A phase 2 open label study of caBozantinib in patients with advanced or unresectable Renal cEll cArcinoma pretreated with one immunochecKPOint INhibiTor (anti PD1/PDL1).

2024-514058-59-00 Protocol BREAKPOINT Therapeutic exploratory (Phase II) Ongoing, recruitment ended

Start 11 Jun 2018 · Status Ongoing, recruitment ended · 1 EU/EEA countries · 2 sites · Protocol BREAKPOINT

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Ongoing, recruitment ended
Participants planned 49
Countries 1
Sites 2

Patients with metastatic clear cell renal cell carcinoma pretreated with immunocheckpoints inhibitors.

Assess the progression free survival (PFS) of cabozantinib in patients pretreated with one immunocheckpoint inhibitor (CPI) in monotherapy or in combination.

Key facts

Sponsor
Fondazione IRCCS Istituto Nazionale Dei Tumori
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
11 Jun 2018 → ongoing
Decision date (initial)
2024-07-29
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes
Funding sources
IPSEN S.P.A.

External identifiers

EU CT number
2024-514058-59-00
EudraCT number
2018-000582-36

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy, Efficacy, Safety

Assess the progression free survival (PFS) of cabozantinib in patients pretreated with one immunocheckpoint inhibitor (CPI) in monotherapy or in combination.

Secondary objectives 3

  1. Assess the overall survival (OS)
  2. Evaluate the efficacy based on objective response rates (ORR) according to RECIST 1:1 criteria
  3. Characterize the safety profile of the drug

Conditions and MedDRA coding

Patients with metastatic clear cell renal cell carcinoma pretreated with immunocheckpoints inhibitors.

VersionLevelCodeTermSystem organ class
21.0 PT 10073251 Clear cell renal cell carcinoma 100000004864

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 11

  1. Signed written informed consent
  2. One previous anticancer treatment with a PD1/PDL1 inhibitor, as monotherapy or in combination with an angiogenesis inhibitor or anti CTLA 4, in both setting first line or adjuvant ( in this case patient having recurrence during the adjuvant treatment or within 6 months after therapy with PD1-PD-L1 therapy)
  3. Age >=18 years
  4. Patients with histological diagnosis of predominant clear cells renal cell carcinoma
  5. Measurable disease (as per RECIST 1.1 criteria) with documented radiological progression
  6. Fertile women (<2 years after last menstruation) and men of childbearing potential must use effective methods of contraception (oral contraceptives, intrauterine contraceptive device, barrier method of contraception in conjunction with spermicidal jelly or surgical sterilisation) during the study and for 4 months after the last dose of study treatment
  7. All sites of disease including brain metastases (non symptomatic)
  8. Karnofsky performance status >= 70%
  9. Life expectancy greater than 3 months
  10. The required values at baseline are as follows: Absolute neutrophil count >1.5 x 10^9 /L, Platelet count > 100 x 10^9 /L, Haemoglobin > 9g/dl, Total bilirubin < 1.5 upper limit of normal (ULN), AST, ALT<2.5 ULN in patients without liver metastases <5 ULN in patients with liver metastases, serum creatinine < 2.0 mg/dl, amylase and lipase <1.5 ULN
  11. Female subjects of childbearing potential must not be pregnant at screening

Exclusion criteria 14

  1. Major surgical procedure within 28 days prior to study treatment start
  2. Other malignancies within the last 5 years (other than curatively treated basal cell carcinoma of the skin and/or in situ carcinoma of the cervix, meningiomas)
  3. Clinically significant cardiovascular disease, for example cerebrovascular accidents (<6 months), myocardial infarction (<6 months), unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure or serious cardiac arrhythmia requiring medication
  4. Recent (within the 30 days prior to randomisation) treatment with another investigational drug or participation in another investigational study
  5. Symptomatic brain metastasis
  6. History of other disease, metabolic dysfunction, physical examination finding or clinical laboratory finding giving reasonable suspicion of a disease condition that contraindicates use of an investigational drug or patient at high risk from treatment complications
  7. or INR and PTT >1.5 times the Upper Normal Limit of the institution (patient who are being therapeutically anticoagulated with an agent such as warfarin or heparin will be allowed to participate provided that no prior evidence of underlying abnormality in these parameters exists).For patients on warfarin, close monitoring of at least weekly evaluations will be performed, until INR is stable based on a measurement at pre-dose, as defined by the local standard of care
  8. Previous or concomitant radiotherapy in the lesion parameter of disease
  9. Previous radiotherapy or other locoregional antitumoral treatment performed within 21 days before the study recruitment
  10. Uncontrolled hypertension (>= 160 mmHg systolic and/or 90 mmHg diastolic) while receiving chronic medication
  11. Inability to swallow tablets or capsules
  12. Female subject who is pregnant or breast-feeding. Confirmation that the subject is not pregnant must be established by a negative serum ß-human chorionic gonadotropin (ßhCG) pregnancy test result obtained during screening. Pregnancy testing is not required for post-menopausal or surgically sterilized women
  13. Known history of human immunodeficiency virus (HIV) infection, active hepatitis B, or active hepatitis C
  14. Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Progression Free Survival (PFS)

Secondary endpoints 3

  1. Overall Survival (OS)
  2. Objective Response Rates (ORR)
  3. Safety profile of the drug

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Cabozantinib

SCP14977795 · ATC

Active substance
Cabozantinib
Substance synonyms
XL-184, Cyclopropane-1,1-dicarboxylic acid [4-(6,7-dimethoxy-quinolin-4-yloxy)-phenyl]-amide (4-fluoro-phenyl)-amide
Route of administration
ORAL USE
Max daily dose
60 mg milligram(s)
Max total dose
60 mg milligram(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
L01XE26 — CABOZANTINIB
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Fondazione IRCCS Istituto Nazionale Dei Tumori

Sponsor organisation
Fondazione IRCCS Istituto Nazionale Dei Tumori
Address
Via Giacomo Venezian 1
City
Milan
Postcode
20133
Country
Italy

Scientific contact point

Organisation
Fondazione IRCCS Istituto Nazionale Dei Tumori
Contact name
Oncologia genitourinaria

Public contact point

Organisation
Fondazione IRCCS Istituto Nazionale Dei Tumori
Contact name
Public Relation Office

Locations

1 EU/EEA country · 2 investigational sites

By country

CountryMS statusPlanned subjectsSites
Italy Ongoing, recruitment ended 49 2
Rest of world 0

Investigational sites

Italy

2 sites · Ongoing, recruitment ended
Azienda Ospedaliero Universitaria Di Modena
D.A.I. Oncologia, Largo Del Pozzo 71, 41124, Modena
Fondazione IRCCS Istituto Nazionale Dei Tumori
Oncologia Genitourinaria, Via Giacomo Venezian 1, 20133, Milan

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Italy 2018-06-11 2018-07-04 2021-04-08

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 6 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol Breakpoint 2024-514858-59_redacted 2
Recruitment arrangements (for publication) K1_Recruitment Arrangements 1
Subject information and informed consent form (for publication) L1_Informativa-ICF-privacy_redacted 3
Subject information and informed consent form (for publication) L2_Lettera MMG 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC Cabometyx na
Synopsis of the protocol (for publication) D1_Synopsis Breakpoint 2024-514858-59_redacted 2

Application history

4 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-05-30 Italy Acceptable
2024-06-25
2024-07-29
2 NON SUBSTANTIAL MODIFICATION NSM-1 2024-10-08 Italy Acceptable
2024-06-25
2024-10-08
3 NON SUBSTANTIAL MODIFICATION NSM-2 2024-10-17 Italy Acceptable
2024-06-25
2024-10-17
4 NON SUBSTANTIAL MODIFICATION NSM-3 2025-12-01 Italy Acceptable
2024-06-25
2025-12-01