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A Study of Avastin (Bevacizumab) Added to Interferon Alfa-2a (Roferon) Therapy in Patients With Metastatic Renal Cell Cancer With Nephrectomy

A Randomised, Double-blind Study to Evaluate the Efficacy and Safety of Avastin Plus Roferon Compared With Placebo Plus Roferon on Overall Survival and Tumor Assessment in Nephrectomised Patients With Metastatic Clear Cell Renal Cell Carcinoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00738530
Enrollment
649
Registered
2008-08-20
Start date
2004-06-30
Completion date
2008-09-30
Last updated
2016-06-23

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

Conditions

Renal Cell Cancer

Brief summary

This 2-arm study will evaluate the efficacy and safety of Avastin versus placebo in combination with Roferon as first-line treatment in participants with metastatic renal cell cancer (clear cell type) who have had nephrectomy. The anticipated time of study treatment is 1-2 years, and the target sample size is greater than (\>)500 individuals.

Interventions

DRUGBevacizumab [Avastin]

10 mg/kg IV every 2 weeks

DRUGInterferon alfa 2a [Roferon]

9 MIU SC 3 times/week

DRUGPlacebo

IV every 2 weeks

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

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

Inclusion criteria

* metastatic renal cell cancer (clear cell type); * nephrectomy; * absence of proteinuria.

Exclusion criteria

* prior systemic treatment for metastatic renal cell cancer; * major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to study treatment start; * presence of brain metastases or spinal cord compression; * ongoing need for full dose anticoagulants; * uncontrolled hypertension; * clinically significant cardiovascular disease.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who DiedBaseline up to 4.25 years
Overall Survival (OS) DurationBaseline until death (up to 4.25 years)Duration of survival was defined as the time between the date of randomization and date of death due to any cause. Participants still alive at the time of analysis were censored at the date they were last known to be alive. Kaplan-Meier estimates were used for analysis.

Secondary

MeasureTime frameDescription
Time to Progression (TTP) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Time to progression was defined as the time between date of randomization and date of documented progression. Tumor assessment was performed using mRECIST. Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions. Participants without an event (including participants who died before progressive disease) were censored at the date of last follow-up for progression or date of last available tumor measurement if no follow-up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow-up were censored on the day of randomization.
Percentage of Participants With Treatment FailureBaseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Treatment failure is defined as insufficient therapeutic response (including disease progression), death, withdrawal of treatment due to adverse events or laboratory abnormality, or withdrawal of informed consent. Tumor assessment was performed using mRECIST. Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions.
Time to Treatment Failure (TTF) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Time to treatment failure was defined as the time between the date of randomization and the date of insufficient therapeutic response (including disease progression), death, withdrawal of treatment due to adverse events or laboratory abnormality, or withdrawal of informed consent. Tumor assessment was performed using mRECIST. Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions. Participants without an event were censored at the date of last tumor assessment or last treatment administration, whichever occurred last. Participants who were randomized but not exposed to study drug and had no further follow-up were censored on the day of randomization.
Percentage of Participants With Disease Progression or DeathBaseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions.
Percentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Best response recorded from the start of treatment until disease progression. Based on assessment of CR, PR, stable disease (SD), or progressive disease (PD), according to mRECIST. CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: \>=30% decrease under baseline of the sum of the LD of all target lesions. CR and PR persist on repeat imaging study at least 4 weeks after initial documentation. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Reference is the smallest sum LD. PD was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions.
Change From Baseline in Karnofsky Performance StatusBaseline, Week 7, 15, 23, 31, 43Karnofsky performance score is used to quantify participant's general well-being and activities of daily life and participants were classified based on their functional impairment. Karnofsky performance score is 11 level score which ranges between 0 (death) to 100 (no evidence of disease). Higher score means higher ability to perform daily tasks.
Percentage of Participants With Objective Response According to mRECISTBaseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Objective response referred to participants with complete response (CR) or partial response (PR). CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: greater than or equal to (\>=) 30% decrease in sum of the longest diameter (LD) of all target lesions taking as reference the screening sum LD. To be assigned a status of PR or CR, changes in tumor measurements had to be confirmed by repeat assessments that should have been performed no less than 4 weeks after the criteria for response were first met. Longer intervals as determined by the study protocol were also appropriate.
Progression Free Survival (PFS) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)Progression-free survival was defined as the time between the date of randomization and the first date of documented progression or date of death due to any cause, whichever occurred first. Tumor assessment was performed using modified RECIST. Progressive disease was defined as at least a 20 percentage(%) increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions. Participants without an event were censored at the date of last follow-up for progression or date of last available tumor measurement if no follow-up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow-up were censored on the day of randomization.

Countries

Australia, Belgium, Czechia, Finland, France, Germany, Hungary, Israel, Italy, Netherlands, Norway, Poland, Russia, Singapore, Spain, Switzerland, Taiwan, United Kingdom

Participant flow

Recruitment details

A total of 821 participants were screened for this study, and 649 of these were randomized to receive double-blind treatment.

Participants by arm

ArmCount
Bevacizumab + IFN-Alfa-2A
Bevacizumab infusions were administered every two weeks at a dose of 10 mg/kg for 52 weeks or until disease progression or unacceptable toxicity. IFN-Alfa-2A was administered 3 times per week as a subcutaneous injection at a dose of 9 MIU for 52 weeks or until disease progression or major toxicity.
327
Placebo + IFN-Alfa-2A
Placebo matched with Bevacizumab infusions were administered every two weeks for 52 weeks or until disease progression or unacceptable toxicity. IFN-Alfa-2A was administered 3 times per week as a subcutaneous injection at a dose of 9 MIU for 52 weeks or until disease progression or major toxicity.
322
Total649

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath220224
Overall StudyLost to Follow-up86
Overall StudyWithdrawal by Subject68

Baseline characteristics

CharacteristicBevacizumab + IFN-Alfa-2APlacebo + IFN-Alfa-2ATotal
Age, Continuous60.1 years
STANDARD_DEVIATION 10.12
59.4 years
STANDARD_DEVIATION 10.89
59.7 years
STANDARD_DEVIATION 10.51
Sex: Female, Male
Female
105 Participants87 Participants192 Participants
Sex: Female, Male
Male
222 Participants235 Participants457 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
319 / 337279 / 304
serious
Total, serious adverse events
103 / 33751 / 304

Outcome results

Primary

Overall Survival (OS) Duration

Duration of survival was defined as the time between the date of randomization and date of death due to any cause. Participants still alive at the time of analysis were censored at the date they were last known to be alive. Kaplan-Meier estimates were used for analysis.

Time frame: Baseline until death (up to 4.25 years)

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (MEDIAN)
Bevacizumab + IFN-Alfa-2AOverall Survival (OS) Duration23.3 months
Placebo + IFN-Alfa-2AOverall Survival (OS) Duration21.3 months
p-value: 0.33695% CI: [0.76, 1.1]Log Rank
Primary

Percentage of Participants Who Died

Time frame: Baseline up to 4.25 years

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (NUMBER)
Bevacizumab + IFN-Alfa-2APercentage of Participants Who Died67.3 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants Who Died69.6 percentage of participants
Secondary

Change From Baseline in Karnofsky Performance Status

Karnofsky performance score is used to quantify participant's general well-being and activities of daily life and participants were classified based on their functional impairment. Karnofsky performance score is 11 level score which ranges between 0 (death) to 100 (no evidence of disease). Higher score means higher ability to perform daily tasks.

Time frame: Baseline, Week 7, 15, 23, 31, 43

Population: Safety population: all participants randomized and exposed to study drug (8 randomized participants did not receive study treatment and were not included, 2 in bevacizumab and 6 in placebo group). 12 participants randomized to placebo received bevacizumab, were included in bevacizumab arm. n=number of evaluable participants at specified time point.

ArmMeasureGroupValue (MEDIAN)
Bevacizumab + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusBaseline (n=337, 304)90 score on a scale
Bevacizumab + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 7 (n=291, 263)0 score on a scale
Bevacizumab + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 15 (n=242, 196)0 score on a scale
Bevacizumab + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 23 (n=195, 143)0 score on a scale
Bevacizumab + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 31 (n=166, 108)0 score on a scale
Bevacizumab + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 43 (n=137, 79)0 score on a scale
Placebo + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 31 (n=166, 108)0 score on a scale
Placebo + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusBaseline (n=337, 304)90 score on a scale
Placebo + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 23 (n=195, 143)0 score on a scale
Placebo + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 7 (n=291, 263)0 score on a scale
Placebo + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 43 (n=137, 79)0 score on a scale
Placebo + IFN-Alfa-2AChange From Baseline in Karnofsky Performance StatusChange at Week 15 (n=242, 196)0 score on a scale
Secondary

Percentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)

Best response recorded from the start of treatment until disease progression. Based on assessment of CR, PR, stable disease (SD), or progressive disease (PD), according to mRECIST. CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: \>=30% decrease under baseline of the sum of the LD of all target lesions. CR and PR persist on repeat imaging study at least 4 weeks after initial documentation. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Reference is the smallest sum LD. PD was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study. Number of participants analyzed (N) = participants with measurable disease at baseline.

ArmMeasureGroupValue (NUMBER)
Bevacizumab + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Partial Response (PR)30.7 percentage of participants
Bevacizumab + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Progressive Disease (PD)20.6 percentage of participants
Bevacizumab + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Stable Disease (SD)44.4 percentage of participants
Bevacizumab + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Missing (no response assessment)2.6 percentage of participants
Bevacizumab + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Complete Response (CR)1.6 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Missing (no response assessment)3.8 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Complete Response (CR)2.4 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Partial Response (PR)10.0 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Stable Disease (SD)50.5 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Best Overall Response According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)Progressive Disease (PD)33.2 percentage of participants
Secondary

Percentage of Participants With Disease Progression or Death

Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (NUMBER)
Bevacizumab + IFN-Alfa-2APercentage of Participants With Disease Progression or Death92.0 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Disease Progression or Death92.5 percentage of participants
Secondary

Percentage of Participants With Objective Response According to mRECIST

Objective response referred to participants with complete response (CR) or partial response (PR). CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: greater than or equal to (\>=) 30% decrease in sum of the longest diameter (LD) of all target lesions taking as reference the screening sum LD. To be assigned a status of PR or CR, changes in tumor measurements had to be confirmed by repeat assessments that should have been performed no less than 4 weeks after the criteria for response were first met. Longer intervals as determined by the study protocol were also appropriate.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study. Number of participants analyzed (N) = participants with measurable disease at baseline.

ArmMeasureValue (NUMBER)
Bevacizumab + IFN-Alfa-2APercentage of Participants With Objective Response According to mRECIST32.4 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Objective Response According to mRECIST12.5 percentage of participants
p-value: <0.000195% CI: [13.2, 26.6]Chi-squared
Secondary

Percentage of Participants With Treatment Failure

Treatment failure is defined as insufficient therapeutic response (including disease progression), death, withdrawal of treatment due to adverse events or laboratory abnormality, or withdrawal of informed consent. Tumor assessment was performed using mRECIST. Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (NUMBER)
Bevacizumab + IFN-Alfa-2APercentage of Participants With Treatment Failure90.5 percentage of participants
Placebo + IFN-Alfa-2APercentage of Participants With Treatment Failure91.6 percentage of participants
Secondary

Progression Free Survival (PFS) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)

Progression-free survival was defined as the time between the date of randomization and the first date of documented progression or date of death due to any cause, whichever occurred first. Tumor assessment was performed using modified RECIST. Progressive disease was defined as at least a 20 percentage(%) increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions. Participants without an event were censored at the date of last follow-up for progression or date of last available tumor measurement if no follow-up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow-up were censored on the day of randomization.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (MEDIAN)
Bevacizumab + IFN-Alfa-2AProgression Free Survival (PFS) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)10.2 months
Placebo + IFN-Alfa-2AProgression Free Survival (PFS) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)5.5 months
p-value: 0.000495% CI: [0.64, 0.88]Log Rank
Secondary

Time to Progression (TTP) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)

Time to progression was defined as the time between date of randomization and date of documented progression. Tumor assessment was performed using mRECIST. Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions. Participants without an event (including participants who died before progressive disease) were censored at the date of last follow-up for progression or date of last available tumor measurement if no follow-up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow-up were censored on the day of randomization.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (MEDIAN)
Bevacizumab + IFN-Alfa-2ATime to Progression (TTP) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)10.2 months
Placebo + IFN-Alfa-2ATime to Progression (TTP) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)5.5 months
p-value: 0.000295% CI: [0.62, 0.86]Log Rank
Secondary

Time to Treatment Failure (TTF) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)

Time to treatment failure was defined as the time between the date of randomization and the date of insufficient therapeutic response (including disease progression), death, withdrawal of treatment due to adverse events or laboratory abnormality, or withdrawal of informed consent. Tumor assessment was performed using mRECIST. Progressive disease was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since treatment started or the appearance of one or more new lesions and/or the unequivocal progression of existing non-target lesions. Participants without an event were censored at the date of last tumor assessment or last treatment administration, whichever occurred last. Participants who were randomized but not exposed to study drug and had no further follow-up were censored on the day of randomization.

Time frame: Baseline until disease progression or death, whichever occurred first (assessed at baseline, Weeks 8, 16, 24, 32, 44, 56, 68 thereafter every 12 weeks up to week 104 and then every 6 months up to 4.25 years)

Population: ITT population included all participants randomized into the study.

ArmMeasureValue (MEDIAN)
Bevacizumab + IFN-Alfa-2ATime to Treatment Failure (TTF) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)8.1 months
Placebo + IFN-Alfa-2ATime to Treatment Failure (TTF) According to Modified Response Evaluation Criteria in Solid Tumors (mRECIST)4.5 months
p-value: 0.002395% CI: [0.66, 0.92]Log Rank

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