The High-Dose Aldesleukin (IL-2) "Select" Trial for Patients With Metastatic Renal Cell Carcinoma

NCT ID: NCT00554515

Last Updated: 2024-08-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

123 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-11-30

Study Completion Date

2013-10-31

Brief Summary

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High-dose interleukin 2 (Proleukin, Novartis) (IL-2) is approved by the U.S Food and Drug Administration (FDA) for the treatment of metastatic kidney cancer and is a standard treatment of this disease. At the present time, IL-2 is the only therapy for kidney cancer that can produce a remission of disease that lasts after treatment is completed. However, most patients who receive IL-2 do not benefit and all patients experience potentially dangerous side effects.

Recent research has suggested that certain patients may respond better to IL-2 than others. The Cytokine Working Group is currently conducting a clinical trial that aims to identify and confirm this research and narrow the application of IL-2 to those patients most likely to benefit.

Detailed Description

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OBJECTIVES:

Primary

* To determine, in a prospective fashion, if the response rate to high-dose IL-2 for patients with metastatic renal cell carcinoma and "good" pathologic predictive features is significantly higher than a historical, unselected patient population.

Secondary

* To determine, in a prospective fashion, the response rate to high-dose IL-2 for patients with metastatic renal cell carcinoma and "poor" pathologic predictive features and to compare this response rate to the response rate of patients with "good" pathologic predictive features.
* To determine if components of other predictive and prognostic models (e.g MSKCI or UCLA criteria) can help to further define the optimal population to receive high-dose IL2 for metastatic renal cell carcinoma.
* To identify features of the baseline immune function (arginine, arginase, T cell zeta chain) of patients with metastatic renal cell carcinoma that are associated with response to high-dose IL-2.
* To identify new proteins or patterns of gene expression that might be associated with high-dose IL-2 responsiveness in order to further narrow the application of IL-2 therapy to those who will benefit the most.

Conditions

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Metastatic Renal Cell Carcinoma

Keywords

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Kidney Renal Cell Metastatic interleukin-2 select

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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HD IL2

Participants received high-dose (HD) IL2, 600,000 IU/kg/dose (Prometheus Laboratories Inc.) i.v. every 8 hours for 5 days (maximum of 14 doses) beginning on day 1 and again on day 15. One course generally consisted of 5 days of treatment, 9 days of rest, 5 more days of treatment, and 9 weeks of rest, followed by up to two additional courses of HD IL2 for patients who benefited and tolerated most of the planned IL2 doses. A treatment delay of up to 4 weeks was allowed for resolution of side effects between courses. Patients were eligible to receive a maximum of three courses of treatment.

Group Type EXPERIMENTAL

HD IL2

Intervention Type DRUG

Interventions

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HD IL2

Intervention Type DRUG

Other Intervention Names

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Proleukin Aldesleukin

Eligibility Criteria

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Inclusion Criteria

* Patients must have histologically confirmed renal cell carcinoma that is metastatic or unresectable.
* If patients have measurable disease restricted to a solitary lesion, its neoplastic nature should be confirmed by cytology/histology.
* Patients must provide access to tissue blocks containing adequate tumor for interpretation and analysis.
* Patients must have measurable disease.
* Patients must have good performance status (ECOG 0 or 1; Karnofsky PS 100-80%).
* Patients must have adequate organ function.
* Patients must have no contraindication of vasopressor agents.
* Patients must be ≥ 18 years of age.

Exclusion Criteria

* Patients who have received systemic therapy for metastatic disease.
* Patients with organ allografts.
* Patients who require or are likely to require systemic corticosteroid therapy for intercurrent illness.
* Patients with any significant medical disease other than the malignancy (e.g. COPD, patients with ascites or pleural effusions), which in the opinion of the investigator would significantly increase the risk of immunotherapy.
* Patients with a history of another malignancy within the past 5 years other than surgically cured non-melanoma skin cancer, carcinoma-in-situ or Stage I carcinoma of the cervix.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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City of Hope National Medical Center

OTHER

Sponsor Role collaborator

Providence Cancer Center, Earle A. Chiles Research Institute

OTHER

Sponsor Role collaborator

Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role collaborator

Indiana University

OTHER

Sponsor Role collaborator

Loyola University

OTHER

Sponsor Role collaborator

Our Lady of Mercy Medical Center

OTHER

Sponsor Role collaborator

Roswell Park Cancer Institute

OTHER

Sponsor Role collaborator

University of California, Los Angeles

OTHER

Sponsor Role collaborator

University of Cincinnati

OTHER

Sponsor Role collaborator

University of Pittsburgh

OTHER

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role collaborator

Vanderbilt University

OTHER

Sponsor Role collaborator

Wayne State University

OTHER

Sponsor Role collaborator

Dana-Farber Cancer Institute

OTHER

Sponsor Role collaborator

Beth Israel Deaconess Medical Center

OTHER

Sponsor Role lead

Responsible Party

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David McDermott

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David F McDermott, MD

Role: STUDY_CHAIR

Beth Israel Deaconess Medical Center

Kim Margolin, MD

Role: PRINCIPAL_INVESTIGATOR

City of Hope National Medical Center

Walter Urba, MD

Role: PRINCIPAL_INVESTIGATOR

Chiles Cancer Center

Marc Ernstoff, MD

Role: PRINCIPAL_INVESTIGATOR

Dartmouth-Hitchcock Medical Center

Theodore Logan, MD

Role: PRINCIPAL_INVESTIGATOR

Indiana University

Joseph Clark, MD

Role: PRINCIPAL_INVESTIGATOR

Loyola University

Janice Dutcher, MD

Role: PRINCIPAL_INVESTIGATOR

Our Lady of Mercy Cancer Center

Michael Wong, MD

Role: PRINCIPAL_INVESTIGATOR

Roswell Park Cancer Institute

Allen Pantuck, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, Los Angeles

Leslie Oleksowicz, MD

Role: PRINCIPAL_INVESTIGATOR

University of Cincinnati

Leonard Appleman, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Geoffrey Weiss, MD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Jeffrey Sosman, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University

Ulka Vaishampayan, MD

Role: PRINCIPAL_INVESTIGATOR

Wayne State University

Locations

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Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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McDermott DF. Update on the application of interleukin-2 in the treatment of renal cell carcinoma. Clin Cancer Res. 2007 Jan 15;13(2 Pt 2):716s-720s. doi: 10.1158/1078-0432.CCR-06-1872.

Reference Type BACKGROUND
PMID: 17255299 (View on PubMed)

Atkins M, Regan M, McDermott D, Mier J, Stanbridge E, Youmans A, Febbo P, Upton M, Lechpammer M, Signoretti S. Carbonic anhydrase IX expression predicts outcome of interleukin 2 therapy for renal cancer. Clin Cancer Res. 2005 May 15;11(10):3714-21. doi: 10.1158/1078-0432.CCR-04-2019.

Reference Type BACKGROUND
PMID: 15897568 (View on PubMed)

McDermott DF, Cheng SC, Signoretti S, Margolin KA, Clark JI, Sosman JA, Dutcher JP, Logan TF, Curti BD, Ernstoff MS, Appleman L, Wong MK, Khushalani NI, Oleksowicz L, Vaishampayan UN, Mier JW, Panka DJ, Bhatt RS, Bailey AS, Leibovich BC, Kwon ED, Kabbinavar FF, Belldegrun AS, Figlin RA, Pantuck AJ, Regan MM, Atkins MB. The high-dose aldesleukin "select" trial: a trial to prospectively validate predictive models of response to treatment in patients with metastatic renal cell carcinoma. Clin Cancer Res. 2015 Feb 1;21(3):561-8. doi: 10.1158/1078-0432.CCR-14-1520. Epub 2014 Nov 25.

Reference Type RESULT
PMID: 25424850 (View on PubMed)

Other Identifiers

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DFHCC 06-149

Identifier Type: -

Identifier Source: org_study_id

NCT00536757

Identifier Type: -

Identifier Source: nct_alias