Advanced Non-Clear Cell Kidney Cancer
Conditions
Keywords
Kidney Cancer
Brief summary
This research study is studying the combination of Atezolizumab and Bevacizumab as a possible treatment for Advanced Non-Clear Cell Kidney Cancer.
Detailed description
This research study is a Phase II clinical trial. In this research the investigators are studying the combination of Atezolizumab with Bevacizumab. Participants will receive both vascular endothelial targeted therapy and immunotherapy. The FDA (the U.S. Food and Drug Administration) has not approved Atezolizumab for Advanced Non-Clear Cell Kidney Cancer, but it has been approved for other uses. The FDA has approved Bevacizumab with Interferon (IFNα) as a treatment option for Advanced Kidney Cancer.
Interventions
DRUGBevacizumab
DRUGAtezolizumab
Sponsors
Genentech, Inc.
Dana-Farber Cancer Institute
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years. * Unresectable advanced or metastatic non-clear cell RCC to include but not limited to: * Papillary RCC, any type * Unclassified RCC * Translocation RCC * Chromophobe RCC * Collecting duct RCC * Medulary RCC * Clear cell RCC or any histology with \> 20% sarcomatoid features will be eligible. * Other non-clear cell histologies that are not included above need to be discussed with the PI. * Request for formalin-fixed, paraffin-embedded (FFPE) archival tumor specimens if available and willingness of the participant to undergo mandatory fresh tumor biopsy unless determined medically unsafe or not feasible. A note from the study team should be provided documenting availability of tissue. If a target lesion is biopsied at screening, this lesion must be followed as non-target lesion after the biopsy unless it is the patient's only target lesion. If there is only one target lesion, it should be followed as a target lesion regardless. * The archival specimen should contain adequate viable tumor tissue. * The specimen may consist of a tissue block (preferred and should contain the highest grade of tumor) or at least 30 unstained serial sections. Fine-needle aspiration, brushings, cell pellet from pleural effusion, bone marrow aspirate/biopsy are not acceptable. * Fresh tumor biopsy at progression will be required in cases where patients experience relapse after an initial response if medically safe. * Measurable disease as defined by Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. * ECOG performance status ≤ 2 (See Appendix A). * Adequate hematologic and end-organ function as defined by the following laboratory results obtained within 28 days prior to the first study treatment: * Absolute neutrophil count (ANC) ≥ 1500 cells/uL. * Lymphocyte count ≥ 500/uL. * Platelet count ≥ 100,000/uL. * Hemoglobin ≥ 9 g/dL (patients may be transfused to meet this criterion). * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x upper limit of normal (ULN) with the following exceptions: Patients with documented liver metastases should have AST and ALT ≤ 5 x ULN. * Serum bilirubin ≤ 2.0 x ULN with the following exception: Patients with known Gilbert's disease should have a serum bilirubin ≤ 3 x ULN. * Creatinine clearance ≥ 30 mL/min as calculated by Cockcroft-Gault equation. * For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use highly effective forms of contraception and to continue its use 6 months after the last dose of atezolizumab or bevacizumab. * Signed informed consent form. * Ability and capacity to comply with study and follow-up procedures.
Exclusion criteria
•Prior treatment with CD137 agonists, anti- cytotoxic T-lymphocyte-associated protein 4, anti-PD-1, or anti-PDL1 therapeutic antibody or pathway targeting agents. Prior IFNα or IL-2 is allowed following 4 week washout from treatment end date. * Receipt of any type of small molecule kinase inhibitor (including investigational kinase inhibitors) within 2 weeks of enrollment or receipt of any anti-cancer therapy (including investigational therapy, monoclonal antibodies, cytokine therapy) within 4 weeks of enrollment. * Prior therapy with bevacizuamab. * Thrombologic event within 3 weeks of treatment start date, unless stable on anticoagulation with LMWH or Factor Xa inhibitor for at least 2 weeks. * Treatment with systemic immunosuppressive medications including but not limited to: prednisone, dexamethasone, cyclosporin, azathioprine, methotrexate, thalidomide, anti- tumor necrosis factor (TNF) agents, hydroxychloroquine within 2 weeks of first study dose. * Patients who have received acute, low-dose systemic immunosuppressant medications may be enrolled. * Patients with adrenal insufficiency on physiologic replacement doses of steroids may be enrolled. * The use of inhaled, topical intraocular, or intra articular corticosteroids or, mineralocorticoids are allowed. * Radiotherapy for RCC within 14 days of first study treatment with the exception of a single fraction of radiation administered for palliation of symptoms. * Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy, radiosurgery, or surgery and stable for at least 4 weeks prior to the initiation of study treatment. Stability must be confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) imaging and/or treating investigator determination. * Malignancies other than RCC within 2 years of first study treatment with the exception of those with negligible risk of metastases or death (included but not limited to carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer, ductal carcinoma in situ of the breast, non-muscle invasive urothelial carcinoma, or other malignancy not deemed to impact that patients 5-year life expectancy). * History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion protein. * Known hypersensitivity to any component of the atezolizumab product. * History of autoimmune disease including: myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with anti-phospholipid syndrome, Wegner's granulomatosis, Sjogren's syndrome, Guillain-Barre syndrome, multiple sclerosis, type I diabetes mellitus, vasculitis, or glomerulonephritis. Patients with a history of autoimmune-related hypothyroidism on thyroid replacement hormone or those with autoimmune dermatologic conditions not requiring the use of prednisone \> 10 mg or equivalent are eligible. * History of idiopathic pulmonary fibrosis, organized pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening imaging CT of the chest. History of radiation pneumonitis in the radiation field is permitted. * Positive test for HIV (test to be performed within 28 days of first treatment start). * Patients with active or chronic hepatitis B (defined as having a positive hepatitis B surface antigen \[HBsAg\] test at screening). Patients with past/resolved HBV infection (defined as having negative HBsAg test and a positive antibody to hepatitis B core antigen \[anti-HBc\] antibody test) are eligible. A negative HBA DNA test must be obtained in patients with positive hepatitis B core antibody prior to Cycle 1 Day 1. * Active hepatitis C infection. Patients positive hepatitis C antibody test are eligible if PCR is negative for hepatitis C viral DNA. * Infection requiring receipt of therapeutic oral or IV anti-microbials within 2 weeks of first study treatment. Patients receiving routine anti-microbial prophylaxis (for dental extractions/procedures) are eligible. * Significant cardiovascular disease such as New York Heart Association (NYHA) class II or greater, myocardial infarction within the previous 3 months of first study treatment, unstable arrhythmias, unstable angina. Patients with known coronary artery disease, congestive heart failure not meeting the above criteria, or left ventricular ejection fraction \< 50% must be on a stable regimen that is optimized in the opinion of the treating physician, in consultation with a cardiologist when appropriate. * Inadequately controlled hypertension (defined as systolic blood pressure \> 150 mmHg and/or diastolic blood pressure \> 100 mmHg). Anti-hypertensive therapy to achieve these parameters is allowed. * Prior history of hypertensive crisis or hypertensive encephalopathy within the previous 3 months of first study treatment. * History of stroke or transient ischemic attack within 3 months of first study dose. * Significant vascular disease (such as aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis) within 6 months of first study dose. Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation). * Current or recent use of dipyramidole, ticlopidine, clopidogrel, cilostazol is excluded. Aspirin (≤ 325 mg per day) is allowed. Prophylactic anticoagulation with oral or parenteral anticoagulants for the patency of venous access devices or other indications is allowed. Therapeutic use of low-molecular weight heparin (such as enoxaparin), and factor Xa inhibitors are allowed. Use of warfarin is prohibited. * Use of plaquenil must be discontinued two weeks prior to first study treatment. * History of abdominal or tracheoesophageal fistula or GI perforation within 6 months of first study treatment. * Clinical signs or symptoms of active GI obstruction or requirement of routine parenteral nutrition or tube feedings. * Evidence of abdominal free air not explained by paracentesis or recent surgical procedure. * Serious, non-healing or dehiscing wound or active ulcer. * Proteinuria, as demonstrated by \> 1.5 gram of protein in a 24-hour urine collection. All patients with ≥ 2+ protein on dipstick urinalysis at baseline must undergo 24-hour urine collection for protein. * Major surgical procedure within 21 days of first study treatment. * Prior allogenic stem cell or solid organ transplant. * Administration of a live, attenuated vaccine within 4 weeks for first study treatment. * Pregnant or lactating women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Best Overall Response Rate | Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months . | The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria. CR and PR must meet the following lesion criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (\<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Treatment-related Adverse Events | Adverse events are measured continuously on treatment and up to thirty days after going off treatment (up to ~32 months). | Assessed by -Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. All treatment-related all-grade adverse events occurring in \>10% of participants. Treatment Related is discerned as follows: * Yes: There is a plausible temporal relationship between the onset of the AE and administration of atezolizumab or bevacizumab, and the AE cannot be readily explained by the patient's clinical state, intercurrent illness, or concomitant therapies; and/or the AE follows a known pattern of response to atezolizumab or bevacizumab or with similar treatments; and/or the AE resolves upon discontinuation of the study drugs or dose reduction and, if applicable, reappears upon re-challenge. * No: Evidence exists that the AE has an etiology other than the study drugs (e.g., pre existing medical condition, underlying disease, intercurrent illness, or concomitant medication); and/or the AE has no plausible temporal relationship to the study drugs administration. |
