Trial Outcomes & Findings for Testing the Combination of XL184 (Cabozantinib), Nivolumab, and Ipilimumab for Poorly Differentiated Neuroendocrine Tumors (NCT NCT04079712)

NCT ID: NCT04079712

Last Updated: 2025-12-12

Results Overview

Participants who are considered to have a response are those with either a complete response (CR) (disappearance of all target lesions) or a partial response (PR) (\>=30% decrease in the sum of the longest diameter of target lesions) using Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1 and assessed by CT or MRI scan.

Recruitment status

ACTIVE_NOT_RECRUITING

Study phase

PHASE2

Target enrollment

17 participants

Primary outcome timeframe

Up to 3.5 years

Results posted on

2025-12-12

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Overall Study
STARTED
17
Overall Study
COMPLETED
16
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Overall Study
Disease progression before starting treatment
1

Baseline Characteristics

Testing the Combination of XL184 (Cabozantinib), Nivolumab, and Ipilimumab for Poorly Differentiated Neuroendocrine Tumors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=17 Participants
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Age, Categorical
<=18 years
0 Participants
n=26 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=26 Participants
Age, Categorical
>=65 years
8 Participants
n=26 Participants
Age, Continuous
62 Years
n=26 Participants
Sex: Female, Male
Female
4 Participants
n=26 Participants
Sex: Female, Male
Male
13 Participants
n=26 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=26 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
15 Participants
n=26 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=26 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=26 Participants
Race (NIH/OMB)
Asian
1 Participants
n=26 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=26 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=26 Participants
Race (NIH/OMB)
White
15 Participants
n=26 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=26 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=26 Participants
Region of Enrollment
United States
17 participants
n=26 Participants
Weight
88 kilogram (kg)
n=26 Participants
Body Surface Area (BSA)
2.0 meters squared (m^2)
n=26 Participants

PRIMARY outcome

Timeframe: Up to 3.5 years

Participants who are considered to have a response are those with either a complete response (CR) (disappearance of all target lesions) or a partial response (PR) (\>=30% decrease in the sum of the longest diameter of target lesions) using Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1 and assessed by CT or MRI scan.

Outcome measures

Outcome measures
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=16 Participants
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Number of Participants With a Response
Response
2 Participants
Number of Participants With a Response
No Response
14 Participants

SECONDARY outcome

Timeframe: Up to 3.5 years

Progression is defined as a \>= 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) and assessed by CT or MRI scan. The duration is from the date of registration to the time of progression or death, whichever occurs first.

Outcome measures

Outcome measures
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=16 Participants
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Progression Free Survival (PFS)
85 Days
Interval 23.0 to 902.0

SECONDARY outcome

Timeframe: Up to 3.5 years

Adverse events will be assessed using the Common Terminology Criteria for Adverse Events (CTCAE) 5.0 criteria. The population is defined as all patients who have received the study treatment. The highest grade is reported.

Outcome measures

Outcome measures
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=16 Participants
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Number of Participants Reporting Adverse Events
Grade 5
0 Participants
Number of Participants Reporting Adverse Events
Grade 4
3 Participants
Number of Participants Reporting Adverse Events
Grade 3
7 Participants
Number of Participants Reporting Adverse Events
Grades 1-2
6 Participants

SECONDARY outcome

Timeframe: Up to 3.5 years

DCR will be defined as the achievement of Complete Response (CR) (disappearance of all target lesions), Partial Response (PR) (\>=30% decrease in the sum of the longest diameter of target lesions), or Stable Disease (SD) (between \< 30% decrease and \>20% increase in the sum of the longest diameter of target lesions) using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT or MRI scan.

Outcome measures

Outcome measures
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=16 Participants
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Disease Control Rate (DCR)
Achieved disease control
9 Participants
Disease Control Rate (DCR)
Did not achieve disease control
7 Participants

SECONDARY outcome

Timeframe: Up to 3.5 years

The time when measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented.

Outcome measures

Outcome measures
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=2 Participants
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Duration of Response (DOR)
664 Days
Interval 504.0 to 824.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to Day 35

Population: This biomarker assay was not performed as there were insufficient samples available to interpret the planned correlative studies.

Expression of CD8+ T lymphocytes in the tumor tissue at baseline and during treatment.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to Day 35

Population: This biomarker assay was not performed as there were insufficient samples available to interpret the planned correlative studies.

Presence of myeloid derived suppressor cells in the tumor before and during treatment.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to Day 35

Population: This biomarker assay was not performed as there were insufficient samples available to interpret the planned correlative studies.

Presence of tumor-associated macrophages in the tumor at baseline and during treatment.

