Clinical trial NCT06222593: Study to Evaluate the Safety and Efficacy of Bicalutamide in Combination with Sunitinib in Patients with TKIs-resistant RCC
Official title: A Phase I/II Study to Evaluate the Safety and Efficacy of Bicalutamide in Combination with Sunitinib in Patients with Receptor Tyrosine Kinase Inhibitor Resistant Renal Cell Carcinoma
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE1
PHASE2
Conditions: Carcinoma, Renal Cell
Lead sponsor: State University of New York at Buffalo
Sponsor class: OTHER
First posted: 2024-01-24
Enrollment: 28
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Longitudinal
Primary purpose: TREATMENT

Brief summary: This is a Phase I/II open-label, efficacy and safety study of bicalutamide in combination with sunitinib in patients with advanced renal cell carcinoma (RCC) who have been treated with a receptor tyrosine kinase inhibitor (RTKI) and experienced disease progression.

Detailed description: This is a Phase I/II open-label, efficacy and safety study of bicalutamide in combination with sunitinib in patients with advanced renal cell carcinoma (RCC) who have been treated with a receptor tyrosine kinase inhibitor (RTKI) and experienced disease progression. After entering the study, patients will have sunitinib dosed at the 2 weeks ON and one week OFF scheduled. Dose and schedule modification of sunitinib will be allowed at the discretion of the treating physician. Bicalutamide will be administrated orally at 50 mg daily. This clinical study will utilize the Simon's optimal two stage design. Investigators will enroll 9 patients in the first stage. If no response is seen, then the trial is terminated for futility. Otherwise, accrual continues to a total of 16 patients. If at most 2 patients respond among the 16 patients, this therapy would warrant further investigation.

Eligibility criteria: Inclusion Criteria:

1. Be willing and able to provide written informed consent for the trial.
2. Be greater than or equal to 18 years of age on day of signing informed consent.
3. Have measurable disease based on RECIST 1.1
4. Have a performance status of 0-2 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale
5. Demonstrate adequate organ function
6. Female subject of childbearing potential should have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication.
7. Subjects of childbearing potential should be willing to use 2 methods of contraception for the course of the study through 120 days after the last dose of study medication
8. Male subjects without a previous vasectomy should agree to use an adequate method of contraception (i.e. abstinence, condom with spermicidal foam/gel/film/cream) starting with the first dose of study therapy through 120 days after the last dose of study therapy.
9. Subjects have archival tumor tissue available or are willing to undergo a baseline biopsy prior to treatment.
10. Subjects must have a life expectancy of at least 6 months.

Exclusion Criteria:

1. Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
2. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
3. Has active Bacillus tuberculosis (TB)
4. Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
5. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
6. Has an active infection requiring systemic therapy.
7. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
8. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
9. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment.
10. Has a known history of Human Immunodeficiency Virus (HIV)
11. Has known active Hepatitis B or Hepatitis C
12. Has received a live vaccine within 30 days of planned start of study therapy

Primary outcomes:
measure: To assess safety and tolerability of bicalutamide in combination with sunitinib in patients with RTKIs-resistant renal cell carcinoma.
timeFrame: 3 years
measure: To assess efficacy of bicalutamide in combination with sunitinib in patients with RTKIs-resistant renal cell carcinoma.
timeFrame: 3 years
Secondary outcomes:
Other outcomes:
measure: To characterize androgen receptor (AR) expression in tumor samples immunohistochemistry (IHC)
timeFrame: 3 years
measure: To characterize expression of AR-related micro-RNA (miR) in tumor and/or blood by polymerase chain reaction (PCR)
timeFrame: 3 years
measure: To characterize Kallikrein-2 (KLK2) expression in blood by ELISA
timeFrame: 3 years
measure: To characterize KLK2 expression in tumor samples immunohistochemistry (IHC)
timeFrame: 3 years
Locations:
city: Buffalo
country: United States
facility: UB/ Great Lakes Cancer Care
state: New York
Study officials:
affiliation: State University of New York at Buffalo
name: Roberto Pili, MD
role: PRINCIPAL_INVESTIGATOR
References: