Systemic Therapy Alone or with Stereotactic Body Radiotherapy for Oligometastatic Kidney Cancer (STROKER Study)

NCT ID: NCT06726421

Last Updated: 2024-12-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

252 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-18

Study Completion Date

2033-09-30

Brief Summary

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This phase III randomized controlled trial evaluates the efficacy of stereotactic body radiation therapy (SBRT) in oligometastatic renal cell carcinoma. The study aims to determine if the addition of SBRT to standard systemic therapy prolong survival compared to the standard systemic therapy alone. In addition, the study will explore the impact of this combined modality therapy on patients' toxicity and quality of life. The researchers will compare SBRT plus standard systemic therapy to standard systemic therapy alone, which is targeted agents and immunotherapy in this case, to determine if SBRT could prolong survival.

Detailed Description

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PRIMARY OBJECTIVES:

To compare the progression-free survival (PFS) between patients receiving SBRT + standard systemic therapy versus standard systemic therapy alone.

SECONDARY OBJECTIVES:

I. To compare the overall survival (OS) between patients receiving SBRT + standard systemic therapy versus standard systemic therapy alone.

II. To compare the cancer specific survival (CSS) between patients receiving SBRT + standard systemic therapy versus standard systemic therapy alone.

III. To estimate the local control (LC) rate of SBRT. IV. To compare the post-treatment progression-free survival (post-treatment PFS) between patients receiving SBRT + standard systemic therapy versus standard systemic therapy alone.

V. To evaluate treatment-related toxicity after adding SBRT based on patient-reported outcomes and researcher reported adverse events.

VI. To compare the quality of life between patients treated with SBRT or not using EQ-5D-5L, FKSI-DRS and FKSI-19.

OUTLINE: Patients are randomized to either Control arm or SBRT arm.

Control arm: Patients receive standard of care systemic therapy on study. SBRT arm: Patients undergo SBRT to all metastatic sites in addition to standard of care systemic therapy on study.

Patients periodically receive computed tomography (CT), positron emission tomography (PET)/CT, and/or magnetic resonance imaging (MRI) throughout the trial.

Conditions

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Renal Cell Carcinoma (Kidney Cancer) Kidney Cancer Metastatic Renal Cell Carcinoma Metastatic

Keywords

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radiotherapy SBRT SABR oligometastatic oligometastasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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SBRT arm

Patients undergo SBRT to all metastatic sites in addition to standard systemic therapy. Patients should complete radiotherapy for all lesions within 6 months of enrollment, preferably within the first 3 months.

Group Type EXPERIMENTAL

Stereotactic body radiotherapy (SBRT)

Intervention Type RADIATION

The preferred treatment plan is SBRT with a fraction dose ≥7 Gy. The prescription dose should ensure a BED of no less than 115. Radiotherapy is usually delivered daily, every other day, or other interval decided by treating radiation oncologist.

axitinib ± immune checkpoint inhibitors (ICIs), lenvatinib ± ICIs, cabozantinib ± ICIs, sunitinib and pazopanib

Intervention Type DRUG

Standard systemic therapy are targeted agents or their combination with immunotherapy recommended by guidelines. This may include axitinib ± immune checkpoint inhibitors (ICIs), lenvatinib ± ICIs, cabozantinib ± ICIs, sunitinib and pazopanib, etc.

Control arm

Patients receive standard systemic therapy.

Group Type ACTIVE_COMPARATOR

axitinib ± immune checkpoint inhibitors (ICIs), lenvatinib ± ICIs, cabozantinib ± ICIs, sunitinib and pazopanib

Intervention Type DRUG

Standard systemic therapy are targeted agents or their combination with immunotherapy recommended by guidelines. This may include axitinib ± immune checkpoint inhibitors (ICIs), lenvatinib ± ICIs, cabozantinib ± ICIs, sunitinib and pazopanib, etc.

Interventions

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Stereotactic body radiotherapy (SBRT)

The preferred treatment plan is SBRT with a fraction dose ≥7 Gy. The prescription dose should ensure a BED of no less than 115. Radiotherapy is usually delivered daily, every other day, or other interval decided by treating radiation oncologist.

Intervention Type RADIATION

axitinib ± immune checkpoint inhibitors (ICIs), lenvatinib ± ICIs, cabozantinib ± ICIs, sunitinib and pazopanib

Standard systemic therapy are targeted agents or their combination with immunotherapy recommended by guidelines. This may include axitinib ± immune checkpoint inhibitors (ICIs), lenvatinib ± ICIs, cabozantinib ± ICIs, sunitinib and pazopanib, etc.

Intervention Type DRUG

Other Intervention Names

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Stereotactic ablative radiotherapy Standard systemic therapy

Eligibility Criteria

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Inclusion Criteria

* Pathologically confirmed diagnosis of renal cell carcinoma of any histology
* Age ≥ 18 years.
* ECOG performance status of 0-2.
* Imaging suggests the presence of distant metastases, with no more than 5 metastatic lesions according to RECIST 1.1 criteria and MDA standards.
* The patient has received local therapy to primary site, including surgery, stereotactic radiotherapy, or ablation.
* The patient has received no more than 2 lines of systemic therapy.
* No significant impairment of major organ function:

Hemoglobin (HB) ≥ 80 g/L Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L Platelets (PLT) ≥ 75 × 10⁹/L Serum total bilirubin ≤ 1.5 × ULN Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × ULN Prothrombin time (PT) and activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN

Exclusion Criteria

* Presence of intracranial metastases.
* Target lesions have previously received high-dose irradiation with .
* Target lesions are unsuitable for radiation therapy judged by treating radiation oncologist (e.g., lesions invading the gastrointestinal tract or penetrating the bronchus).
* Uncontrollable metastatic pleural effusion or ascites.
* Presence of other malignancies that have not been cured.
* History of significant psychiatric disorders that impede understanding of informed consent and compliance with the study protocol.
* Presence of other serious illnesses that may pose significant risks or affect radiation therapy.
* Women who are pregnant, breastfeeding, or with plans for childbearing during the study.
* Any other reasons deemed by the investigator to make the subject unsuitable for participation in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sun Yat-sen University

OTHER

Sponsor Role lead

Responsible Party

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ZHOU FANGJIAN

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sun Yat-sen University Cancer Center

Guangzhou, Guangdong, China

Site Status RECRUITING

West China Hospital, Sichuan University

Chengdu, Sichuan, China

Site Status NOT_YET_RECRUITING

Cancer Hospital, Chinese Academy of Medical Sciences

Beijing, , China

Site Status NOT_YET_RECRUITING

Peking University First Hospital

Beijing, , China

Site Status NOT_YET_RECRUITING

Fudan University Shanghai Cancer Center

Shanghai, , China

Site Status NOT_YET_RECRUITING

Countries

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China

Central Contacts

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Liru He, PhD

Role: CONTACT

Phone: 0086-13631365597

Email: [email protected]

Fangjian Zhou, PhD

Role: CONTACT

Phone: 0086-13922735659

Email: [email protected]

Facility Contacts

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Liru He, PhD

Role: primary

Fangjian Zhou, PhD

Role: backup

Liru He, PhD

Role: backup

Yali Shen

Role: primary

Yali Shen

Role: backup

Hao Zeng

Role: backup

Ningning Lu

Role: primary

Yueping Liu

Role: backup

Ningning Lu

Role: backup

Xiongjun Ye

Role: backup

Mingwei Ma

Role: primary

Xianshu Gao

Role: backup

Wei Yu

Role: backup

Xuejun Ma

Role: primary

Xuejun Ma

Role: backup

Hailiang Zhang

Role: backup

Other Identifiers

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B2024-536-01

Identifier Type: OTHER

Identifier Source: secondary_id

2024-FXY-190

Identifier Type: -

Identifier Source: org_study_id