Clear Cell Renal Cell Carcinoma, Stage I Renal Cell Cancer
Conditions
Brief summary
This pilot phase 0 trial studies how well enzalutamide works before surgery in treating patients with kidney cancer. Androgens are a type of hormone produced by the body that may cause kidney tumors to grow. Anti-hormone therapy, such as enzalutamide, may lessen the amount of androgens produced by the body and keep kidney tumors from growing.
Detailed description
PRIMARY OBJECTIVES: I. To investigate the effects of neoadjuvant enzalutamide on clear cell renal cell carcinoma (ccRCC). OUTLINE: Patients receive enzalutamide orally (PO) daily for 90 days in the absence of disease progression or unacceptable toxicity. Patients then undergo partial or radical nephrectomy. After completion of study treatment, patients are followed up every 3 months.
Interventions
DRUGEnzalutamide
Given PO
OTHERLaboratory Biomarker Analysis
Correlative studies
PROCEDURENephrectomy
Undergo partial or radical nephrectomy
Sponsors
National Cancer Institute (NCI)
Rutgers, The State University of New Jersey
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
* Clinical T1N0M0 (=\< 7 cm) renal mass as measured on cross-sectional imaging (computed tomography \[CT\] or magnetic resonance imaging \[MRI\]) * Biopsy proven ccRCC * Tumor with androgen receptor (AR) expressed \>= 4580 copies/ug ribonucleic acid (RNA) * Can provide informed consent * Adequate hepatic function (\>= 1.5 x upper limit of normal \[ULN\]; patient's with Gilbert's disease are not excluded) * Adequate renal function (estimated glomerular filtration rate \[GFR\] \> 40mL/min) * No evidence of metastatic disease on baseline imaging (chest x-ray \[CXR\] or chest CT, abdominal CT or MRI) * Eastern Cooperative Oncology Group (ECOG) performance status =\< 2
Exclusion criteria
* Prior use of androgen deprivation including enzalutamide * Pregnant women or women who are of child bearing age who are not willing to use two (2) forms of contraception during treatment with enzalutamide and for six (6) months after treatment * Men must use adequate methods of contraception during and at least 3 months after treatment if engaging in sexual activity with a female of child bearing age * Known hypersensitivity to enzalutamide * History of unprovoked deep vein thrombosis/pulmonary embolism (DVT/PE) in past twelve (12) months * Inability to stop anticoagulants/antiplatelet therapy peri-operatively * History of seizure or any condition that may predispose to seizure (e.g., prior cortical stroke or significant brain trauma) * History of loss of consciousness or transient ischemic attack within twelve (12) months of enrollment * Any unstable, serious co-existing medical conditions including but not limited to myocardial infarction, coronary bypass surgery, unstable angina, cardiac arrhythmias, clinically evident congestive heart failure, or cerebrovascular accident within twelve (12) months prior to screening * Known or suspected brain metastasis or active leptomeningeal disease * Current use of exogenous testosterone * Retroperitoneal/hilar adenopathy concerning for locally advanced disease * Metastatic RCC
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cell proliferation | Up to 36 months |
| Tumor apoptosis as measured by annexin | Up to 36 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of adverse events (AEs) as assessed by Common Terminology Criteria for Adverse Events version 4 | Up to 36 months | Post-operative complications will be documented according to the Clavien-Dindo Classification System. |
| Tumor size as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 | Up to 36 months | — |
Other
| Measure | Time frame | Description |
|---|---|---|
| Genome-wide analysis of post-treatment tissue samples assessed by whole exome and RNA sequencing | Up to 36 months | — |
| Intracrine androgen signaling levels of testosterone and dihydrotestosterone assessed in tissue | Up to 36 months | Pre- and post-treatment tissue levels of testosterone and dihydrotestosterone will be compared to their respective serum levels to assess intracrine androgen signaling in ccRCC following enzalutamide treatment. |
| AR expression measured in pre- and post-treatment tissue samples by immunohistochemistry (IHC) | Up to 36 months | Pre- and post-treatment ccRCC samples will be used to purify mRNA, construct cDNA, and perform qPCR to quantify expression of mRNA. IHC staining will be performed on ccRCC pre- and post-treatment. |
Countries
United States
Outcome results
None listed