Outcome measures

Outcome data not reported

Adverse Events

Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)

Serious events: 10 serious events
Other events: 16 other events
Deaths: 13 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=17 participants at risk
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Cardiac disorders
Pericardial effusion
5.9%
1/17 • About 3.5 years
General disorders
Malaise
5.9%
1/17 • About 3.5 years
General disorders
Non-cardiac chest pain
5.9%
1/17 • About 3.5 years
Hepatobiliary disorders
Hepatic failure
11.8%
2/17 • About 3.5 years
Infections and infestations
Appendicitis
5.9%
1/17 • About 3.5 years
Infections and infestations
Cholangitis
5.9%
1/17 • About 3.5 years
Infections and infestations
Sepsis
5.9%
1/17 • About 3.5 years
Infections and infestations
Stoma site infection
5.9%
1/17 • About 3.5 years
Infections and infestations
Tracheitis
5.9%
1/17 • About 3.5 years
Injury, poisoning and procedural complications
Fall
5.9%
1/17 • About 3.5 years
Metabolism and nutrition disorders
Hyponatremia
5.9%
1/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
5.9%
1/17 • About 3.5 years
Renal and urinary disorders
Acute kidney injury
5.9%
1/17 • About 3.5 years
Renal and urinary disorders
Urinary retention
5.9%
1/17 • About 3.5 years
Vascular disorders
Hypotension
5.9%
1/17 • About 3.5 years
Vascular disorders
Thromboembolic event
5.9%
1/17 • About 3.5 years

