This three-arm randomized phase 2 trial will enroll advanced clear cell RCC patients (all IMDC risk groups). Patients will be randomized 2:2:1 to either Arm A (fianlimab/ cemiplimab/ ipilimumab), Arm B (fianlimab/ cemiplimab), or Arm C (standard ipilimumab/ nivolumab), respectively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Fianlimab will be co-administered by IV.
Ipilimumab will be administered by IV.
Nivolumab will be administered by IV. Maintenance nivolumab will then be administered by IV.
Objective Response Rate (ORR)
ORR is defined as confirmed complete response (CR) + confirmed partial response (PR) and will be determined as per RECIST 1.1.
Time frame: 2 years
Median Progression Free Survival (PFS)
PFS is defined as the time from Day 1 of treatment to the first documented disease progression per RECIST 1.1, clinically progressive disease per investigator, or death due to any cause, whichever occurs first.
Time frame: 5 years
12-month Progression Free Survival (PFS)
PFS is defined as the time from Day 1 of treatment to the first documented disease progression per RECIST 1.1, clinically progressive disease per investigator, or death due to any cause, whichever occurs first.
Time frame: 12 months
24-month Progression Free Survival (PFS)
PFS is defined as the time from Day 1 of treatment to the first documented disease progression per RECIST 1.1, clinically progressive disease per investigator, or death due to any cause, whichever occurs first.
Time frame: 24 months
Duration of Response (DOR)
DOR is defined as the time from first documented evidence of CR or PR per RECIST 1.1 until disease progression based on RECIST 1.1 or death due to any cause, whichever occurs first.
Time frame: 5 years
Treatment Free Survival (TFS)
TFS will be assessed based on the area between two time to event KM curves from the time of study treatment initiation to study treatment discontinuation and from study initiation to initiation of subsequent systemic anti-cancer treatment or death. Time on or off treatment with Grade 3 or greater treatment related toxicities per CTCAE v5 will be determined as the area between study initiation and toxicity start and study initiation and Grade 3 toxicity ending.
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Cemiplimab will co-administered by IV.
Time frame: 5 years
Adverse Event Rates
The frequency of subjects experiencing treatment related adverse events and SAEs graded per NCI Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.
Time frame: 5 years