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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT00903175




Registration number
NCT00903175
Ethics application status
Date submitted
24/04/2009
Date registered
14/05/2009
Date last updated
4/10/2016

Titles & IDs
Public title
Efficacy and Safety Comparison of RAD001 Versus Sunitinib in the First-line and Second-line Treatment of Patients With Metastatic Renal Cell Carcinoma
Scientific title
An Open-label, Multicenter Phase II Study to Compare the Efficacy and Safety of RAD001 as First-line Followed by Second-line Sunitinib Versus Sunitinib as First-line Followed by Second-line RAD001 in the Treatment of Patients With Metastatic Renal Cell Carcinoma.
Secondary ID [1] 0 0
2009-011056-21
Secondary ID [2] 0 0
CRAD001L2202
Universal Trial Number (UTN)
Trial acronym
RECORD-3
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Renal Cell Carcinoma 0 0
Condition category
Condition code
Cancer 0 0 0 0
Non melanoma skin cancer
Cancer 0 0 0 0
Kidney

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - everolimus
Treatment: Drugs - sunitinib

Experimental: everolimus 1L/sunitinib 2L - everolimus First Line: 10 mg orally, once daily, (two 5 mg tablets), continuous treatment. sunitinib Second Line: 50 mg orally, once daily, 4 weeks on treatment followed by 2 weeks off (4/2)

Active Comparator: sunitinib 1L/everolimus 2L - sunitinib First Line: 50 mg orally, once daily, 4 weeks on treatment followed by 2 weeks off (4/2) everolimus Second Line: 10 mg orally, once daily (two 5 mg tablets), continuous treatment


Treatment: Drugs: everolimus
Everolimus was administered orally at 10 mg/day. Everolimus is formulated as tablets of 5 mg strength, blister-packed under aluminum foil in units of 10 tablets.

Treatment: Drugs: sunitinib
Sunitinib was administered orally 50 mg daily, on a schedule of 4 weeks on/2 weeks off. Sunitinib was supplied as hard gelatin capsules of 12.5 mg, 25 mg, or 50 mg strength according to local practice.

Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Progression Free Survival First-Line (PFS 1-L) - PFS_1L based on investigator assessment of radiology data by RECIST 1.0, was defined as the time from the date of randomization to the date of the first documented disease progression or death due to any cause during or after first-line treatment with everolimus or sunitinib. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Timepoint [1] 0 0
based on radiological assessments every 3 months until disease progression, start of another antineoplastic therapy or for any other reason up to 35 months
Secondary outcome [1] 0 0
Progression-free Survival Combined (PFS-C) - PFS-C (1L and 2L study drugs combined) was a composite endpoint which combined both lines of study treatment. It was defined as the time from the date of randomization to the first of the following: date of death due to any cause, or date of the first radiologically documented progression disease during or after the second-line treatment period for patients with a radiologically documented progression disease in the first-line treatment period and who had crossed-over to second-line treatment no more than 6 weeks after progression.
Timepoint [1] 0 0
based on radiological assessments every 3 months until disease progression, start of another antineoplastic therapy or for any other reason up to about 56 months
Secondary outcome [2] 0 0
Overall Survival (OS) - Overall survival was defined as the time from date of randomization to date of death due to any cause. The analysis of OS included all deaths in the FAS regardless of when they were observed.
Timepoint [2] 0 0
Every 2 months from randomization up to 3 years after last patient randomized
Secondary outcome [3] 0 0
Overall Response Rate (ORR) - First -Line (1-L) - ORR was defined as the number of participants with best overall response (BOR) of complete response (CR) or partial response (PR) and was based on investigator assessment of radiology data per RECIST. Participants with best overall response of 'Unknown' were treated as non-responders in the calculation of the ORR. Confirmed CR = at least two determinations of CR at least 4 weeks apart before progression. Confirmed PR = at least two determinations of PR or better at least 4 weeks apart before progression. CR required a disappearance of all target and non-target lesions. PR required at least a 30% decrease in the sum of the longest diameters of all target lesions, taking as a reference the baseline sum of the longest diameters. Radiological assessments : every 12 weeks until disease progression, the start of another antineoplastic therapy or for any other reason.
Timepoint [3] 0 0
based on radiological assessments every 3 months until disease progression, start of another antineoplastic therapy or for any other reason up to 35 months
Secondary outcome [4] 0 0
Duration of Response (DoR) - First-Line (1-L) - Duration of overall response (CR or PR) applies only to patients whose Best Overall Response (BOR) was Complete Response (CR) or Partial Response (PR) during the first-line treatment period. The start date was the date of first documented response (CR or PR) during the first-line treatment and the end date was the date of the event defined as the first documented progression or death due to underlying cancer during or after the same treatment line.
Timepoint [4] 0 0
based on radiological assessments every 3 months until disease progression, start of another antineoplastic therapy or for any other reason up to 35 months
Secondary outcome [5] 0 0
Time to Definitive Deterioration of the FKSI-DRS Risk Score by at Least 3 Score Units by First-line Drug - The Functional Assessment of Cancer Therapy - Kidney Symptom Index, Disease Related Symptoms (FKSI-DRS) is a set of items to assess symptoms experienced by patients with advanced kidney cancer. These symptoms include fatigue, pain, weight loss, dyspnea, cough, fever and hematuria. Each item is scored on a 5-point scale (0 = not at all; 4 = very much). The FKSI-DRS total score ranges from 0 (most severe symptoms) to 36 (no symptoms). Definitive deterioration was defined as a decrease by at least 3 units compared to baseline, with no later increase above this threshold observed during the 1-L of treatment. A single measure reporting a decrease of at least 3 units was considered definitive only if it was the last one available for the patient.
Timepoint [5] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [6] 0 0
Time to Definitive Deterioration of the FKSI-DRS Risk Score by at Least 3 Score Units by First and Second-line Drugs Combined - The Functional Assessment of Cancer Therapy - Kidney Symptom Index, Disease Related Symptoms (FKSI-DRS) is a set of items to assess symptoms experienced by patients with advanced kidney cancer. These symptoms include fatigue, pain, weight loss, dyspnea, cough, fever and hematuria. Each item is scored on a 5-point scale (0 = not at all; 4 = very much). The FKSI-DRS total score ranges from 0 (most severe symptoms) to 36 (no symptoms). Definitive deterioration was defined as a decrease by at least 3 units compared to baseline, with no later increase above this threshold observed during the 1-L or 2-L treatment. A single measure reporting a decrease of at least 3 units was considered definitive only if it was the last one available for the patient.
Timepoint [6] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [7] 0 0
Time to Definitive Deterioration of the Physical Functioning (PF) Scale of the EORTC QLQ-C30 - by First-Line (1L) Drug - The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) contains 30 items. These include a global health status/QoL scale, five functional scales, three symptom scales, and six single items. The standardized score for the PF, fatigue subscales and global health status ranges from 0 to 100, with a higher score representing a high level of functioning/high level of symptom/high quality of life. Definitive deterioration by at least 10% was defined as a decrease in score by at least 10% compared to baseline, with no later increase above this threshold observed during the first line of treatment. A single measure reporting a decrease of at least 10% was considered definitive only if it was the last one available for the participant.
Timepoint [7] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [8] 0 0
Time to Definitive Deterioration of the Physical Functioning Scale of the EORTC QLQ-C30 - by First and Second-Line Drugs Combined - The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) contains 30 items. These include a global health status/QoL scale, five functional scales, three symptom scales, and six single items.The standardized score for the PF, fatigue subscales and global health status ranges from 0 to 100, with a higher score representing a high level of functioning/high level of symptom/high quality of life. Definitive deterioration by at least 10% was defined as a decrease in score by at least 10% compared to baseline, with no later increase above this threshold observed during the first line or second line treatment. A single measure reporting a decrease of at least 10% was considered definitive only if it was the last one available for the participant.
Timepoint [8] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [9] 0 0
Time to Definitive Deterioration of the Global Health Status/QoL Scores of the EORTC QLQ-C30 by First-Line Drug - The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) contains 30 items. These include a global health status/QoL scale, five functional scales, three symptom scales, and six single items.The standardized score for the PF, fatigue subscales and global health status ranges from 0 to 100, with a higher score representing a high level of functioning/high level of symptom/high quality of life. Definitive deterioration by at least 10% was defined as a decrease in score by at least 10% compared to baseline, with no later increase above this threshold observed during the first line of treatment. A single measure reporting a decrease of at least 10% was considered definitive only if it was the last one available for the participant.
Timepoint [9] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [10] 0 0
Time to Definitive Deterioration of the Global Health Status/QoL Scores of the EORTC QLQ-C30 by First and Second-Line Drugs Combined - The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) contains 30 items. These include a global health status/QoL scale, five functional scales, three symptom scales, and six single items. The standardized score for the PF, fatigue subscales and global health status ranges from 0 to 100, with a higher score representing a high level of functioning/high level of symptom/high quality of life. Definitive deterioration by at least 10% was defined as a decrease in score by at least 10% compared to baseline, with no later increase above this threshold observed during the first line or second line treatment. A single measure reporting a decrease of at least 10% was considered definitive only if it was the last one available for the participant.
Timepoint [10] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [11] 0 0
Time to Definitive Deterioration of the Fatigue Scale of the EORTC QLQ-C30 by First-Line Drug - The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) contains 30 items. These include a global health status/QoL scale, five functional scales, three symptom scales, and six single items.The standardized score for the PF, fatigue subscales and global health status ranges from 0 to 100, with a higher score representing a high level of functioning/high level of symptom/high quality of life. Definitive deterioration by at least 10% was defined as a decrease in score by at least 10% compared to baseline, with no later increase above this threshold observed during the first line of treatment. A single measure reporting a decrease of at least 10% was considered definitive only if it was the last one available for the participant.
Timepoint [11] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months
Secondary outcome [12] 0 0
Time to Definitive Deterioration of the Fatigue Scale of the EORTC QLQ-C30 by First and Second-Line Drugs Combined - The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) contains 30 items. These include a global health status/QoL scale, five functional scales, three symptom scales, and six single items. The standardized score for the PF, fatigue subscales and global health status ranges from 0 to 100, with a higher score representing a high level of functioning/high level of symptom/high quality of life. Definitive deterioration by at least 10% was defined as a decrease in score by at least 10% compared to baseline, with no later increase above this threshold observed during the first line or second line treatment. A single measure reporting a decrease of at least 10% was considered definitive only if it was the last one available for the participant.
Timepoint [12] 0 0
<=14 days prior to the first dose of study medication, on day 1, day 28 of every cycle, at the end of treatment visit, at the 28 day FUP visit and monthly thereafter for up to 3 months or until initiation of another anticancer therapy up to 35 months

