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Sequential ATRA Then IL-2 for Modulation of Dendritic Cells and Treatment of Metastatic Renal Cell Cancer

Randomized Phase II Trial Of Sequential ATRA Then IL-2 For Modulation Of Dendritic Cells And Treatment Of Metastatic Renal Cancer

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00100906
Enrollment
18
Registered
2005-01-07
Start date
2004-08-31
Completion date
2013-07-31
Last updated
2013-08-16

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Kidney Cancer

Keywords

stage IV renal cell cancer, recurrent renal cell cancer, clear cell renal cell carcinoma

Brief summary

RATIONALE: Tretinoin may help cells that are involved in the body's immune response to work better. Interleukin-2 may stimulate the white blood cells to kill kidney cancer cells. Giving tretinoin together with interleukin-2 may kill more tumor cells. PURPOSE: This randomized phase II trial is studying how well giving three different doses of tretinoin together with interleukin-2 works in treating patients with stage IV kidney cancer.

Detailed description

OBJECTIVES: Primary * Determine the ratio of dendritic cells (DC) to circulating immature cells (ImC) before and after treatment with 3 different doses of tretinoin in patients with stage IV renal cell cancer. * Assess in vitro immune response assays to tetanus toxoid and influenza virus peptide before and after treatment with tretinoin and interleukin-2 in these patients. Secondary * Determine the frequency of treatment-related side effects in these patients. * Determine clinical objective response and progression-free survival of patients treated with this regimen. * Correlate DC:ImC ratio with clinical objective response in patients treated with this regimen. * Correlate the extent of change of the DC:ImC ratio with tretinoin dose and tretinoin blood levels in these patients. OUTLINE: This is a randomized, open-label study. Specimens are stratified according to patient prognostic factors, tumor bulk, and extent of dendritic cell to circulating immature cell ratio derangement. Patients are randomized to 1 of 3 tretinoin doses. Patients are followed for up to 2 years. PROJECTED ACCRUAL: A total of 27-36 patients (9-12 per treatment arm) will be accrued for this study within 2 years.

Interventions

DRUGIL-2

Immunotherapy with interleukin-2

DRUGATRA

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
National Institutes of Health (NIH)
CollaboratorNIH
Chiron Corporation
CollaboratorINDUSTRY
H. Lee Moffitt Cancer Center and Research Institute
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed renal cell cancer * Stage IV disease * Histology with clear cell component * Metastatic OR incompletely resected disease * Non-measurable disease allowed * Underwent complete or partial nephrectomy more than 90 days ago * No unresected primary cancer * No more than 2 of the following adverse factors: * Hemoglobin \< 10.0 g/dL * Corrected calcium \> upper limit of normal (ULN) * Lactic dehydrogenase \> 1.5 times ULN * Eastern Cooperative Oncology Group (ECOG) performance status 2 * Brain metastasis allowed provided more than 90 days of clinical and radiologic stability after the end of its active treatment PATIENT CHARACTERISTICS: Age * Over 18 Performance status * See Disease Characteristics * ECOG 0-2 Life expectancy * Not specified Hematopoietic * See Disease Characteristics Hepatic * See Disease Characteristics * Serum glutamic oxaloacetic transaminase (SGOT) \< 3 times normal * Bilirubin \< 2 times normal Renal * See Disease Characteristics * Creatinine clearance \> 40 mL/min Cardiovascular * None of the following cardiovascular conditions within the past year: * Uncontrolled hypertension * Myocardial infarction * Unstable angina * New York Heart Association class II-IV congestive heart failure * Serious cardiac arrhythmia requiring medication * Class II-IV peripheral vascular disease within the past year * Other clinically significant cardiovascular disease Immunologic * No history of immunodeficiency disease * No HIV infection * No ongoing serious infection Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use two methods of effective contraception during and for 1 month (for women) or 6 months (for men) after study treatment * Other prior malignancy allowed provided there is no evidence of active disease * No other medical contraindication to tretinoin or interleukin-2 * No serious non-healing wound, ulcer, or bone fracture PRIOR CONCURRENT THERAPY: Biologic therapy * At least 60 days since prior immunotherapy Chemotherapy * At least 60 days since prior cytotoxic chemotherapy Endocrine therapy * See Radiotherapy * No prior corticosteroids at \> physiologic replacement doses for \> 3 days within the past 90 days * Concurrent tamoxifen, toremifene, megestrol, or gonadotropin-releasing hormone agonists allowed * Concurrent inhaled steroids allowed Radiotherapy * More than 7 days since prior external-beam radiotherapy * No steroid requirement during radiotherapy Surgery * See Disease Characteristics * At least 30 days since other prior debulking surgery Other * Prior adjuvant therapy for resected, synchronous stage IV disease allowed * Prior adjuvant therapy allowed * Study therapy is not to be used as adjuvant therapy for completely resected late (\> 1 year until identification) solitary site of disease metastasis or non-metastatic disease * No prior participation in this clinical study * At least 60 days since other prior anticancer drugs * Concurrent seizure medication allowed

Design outcomes

Primary

MeasureTime frameDescription
Ratio of Dendritic Cells (DC) to Circulating Immature Cells (ImC) Before and After Treatment1 year, 3 monthsDetermine the ratio of dendritic cells (DC) to circulating immature cells (ImC) before and after treatment with 3 different doses of tretinoin in patients with stage IV renal cell cancer.

Secondary

MeasureTime frameDescription
Frequency of Treatment-Related Side Effects1 year, 3 monthsReview of adverse events utilizing Common Toxicity Criteria (CTC) V3.
Overall Response Rate (ORR)1 year, 3 monthsObjective Response Rate according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Evaluate per-patient observed best clinical responses, after 11-12 weeks of treatment.

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026