| Duration of Response | Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months. | The duration of overall response (based on RECIST 1.1) is measured from the time measurement criteria are met for CR and PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented taking as reference for progressive disease the smallest measurements recorded since the treatment started or death due to any cause. Participants without events reported are censored at the last disease evaluation. |
| Immune Related Best Overall Response Rate | Measured every 6 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months. | The best overall Immune-Related Complete Response (irCR) or Immune-Related Partial Response (irPR) is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). irCR: Complete disappearance of all target lesions in two consecutive observations not less than 4 weeks apart. This category encompasses exactly the same subjects as complete response (CR). irPR: Decrease, relative to baseline, of 50% or greater in the sum of the products of the two largest perpendicular diameters (SPD) of all target and all new measurable lesions in two consecutive observations not less than 4 weeks apart. Note: the appearance of new measurable lesions is factored into the overall tumor burden, but does not automatically qualify as progressive disease until the SPD increases by \> 25% when compared to SPD at nadir. |
| Median Progression Free Survival | Participants followed for up to 32 months. | Progression free survival (PFS) is defined as the time from start of treatment to disease progression (PD) or death from any cause as estimated by Kaplan Meier methods. Patients who have not progressed and are alive are censored at the date the patient is known to be progression-free. Progression is defined by Response Evaluation Criteria In Solid Tumors Criteria 1.1 (RECIST) as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (including baseline if it's the smallest). The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. |
| 1-Year Overall Survival | 1 year | 1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive. |
| Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | Assessed at baseline, week 3, week 5, week 7, week 9, and end of therapy. | The Function Assessment of Cancer Therapy-Kidney Symptom Index-19 (FKSI-19) is a 19 item questionnaire with each item scored on a scale of 0-4 for a total score of 0-76 with higher scores indicating fewer symptom. |
| Brief Fatigue Inventory Score - Items 1-3 | Assessed at baseline, week 9, week 15, week 21, week 27, and end of therapy. | The Brief Fatigue Inventory Score (BFI) is a 9 item questionnaire with each items 1-3 scored on a scale of 0-10 Scores are categorized is mild (1-3), moderate (4-6), or severe (7-10). A global fatigue score can be found by averaging the score obtained on each test item completed. Items 1-3 of the 9 are reported here. |
| 6-Month Progression-Free Survival by Histological Subgroups | 6 months | 6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. Histological subgroups are categorized using established methods. |
| 1-Year Overall Survival by Histological Subgroup | 1 year | 1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive. |
| Best Overall Response Rate by Histological Subtypes | Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months | The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria. Please see the primary endpoint Best Overall Response Rate description for the definition of CR and PR. Non-clear cell renal cell carcinoma includes different histologic and genetic subtypes to include: papillary, chromophobe, collecting duct, unclassified, translocation, and medullary carcinoma. These subtypes are measured using established methods. |
| 1-Year Overall Survival by Sarcomatoid Differentiation | 1 year | 1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive. |
| Objective Response Rate by Sarcomatoid Differentiation | Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months . | The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1). CR and PR must meet the following criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): \>=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (\<10 mm short axis) Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion Sarcomatoid Differentiation are categorized using established methods |
| 6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group | 6 months | 6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at next assessment at investigator discretion if patient is benefiting from treatment. International Metastatic Renal Cell Carcinoma Risk Group determined by established methods |
| 1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group | 1 year | 1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive. |
| Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group | Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months . | The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using RECIST 1.1. CR and PR must meet the following criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): \>=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (\<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion. International Metastatic Renal Cell Carcinoma Risk Group are categorized using established methods |
| 6-Month Progression-Free Survival by Prior Systemic Therapy | 6 months | 6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. Prior systemic therapy group determined by established methods, |
| 1-Year Overall Survival by Prior Systemic Therapy | 1 year | 1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive. |
| Objective Response Rate by Prior Systemic Therapy | Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months . | The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using RECIST 1.1. CR and PR must meet the following criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): \>=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (\<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion. |
| 6-Month Progression-Free Survival by Sarcomatoid Differentiation | 6 months | 6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. Sarcomatoid Differentiation are categorized using established methods |
Countries
United States
Participant flow
Recruitment details
Enrollment took place between July 2016 and October 2018.
Participants by arm
| Arm | Count |
|---|---|
| Bevacizumab And Atezolizumab Combination 1200 mg of Atezolizumab intravenously x 3 weeks
15 mg/kg of Bevacizumab intravenously x 3 weeks.
One cycle will be 3 weeks in duration. | 60 |
| Total | 60 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Death | 1 |
| Overall Study | Disease Progression | 31 |
| Overall Study | Ineligible for Study Drug | 5 |
| Overall Study | Lost to Follow-up | 2 |
| Overall Study | not started | 1 |
| Overall Study | Protocol Violation | 1 |
| Overall Study | Still on Active Therapy | 15 |
| Overall Study | Toxicity | 5 |
| Overall Study | Withdrawal by Subject | 4 |
Baseline characteristics
| Characteristic | Bevacizumab And Atezolizumab Combination |
|---|---|
| Age, Continuous | 61 years |
| ECOG Performance Status 00 - Fully Active | 29 Participants |
| ECOG Performance Status 01 - Restricted | 30 Participants |
| ECOG Performance Status 02 - Ambulatory and Capable of Self Care | 1 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 56 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Histology Chromophobe | 10 Participants |
| Histology Clear Cell | 18 Participants |
| Histology Collecting Duct | 5 Participants |
| Histology Medullary | 1 Participants |
| Histology Papillary | 12 Participants |
| Histology Transcription Factor E3 Translocation | 5 Participants |
| Histology Unclassified | 9 Participants |
| International Metastatic Renal Cell Carcinoma Database Consortium Risk Group Favorable | 9 Participants |
| International Metastatic Renal Cell Carcinoma Database Consortium Risk Group Intermediate | 33 Participants |
| International Metastatic Renal Cell Carcinoma Database Consortium Risk Group Poor | 18 Participants |
| Metastasis Stage at Diagnosis M0 | 8 participants |
| Metastasis Stage at Diagnosis M1 | 16 participants |
| Metastasis Stage at Diagnosis Unknown | 36 participants |
| Presence of Bone Metastases | 1 Participants |
| Presence of Liver Metastases | 11 Participants |
| Prior Nephrectomy | 52 Participants |
| Prior Systemic Therapy | 21 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants |
| Race (NIH/OMB) More than one race | 2 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 2 Participants |
| Race (NIH/OMB) White | 53 Participants |
| Sarcomatoid Differentiation | 26 Participants |
| Sex: Female, Male Female | 13 Participants |
| Sex: Female, Male Male | 47 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 19 / 60 |
| other Total, other adverse events | 62 / 65 |
| serious Total, serious adverse events | 5 / 65 |
Outcome results
Primary
Best Overall Response Rate
The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria. CR and PR must meet the following lesion criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (\<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion.
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate | 33 percentage of participants |
Comparison: A sample size of 60 would provide 95% power to distinguish the ORR rate of 25% from 10% (historical control) with 1-sided alpha of 0.07. The treatment would be considered effective if 10 or more responses are observed out of 60 patients.80% CI: [25, 42]
Secondary
1-Year Overall Survival
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Time frame: 1 year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival | 67 percent probability of survival |
Secondary
1-Year Overall Survival by Histological Subgroup
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Time frame: 1 year
Population: Each row represents a Histology subgroup.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Histological Subgroup | Clear Cell | 63 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Histological Subgroup | Papillary | 79 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Histological Subgroup | Other non-clear cell Renal Cell Carcinoma | 68 percent probability of survival |
Secondary
1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Time frame: 1 year
Population: Each row represents an International Metastatic Renal Cell Carcinoma Risk Group
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group | Favorable | 100 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group | Intermediate | 79 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by International Metastatic Renal Cell Carcinoma Risk Group | Poor | 28 percent probability of survival |
Secondary
1-Year Overall Survival by Prior Systemic Therapy
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Time frame: 1 year
Population: Each row represents a prior systemic therapy category.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Prior Systemic Therapy | No | 66 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Prior Systemic Therapy | Yes | 66 percent probability of survival |
Secondary
1-Year Overall Survival by Sarcomatoid Differentiation
1-Year Overall Survival (OS) is defined as the probability of survival at 1 year from treatment start date. Survival probability is estimated using Kaplan Meier methods. An event is considered to be death due to any cause. Participants who are lost to follow-up before the 1 year mark are censored at date last known alive.
Time frame: 1 year
Population: Each row represents a Sarcomatoid Differentiation category.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Sarcomatoid Differentiation | Sarcomatoid in clear cell Renal Cell Carcinoma | 63 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Sarcomatoid Differentiation | Sarcomatoid in non-clear cell Renal Cell Carcinoma | 36 percent probability of survival |
| Bevacizumab And Atezolizumab Combination | 1-Year Overall Survival by Sarcomatoid Differentiation | None | 74 percent probability of survival |
Secondary
6-Month Progression-Free Survival by Histological Subgroups
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. Histological subgroups are categorized using established methods.
Time frame: 6 months
Population: Each row represent a histological subgroup
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Histological Subgroups | Clear Cell | 58 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Histological Subgroups | Papillary | 75 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Histological Subgroups | Other clear cell Renal Cell Carcinoma | 59 percent probability of PFS |
Secondary
6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at next assessment at investigator discretion if patient is benefiting from treatment. International Metastatic Renal Cell Carcinoma Risk Group determined by established methods
Time frame: 6 months
Population: Each row represents an International Metastatic Renal Cell Carcinoma Risk Group
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group | Favorable | 78 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group | Intermediate | 79 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by International Metastatic Renal Cell Carcinoma Risk Group | Poor | 19 percent probability of PFS |
Secondary
6-Month Progression-Free Survival by Prior Systemic Therapy
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. Prior systemic therapy group determined by established methods,
Time frame: 6 months
Population: Each row represents a prior systemic therapy category.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Prior Systemic Therapy | No | 56 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Prior Systemic Therapy | Yes | 71 percent probability of PFS |
Secondary
6-Month Progression-Free Survival by Sarcomatoid Differentiation
6-Month Progression free survival (PFS) is defined as the probability of disease progression (PD) or death from any cause 6 months from treatment start date as estimated by Kaplan Meier methods. Patients who have not progressed and alive are censored at the date the patient is known to be progression-free. Progression is defined by RECIST 1.1 as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment. Sarcomatoid Differentiation are categorized using established methods
Time frame: 6 months
Population: Each row represents a Sarcomatoid Differentiation category.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Sarcomatoid Differentiation | Sarcomatoid in clear cell Renal Cell Carcinoma | 58 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Sarcomatoid Differentiation | Sarcomatoid in non-clear cell Renal Cell Carcinoma | 38 percent probability of PFS |
| Bevacizumab And Atezolizumab Combination | 6-Month Progression-Free Survival by Sarcomatoid Differentiation | None | 70 percent probability of PFS |
Secondary
Best Overall Response Rate by Histological Subtypes
The best overall response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response recorded on treatment based on Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1) criteria. Please see the primary endpoint Best Overall Response Rate description for the definition of CR and PR. Non-clear cell renal cell carcinoma includes different histologic and genetic subtypes to include: papillary, chromophobe, collecting duct, unclassified, translocation, and medullary carcinoma. These subtypes are measured using established methods.