Eligibility
Key inclusion criteria
1. Patients with advanced renal cell carcinoma.

2. Patients with at least one measurable lesion.

3. Patients with a Karnofsky Performance Status =70%.

4. Adequate bone marrow function.

5. Adequate liver function.

6. Adequate renal function.

7. Left ventricular ejection fraction (LVEF) = lower limit of institutional normal (LLN)

8. Women of childbearing potential must have had a negative serum pregnancy test within
14 days prior to the administration of the study medication. Adequate contraception
must be used while on study.
Minimum age
18 Years
Maximum age
No limit
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Less than 4 weeks post-major surgery

2. Patients who had radiation therapy within 4 weeks prior to start of study treatment
(palliative radiotherapy to bone lesions allowed within 2 weeks prior to study
treatment start).

3. Patients in need for major surgical procedure during the course of the study

4. Patients with a serious non-healing wound, ulcer, or bone fracture

5. Patients with a history of seizure(s) not controlled with standard medical therapy

6. Patients who have received prior systemic treatment for their metastatic RCC

7. Patients who have previously received systemic mTOR inhibitors (sirolimus,
temsirolimus, everolimus) or VEGF inhibitors. Note: History of adjuvant immunotherapy,
vaccines or adjuvant sorafenib following localized surgical nephrectomy is acceptable.