Other adverse events

Other adverse events
Measure
Treatment (Cabozantinib S-malate, Nivolumab, Ipilimumab)
n=17 participants at risk
Patients receive cabozantinib s-malate PO QD on days 1-21 of cycles 1-4 and days 1-28 of subsequent cycles, nivolumab IV over 30 minutes on day 1 all cycles, and ipilimumab IV over 90 minutes on day 1 of cycles 1-4 only. Treatment repeats every 21 days for 4 cycles then every 28 days for subsequent cycles in the absence of disease progression or unacceptable toxicity.
Metabolism and nutrition disorders
Hypophosphatemia
41.2%
7/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Arthralgia
5.9%
1/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Arthritis
5.9%
1/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Back pain
17.6%
3/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Bone pain
5.9%
1/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
23.5%
4/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Muscle cramp
17.6%
3/17 • About 3.5 years
Musculoskeletal and connective tissue disorders
Myalgia
5.9%
1/17 • About 3.5 years
Nervous system disorders
Dizziness
11.8%
2/17 • About 3.5 years
Nervous system disorders
Dysgeusia
11.8%
2/17 • About 3.5 years
Nervous system disorders
Headache
23.5%
4/17 • About 3.5 years
Nervous system disorders
Hypersomnia
5.9%
1/17 • About 3.5 years
Nervous system disorders
Peripheral motor neuropathy
5.9%
1/17 • About 3.5 years
Nervous system disorders
Peripheral sensory neuropathy
5.9%
1/17 • About 3.5 years
Nervous system disorders
Presyncope
5.9%
1/17 • About 3.5 years
Psychiatric disorders
Confusion
5.9%
1/17 • About 3.5 years
Psychiatric disorders
Insomnia
17.6%
3/17 • About 3.5 years
Renal and urinary disorders
Dysuria
5.9%
1/17 • About 3.5 years
Renal and urinary disorders
Proteinuria
11.8%
2/17 • About 3.5 years
Reproductive system and breast disorders
Benign Prostatic Hyperplasia
5.9%
1/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
11.8%
2/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Cough
17.6%
3/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
35.3%
6/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Hoarseness
11.8%
2/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Laryngeal mucositis
5.9%
1/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Nasal congestion
5.9%
1/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Pleural effusion
5.9%
1/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Postnasal drip
5.9%
1/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Productive cough
5.9%
1/17 • About 3.5 years
Respiratory, thoracic and mediastinal disorders
Sore throat
5.9%
1/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Alopecia
5.9%
1/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Dry skin
11.8%
2/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Hair color change
5.9%
1/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Hyperhidrosis
11.8%
2/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Nail changes
5.9%
1/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Pruritus
17.6%
3/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Rash maculo-papular
17.6%
3/17 • About 3.5 years
Skin and subcutaneous tissue disorders
Skin lesion
5.9%
1/17 • About 3.5 years
Vascular disorders
Hypertension
35.3%
6/17 • About 3.5 years
Vascular disorders
Hypotension
11.8%
2/17 • About 3.5 years
Gastrointestinal disorders
Ascites
11.8%
2/17 • About 3.5 years
Gastrointestinal disorders
Bloating
11.8%
2/17 • About 3.5 years
Gastrointestinal disorders
Constipation
29.4%
5/17 • About 3.5 years
Gastrointestinal disorders
Diarrhea
52.9%
9/17 • About 3.5 years
Gastrointestinal disorders
Dry mouth
11.8%
2/17 • About 3.5 years
Gastrointestinal disorders
Dyspepsia
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Dysphagia
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Flatulence
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Hemorrhoids
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Mucositis oral
23.5%
4/17 • About 3.5 years
Gastrointestinal disorders
Nausea
41.2%
7/17 • About 3.5 years
Gastrointestinal disorders
Oral hemorrhage
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Oral pain
11.8%
2/17 • About 3.5 years
Gastrointestinal disorders
Rectal hemorrhage
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Rectal pain
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Vomiting
23.5%
4/17 • About 3.5 years
General disorders
Chills
17.6%
3/17 • About 3.5 years
General disorders
Edema limbs
29.4%
5/17 • About 3.5 years
General disorders
Fatigue
58.8%
10/17 • About 3.5 years
General disorders
Fever
11.8%
2/17 • About 3.5 years
General disorders
Flu like symptoms
11.8%
2/17 • About 3.5 years
General disorders
Jaw pain
5.9%
1/17 • About 3.5 years
General disorders
Non-cardiac chest pain
11.8%
2/17 • About 3.5 years
General disorders
Pain
17.6%
3/17 • About 3.5 years
Infections and infestations
Covid-19
5.9%
1/17 • About 3.5 years
Infections and infestations
Gum infection
5.9%
1/17 • About 3.5 years
Injury, poisoning and procedural complications
Bruising
17.6%
3/17 • About 3.5 years
Injury, poisoning and procedural complications
Fall
5.9%
1/17 • About 3.5 years
Injury, poisoning and procedural complications
Fracture
5.9%
1/17 • About 3.5 years
Injury, poisoning and procedural complications
Infusion related reaction
5.9%
1/17 • About 3.5 years
Injury, poisoning and procedural complications
Wound complication
5.9%
1/17 • About 3.5 years
Investigations
Activated partial thromboplastin time prolonged
5.9%
1/17 • About 3.5 years
Investigations
Alanine aminotransferase increased
64.7%
11/17 • About 3.5 years
Investigations
Alkaline phosphatase increased
35.3%
6/17 • About 3.5 years
Investigations
Aspartate aminotransferase increased
58.8%
10/17 • About 3.5 years
Investigations
Blood bilirubin increased
23.5%
4/17 • About 3.5 years
Investigations
Blood lactate dehydrogenase increased
11.8%
2/17 • About 3.5 years
Investigations
Creatinine increased
23.5%
4/17 • About 3.5 years
Investigations
Electrocardiogram QT corrected interval prolonged
5.9%
1/17 • About 3.5 years
Investigations
Fibrinogen decreased
5.9%
1/17 • About 3.5 years
Investigations
GGT increased
11.8%
2/17 • About 3.5 years
Investigations
Hemoglobin increased
5.9%
1/17 • About 3.5 years
Investigations
INR increased
5.9%
1/17 • About 3.5 years
Investigations
Lipase increased
23.5%
4/17 • About 3.5 years
Investigations
Lymphocyte count decreased
23.5%
4/17 • About 3.5 years
Investigations
Neutrophil count decreased
23.5%
4/17 • About 3.5 years
Investigations
Platelet count decreased
41.2%
7/17 • About 3.5 years
Investigations
Serum amylase increased
11.8%
2/17 • About 3.5 years
Investigations
Thyroid stimulating hormone increased
11.8%
2/17 • About 3.5 years
Investigations
Weight loss
35.3%
6/17 • About 3.5 years
Investigations
White blood cell decreased
35.3%
6/17 • About 3.5 years
Metabolism and nutrition disorders
Anorexia
23.5%
4/17 • About 3.5 years
Metabolism and nutrition disorders
Dehydration
11.8%
2/17 • About 3.5 years
Metabolism and nutrition disorders
Hypercalcemia
5.9%
1/17 • About 3.5 years
Metabolism and nutrition disorders
Hyperglycemia
17.6%
3/17 • About 3.5 years
Metabolism and nutrition disorders
Hypoalbuminemia
52.9%
9/17 • About 3.5 years
Metabolism and nutrition disorders
Hypocalcemia
23.5%
4/17 • About 3.5 years
Metabolism and nutrition disorders
Hypoglycemia
5.9%
1/17 • About 3.5 years
Metabolism and nutrition disorders
Hypokalemia
23.5%
4/17 • About 3.5 years
Metabolism and nutrition disorders
Hypomagnesemia
23.5%
4/17 • About 3.5 years
Metabolism and nutrition disorders
Hyponatremia
47.1%
8/17 • About 3.5 years
Blood and lymphatic system disorders
Anemia
35.3%
6/17 • About 3.5 years
Cardiac disorders
Sinus bradycardia
17.6%
3/17 • About 3.5 years
Cardiac disorders
Sinus tachycardia
5.9%
1/17 • About 3.5 years
Ear and labyrinth disorders
Hearing impaired
5.9%
1/17 • About 3.5 years
Endocrine disorders
Adrenal insufficiency
5.9%
1/17 • About 3.5 years
Endocrine disorders
Hyperthyroidism
17.6%
3/17 • About 3.5 years
Endocrine disorders
Hypothyroidism
29.4%
5/17 • About 3.5 years
Eye disorders
Dry eye
5.9%
1/17 • About 3.5 years
Eye disorders
Vision Changes
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Abdominal distension
5.9%
1/17 • About 3.5 years
Gastrointestinal disorders
Abdominal pain
35.3%
6/17 • About 3.5 years
Gastrointestinal disorders
Anal pain
5.9%
1/17 • About 3.5 years

Additional Information

Grants Administrative Manager

Johns Hopkins University/SKCCC

Phone: 4439273568

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60