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months
Population: The number analyzed for each row is less than 60 because each row represents a histological subgroup. The sum of number analyzed by row equals the total number analyze (60).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Papillary | 23 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Chromophobe | 10 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Unclassified | 33 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Transcription Factor E3 Translocation | 20 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Collecting Duct | 40 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Medullary | 100 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Best Overall Response Rate by Histological Subtypes | Clear Cell | 50 percentage of participants |
Secondary
Brief Fatigue Inventory Score - Items 1-3
The Brief Fatigue Inventory Score (BFI) is a 9 item questionnaire with each items 1-3 scored on a scale of 0-10 Scores are categorized is mild (1-3), moderate (4-6), or severe (7-10). A global fatigue score can be found by averaging the score obtained on each test item completed. Items 1-3 of the 9 are reported here.
Time frame: Assessed at baseline, week 9, week 15, week 21, week 27, and end of therapy.
Population: Number analyzed reflects the number of participants with a evaluable questionnaire at each timepoint. Items 1-3 are reported because they are fatigue related and fatigue is the most common toxicity in the cohort.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Brief Fatigue Inventory Score - Items 1-3 | Baseline | 3.56 score on scale |
| Bevacizumab And Atezolizumab Combination | Brief Fatigue Inventory Score - Items 1-3 | Week 9 | 3.44 score on scale |
| Bevacizumab And Atezolizumab Combination | Brief Fatigue Inventory Score - Items 1-3 | Week 15 | 3.25 score on scale |
| Bevacizumab And Atezolizumab Combination | Brief Fatigue Inventory Score - Items 1-3 | Week 21 | 2.97 score on scale |
| Bevacizumab And Atezolizumab Combination | Brief Fatigue Inventory Score - Items 1-3 | Week 27 | 2.70 score on scale |
| Bevacizumab And Atezolizumab Combination | Brief Fatigue Inventory Score - Items 1-3 | End of Therapy | 3.97 score on scale |
Secondary
Duration of Response
The duration of overall response (based on RECIST 1.1) is measured from the time measurement criteria are met for CR and PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented taking as reference for progressive disease the smallest measurements recorded since the treatment started or death due to any cause. Participants without events reported are censored at the last disease evaluation.
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bevacizumab And Atezolizumab Combination | Duration of Response | 8.9 months |
Secondary
Immune Related Best Overall Response Rate
The best overall Immune-Related Complete Response (irCR) or Immune-Related Partial Response (irPR) is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). irCR: Complete disappearance of all target lesions in two consecutive observations not less than 4 weeks apart. This category encompasses exactly the same subjects as complete response (CR). irPR: Decrease, relative to baseline, of 50% or greater in the sum of the products of the two largest perpendicular diameters (SPD) of all target and all new measurable lesions in two consecutive observations not less than 4 weeks apart. Note: the appearance of new measurable lesions is factored into the overall tumor burden, but does not automatically qualify as progressive disease until the SPD increases by \> 25% when compared to SPD at nadir.
Time frame: Measured every 6 weeks while on treatment. Off-treatment, patients are followed every 6 months for up to two year. Participants were followed up to 32 months.
Population: Since the trial was designed in 2015, immune-related response has been infrequently used in VEGF/IO trials for kidney cancer. Most RCC trials have mainly focused on the traditional RECIST-based response as the primary endpoint. Therefore, the study team did not pursue immune-related response assessment and that data was not collected.
Secondary
Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score
The Function Assessment of Cancer Therapy-Kidney Symptom Index-19 (FKSI-19) is a 19 item questionnaire with each item scored on a scale of 0-4 for a total score of 0-76 with higher scores indicating fewer symptom.
Time frame: Assessed at baseline, week 3, week 5, week 7, week 9, and end of therapy.
Population: Number analyzed reflects the number of participants with a evaluable questionnaire at each timepoint.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | Baseline | 55.72 score on scale |
| Bevacizumab And Atezolizumab Combination | Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | 3 weeks | 59.13 score on scale |
| Bevacizumab And Atezolizumab Combination | Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | 5 weeks | 59.13 score on scale |
| Bevacizumab And Atezolizumab Combination | Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | 7 weeks | 60.66 score on scale |
| Bevacizumab And Atezolizumab Combination | Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | 9 weeks | 62.41 score on scale |
| Bevacizumab And Atezolizumab Combination | Mean Function Assessment of Cancer Therapy-Kidney Symptom Index-19 Score | End of Therapy | 51.92 score on scale |
Secondary
Median Progression Free Survival
Progression free survival (PFS) is defined as the time from start of treatment to disease progression (PD) or death from any cause as estimated by Kaplan Meier methods. Patients who have not progressed and are alive are censored at the date the patient is known to be progression-free. Progression is defined by Response Evaluation Criteria In Solid Tumors Criteria 1.1 (RECIST) as follows: \- \>20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (including baseline if it's the smallest). The sum must also demonstrate an increase of \>5 mm. OR -Appearance of new lesions and/or unequivocal progression of non-target lesions. It must be representative of overall disease status change, not a single lesion increase. For patients with PD at the first on-treatment imaging assessment, patients will be allowed to remain on study until confirmation at the next assessment at investigator discretion if patient is benefiting from treatment.
Time frame: Participants followed for up to 32 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bevacizumab And Atezolizumab Combination | Median Progression Free Survival | 8.3 months |
Secondary
Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group
The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using RECIST 1.1. CR and PR must meet the following criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): \>=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (\<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion. International Metastatic Renal Cell Carcinoma Risk Group are categorized using established methods
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
Population: Each row represents an International Metastatic Renal Cell Carcinoma Risk Group
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group | Favorable | 33 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group | Intermediate | 45 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by International Metastatic Renal Cell Carcinoma Risk Group | Poor | 11 percentage of participants |
Secondary
Objective Response Rate by Prior Systemic Therapy
The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using RECIST 1.1. CR and PR must meet the following criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): \>=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (\<10 mm short axis). Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion.
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
Population: Each row represents a prior systemic therapy category.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by Prior Systemic Therapy | Yes | 31 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by Prior Systemic Therapy | No | 38 percentage of participants |
Secondary
Objective Response Rate by Sarcomatoid Differentiation
The objective response rate is the percentage of participants achieving complete response (CR) or partial response (PR) as the best response on treatment using Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.1). CR and PR must meet the following criteria without having any new lesions as well: Target Lesion: (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. (PR): \>=30% decrease in the sum of the diameters of target lesion, taking as reference the baseline sum diameter. Non-Target Lesion: (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological (\<10 mm short axis) Non-CR/Non-Progressive Disease: Persistence of 1+ non-target lesion(s) and/or maintenance of tumor marker level above the normal limits. Must have PR in target lesion Sarcomatoid Differentiation are categorized using established methods
Time frame: Measured every 6 weeks for the first 24 weeks and then every 12 weeks while on treatment. The median (range) of treatment time was 9.5 (1-42) cycles, thus participants were assessed up to ~32 months .
Population: Each row represents a Sarcomatoid Differentiation category.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by Sarcomatoid Differentiation | None | 26 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by Sarcomatoid Differentiation | Clear Cell Renal Carcinoma | 50 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Objective Response Rate by Sarcomatoid Differentiation | Variant Histology Renal Cell Carcinoma | 38 percentage of participants |
Secondary
Percentage of Participants With Treatment-related Adverse Events
Assessed by -Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. All treatment-related all-grade adverse events occurring in \>10% of participants. Treatment Related is discerned as follows: * Yes: There is a plausible temporal relationship between the onset of the AE and administration of atezolizumab or bevacizumab, and the AE cannot be readily explained by the patient's clinical state, intercurrent illness, or concomitant therapies; and/or the AE follows a known pattern of response to atezolizumab or bevacizumab or with similar treatments; and/or the AE resolves upon discontinuation of the study drugs or dose reduction and, if applicable, reappears upon re-challenge. * No: Evidence exists that the AE has an etiology other than the study drugs (e.g., pre existing medical condition, underlying disease, intercurrent illness, or concomitant medication); and/or the AE has no plausible temporal relationship to the study drugs administration.
Time frame: Adverse events are measured continuously on treatment and up to thirty days after going off treatment (up to ~32 months).
Population: The analysis population is comprised of all treated patients.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Fatigue | 35 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Proteinuria | 35 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Musculoskeletal Pain | 33 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Diarrhea | 22 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Rash | 20 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Hypertension | 18 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Pruritis | 18 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Thyroid Dysfunction | 17 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Hepatitis | 15 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Fever | 13 percentage of participants |
| Bevacizumab And Atezolizumab Combination | Percentage of Participants With Treatment-related Adverse Events | Mucositis | 12 percentage of participants |