8. Patients with a known hypersensitivity to RAD001 (everolimus) or other rapamycins
(sirolimus, temsirolimus) or to its excipients Patients with a known hypersensitivity
to RAD001 (everolimus) or other rapamycins or to its excipients

9. Patients with a known hypersensitivity to sunitinib or its excipients

10. History or clinical evidence of central nervous system (CNS) metastases. Note:
Subjects who have previously-treated CNS metastases (surgery plus or minus
radiotherapy, radiosurgery, or gamma knife) and meet all 3 of the following criteria
are eligible:

- Are asymptomatic and,

- have had no evidence of active CNS metastases for = 6 months prior to enrollment
and,

- have no requirement for steroids or enzyme-inducing anticonvulsants (EIAC)

11. Clinically significant gastrointestinal abnormalities including, but not limited to:

- Malabsorption syndrome

- Major resection of the stomach or small bowel that could affect the absorption of
study drug

- Active peptic ulcer disease

- Inflammatory bowel disease

- Ulcerative colitis, or other gastrointestinal conditions with increased risk of
perforation

- History of abdominal fistula, gastrointestinal perforation, or intra abdominal
abscess within 28 days prior to beginning study treatment.

12. Poorly controlled hypertension [defined as systolic blood pressure (SBP) of =160mmHg
or diastolic blood pressure (DBP) of = 95mmHg]

13. Patients receiving chronic systemic treatment with corticosteroids or another
immunosuppressive agent

14. Patients with a known history of HIV seropositivity.

15. Patients with active bleeding.

16. Patients who have any severe and/or uncontrolled medical conditions or other
conditions within the past 12 months that could affect their participation in the
study such as:

- Cardiac angioplasty or stenting, unstable angina pectoris, symptomatic peripheral
vascular disease, symptomatic congestive heart failure (NYHA II, III, IV),
myocardial infarction = 6 months prior to first study treatment, serious
uncontrolled cardiac arrhythmia, cerebrovascular accidents = 6 months before
study treatment start.

- Prolongation of corrected QT interval (QTc) > 500 milliseconds (msecs).

- Severally impaired lung function as defined as spirometry and DLCO that is 50% of
the normal predicted value and/or 0^2 saturation that is 88% or less at rest on
room air.

- Poorly controlled diabetes as defined by fasting serum glucose >2.0 x ULN.

- Any active (acute or chronic) or uncontrolled infection/disorders that impair the
ability to evaluate the patient or for the patient to complete the study.

- Liver disease such as chronic active hepatitis or chronic persistent hepatitis.

17. History of cerebrovascular accident (CVA) including transient ischemic attack (TIA).

18. History of pulmonary embolism or untreated deep venous thrombosis (DVT) within the
past 6 months. Note: Subjects with recent DVT who have been treated with therapeutic
anti-coagulating agents for at least 6 weeks are eligible.

19. Patients who have a history of another primary malignancy and off treatment for = 3
years

20. Female patients of child-bearing potential who are not using adequate birth control
methods, or who are pregnant or breast feeding.

21. Patients who are using other investigational agents or who had received
investigational drugs = 2 weeks prior to study treatment start.

