the response rate of abemaciclib alone in patients with advanced ccRCC * Arm 2 - combination therapy of abemaciclib and MK-6482 * To determine the maximum dose of abemaciclib and MK-6482 in combination. * To determine the response rate of abemaciclib and MK-6482 in patients with advanced ccRCC. The research study procedures include screening for eligibility, study treatment, participant evaluations and safety follow-up visits, in addition to general health status follow-up after study treatment. It is estimated that participants will receive 12 to 18 months of study treatment and 3 months of safety follow-up, totaling about 15 to 21 months from the start of study treatment. After the safety follow-up visits, the study doctor may request that participants return to clinic for additional tumor assessments or his/her staff will contact participants about every 6 months to follow their health status and find out about any anticancer treatments participants may have begun after study treatment. It is expected that about 40 people will take part in this research study. The pharmaceutical company Eli Lilly is supporting this research study by providing funding for the research study, tests required for research purposes only, and the study drugs. The pharmaceutical company Merck is supporting this research study by providing study drug.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
11
Tablet taken orally
Tablet taken orally
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Objective Response Rate (ORR) in Abemaciclib Arm (Arm 1)
ORR is defined as percentage of patients with partial (PR) or complete response (CR) as best overall response according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by central review. Imaging assessments will be performed every 8 weeks during the first six months of the study, then every 12 weeks thereafter.
Time frame: From the start of protocol treatment until disease progression or deaths. The total duration assessed was up to 3 months, as all patients either progressed, died, or withdrew from the study within that timeframe.
Objective Response Rate (ORR) in Abemaciclib and MK-6482 Arm (Arm 2)
Percentage of patients with partial (PR) or complete response (CR) as best overall response according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by central review. Imaging assessments will be performed every 8 weeks during the first six months of the study, then every 12 weeks thereafter.
Time frame: From the start of protocol treatment until disease progression or death
Maximum Tolerated Dose (MTD) in Abemaciclib and MK-6482 (Arm 2)
MTD of abemaciclib plus MK-6482, defined as the highest dose studied at which no more than 1 of 6 subjects has experienced a dose limiting toxicity (DLT) in cycle 1.
Time frame: Cycle 1 of during the combination therapy (Arm 2)
Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE 5 of Abemaciclib and MK-6482 (Arm 2)
Toxicity will be graded and analyzed using CTCAE version 5. Treatment related AE will define as "Definitely", "Probably" or "Possibly" related to the study drugs.
Time frame: From start of protocol treatment until 90 days after treatment discontinuation, or until initiation of new cancer-directed treatment, or until death, whichever occurs first.
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Duration of Response (DOR) in Patients Who Achieve an Objective Response in Abemaciclib Arm (Arm 1)
The duration of response is defined from the time measurement criteria are met for complete response or partial response (whichever is first recorded) until the date of disease progression or death due to any cause. Participants without events reported are censored at the last disease evaluation. Response and progression will be evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Imaging assessments will be performed every 8 weeks during the first six months of the study, then every 12 weeks thereafter.
Time frame: From start of complete response or partial response (whichever is first recorded) until the date of disease progression or death.
Progression-free Survival (PFS) in Abemaciclib Arm (Arm 1)
PFS is measured from the start of treatment until documented progression by the Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) or death from any cause or censored at the last disease evaluation. PFS will be estimated using the method of Kaplan-Meier with 95% confidence intervals. Imaging assessments will be performed every 8 weeks during the first six months of the study, then every 12 weeks thereafter.
Time frame: From trial treatment start to the earlier of progression or death due to any cause. The total duration assessed was up to 3 months, as all patients either progressed, died, or withdrew from the study within that timeframe.
Overall Survival (OS) in Abemaciclib Arm (Arm 1)
OS is measured from the start of treatment until date of death from any cause or censored at the date of last follow-up. OS will be estimated using the method of Kaplan-Meier with 95% confidence intervals.
Time frame: From trial treatment start to death due to any cause or date last known alive, up to 23 months
Duration of Response (DOR) in Patients Who Achieve an Objective Response in Abemaciclib and MK-6482 Arm (Arm 2)
The duration of response is defined from the time measurement criteria are met for complete response or partial response (whichever is first recorded) until the date of disease progression or death due to any cause. Participants without events reported are censored at the last disease evaluation. Response and progression will be evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Imaging assessments will be performed every 8 weeks during the first six months of the study, then every 12 weeks thereafter.
Time frame: From the time measurement criteria are met for complete response or partial response (whichever is first recorded) until the date of disease progression or death due to any cause.
Progression-free Survival (PFS) in Abemaciclib and MK-6482 Arm (Arm 2)
PFS is measured from the start of treatment until documented progression by the Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) or death from any cause or censored at the last disease evaluation. PFS will be estimated using the method of Kaplan-Meier with 95% confidence intervals. Imaging assessments will be performed every 8 weeks during the first six months of the study, then every 12 weeks thereafter.
Time frame: From trial treatment start to the earlier of progression or death due to any cause
Overall Survival (OS) in Abemaciclib and MK-6482 Arm (Arm 2)
OS is defined the time from the start of treatment until date of death from any cause or censored at the date of last follow-up. OS will be estimated using the method of Kaplan-Meier with 95% confidence intervals.
Time frame: From trial treatment start to death due to any cause or date last known alive