22. Patients unwilling or unable to comply with the protocol.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 2
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
SA
Recruitment hospital [1] 0 0
Novartis Investigative Site - Woodville
Recruitment postcode(s) [1] 0 0
5011 - Woodville
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Alabama
Country [2] 0 0
United States of America
State/province [2] 0 0
Arkansas
Country [3] 0 0
United States of America
State/province [3] 0 0
California
Country [4] 0 0
United States of America
State/province [4] 0 0
Colorado
Country [5] 0 0
United States of America
State/province [5] 0 0
Connecticut
Country [6] 0 0
United States of America
State/province [6] 0 0
District of Columbia
Country [7] 0 0
United States of America
State/province [7] 0 0
Florida
Country [8] 0 0
United States of America
State/province [8] 0 0
Georgia
Country [9] 0 0
United States of America
State/province [9] 0 0
Illinois
Country [10] 0 0
United States of America
State/province [10] 0 0
Louisiana
Country [11] 0 0
United States of America
State/province [11] 0 0
Maryland
Country [12] 0 0
United States of America
State/province [12] 0 0
Montana
Country [13] 0 0
United States of America
State/province [13] 0 0
New Jersey
Country [14] 0 0
United States of America
State/province [14] 0 0
New York
Country [15] 0 0
United States of America
State/province [15] 0 0
North Carolina
Country [16] 0 0
United States of America
State/province [16] 0 0
Oklahoma
Country [17] 0 0
United States of America
State/province [17] 0 0
Pennsylvania
Country [18] 0 0
United States of America
State/province [18] 0 0
Tennessee
Country [19] 0 0
United States of America
State/province [19] 0 0
Texas
Country [20] 0 0
United States of America
State/province [20] 0 0
Utah
Country [21] 0 0
United States of America
State/province [21] 0 0
Wisconsin
Country [22] 0 0
Argentina
State/province [22] 0 0
Buenos Aires
Country [23] 0 0
Argentina
State/province [23] 0 0
Santa Fe
Country [24] 0 0
Argentina
State/province [24] 0 0
Tucuman
Country [25] 0 0
Brazil
State/province [25] 0 0
RJ
Country [26] 0 0
Brazil
State/province [26] 0 0
RS
Country [27] 0 0
Brazil
State/province [27] 0 0
SP
Country [28] 0 0
Canada
State/province [28] 0 0
Alberta
Country [29] 0 0
Canada
State/province [29] 0 0
British Columbia
Country [30] 0 0
Canada
State/province [30] 0 0
Ontario
Country [31] 0 0
Canada
State/province [31] 0 0
Quebec
Country [32] 0 0
Canada
State/province [32] 0 0
Saskatchewan
Country [33] 0 0
Denmark
State/province [33] 0 0
Herlev
Country [34] 0 0
France
State/province [34] 0 0
Angers cedex 02
Country [35] 0 0
France
State/province [35] 0 0
Lille Cedex
Country [36] 0 0
France
State/province [36] 0 0
Paris
Country [37] 0 0
France
State/province [37] 0 0
Vandoeuvre-Les-Nancy Cede
Country [38] 0 0
Germany
State/province [38] 0 0
Aschaffenburg
Country [39] 0 0
Germany
State/province [39] 0 0
Berlin
Country [40] 0 0
Germany
State/province [40] 0 0
Weiden
Country [41] 0 0
Hong Kong
State/province [41] 0 0
Hongkong
Country [42] 0 0
Hong Kong
State/province [42] 0 0
Shatin, New Territories
Country [43] 0 0
Italy
State/province [43] 0 0
AR
Country [44] 0 0
Italy
State/province [44] 0 0
MO
Country [45] 0 0
Italy
State/province [45] 0 0
Napoli
Country [46] 0 0
Korea, Republic of
State/province [46] 0 0
Korea
Country [47] 0 0
Korea, Republic of
State/province [47] 0 0
Daejeon
Country [48] 0 0
Mexico
State/province [48] 0 0
Chihuahua
Country [49] 0 0
Netherlands
State/province [49] 0 0
Den Haag
Country [50] 0 0
Netherlands
State/province [50] 0 0
Maastricht
Country [51] 0 0
Peru
State/province [51] 0 0
Lima
Country [52] 0 0
Spain
State/province [52] 0 0
Alicante
Country [53] 0 0
Spain
State/province [53] 0 0
Andalucia
Country [54] 0 0
Spain
State/province [54] 0 0
Barcelona
Country [55] 0 0
Spain
State/province [55] 0 0
Cataluna
Country [56] 0 0
Taiwan
State/province [56] 0 0
Taiwan, ROC
Country [57] 0 0
Taiwan
State/province [57] 0 0
Niaosong Township
Country [58] 0 0
Thailand
State/province [58] 0 0
Bangkok
Country [59] 0 0
Turkey
State/province [59] 0 0
Istanbul
Country [60] 0 0
United Kingdom
State/province [60] 0 0
Avon
Country [61] 0 0
United Kingdom
State/province [61] 0 0
London
Country [62] 0 0
United Kingdom
State/province [62] 0 0
Nottingham

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Novartis Pharmaceuticals
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This study assessed the efficacy and safety of first-line RAD001 followed by second-line
sunitinib versus the opposite sequence: first-line sunitinib followed by second-line RAD001
for the treatment of patients with MRCC.
Trial website
https://clinicaltrials.gov/show/NCT00903175
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Novartis Pharmaceuticals
Address 0 0
Novartis Pharmaceuticals
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications