Matthew Zibelman1, Peter Barth2, Elizabeth Handorf3, Marc C Smaldone4, Alexander Kutikov4, Robert G Uzzo5, Marijo Bilusic6, Elizabeth R Plimack6, Yu-Ning Wong6, Daniel M Geynisman6. 1. Department of Medical Oncology, Fox Chase Cancer Center, Temple Health, Philadelphia, PA. Electronic address: matthew.zibelman@fccc.edu. 2. Department of Medicine, Temple University Hospital, Temple Health, Philadelphia, PA. 3. Biometrics and Information Sciences, Fox Chase Cancer Center, Temple Health, Philadelphia, PA. 4. Urologic Oncology, Fox Chase Cancer Center, Temple Health, Philadelphia, PA. 5. Department of Surgery, Genitourinary Cancer Treatment, Urologic Oncology, Fox Chase Cancer Center, Temple Health, Philadelphia, PA. 6. Department of Medical Oncology, Fox Chase Cancer Center, Temple Health, Philadelphia, PA.
Abstract
INTRODUCTION: The treatment of renal cell carcinoma (RCC) has undergone a major shift over the past 10 years and continues to evolve. The objective of this study was to assess the current landscape of clinical trials (CTs) in RCC to identify areas of strength and opportunities for improvement. MATERIALS AND METHODS: ClinicalTrials.gov was queried using 17 prespecified search criteria. Only open, RCC-dedicated, interventional CTs in adult patients were included. Descriptive statistics and Fisher exact tests were used to compare features of CTs. RESULTS: The study cohort consisted of 169 trials. Phase II trials were the most common (67, 39.6%) and 52.7% (89) of CTs examined patients with stage IV disease. Only 26.6% (45) were randomized and 64.5% (109) were single-arm. Targeted therapies (TTs) were studied in 47.9% (81) of CTs overall and 71.1% (81 of 114) of the systemic therapy trials. Immunotherapies (ITs) were the next most common systemic therapy accounting for 5.9% (10) of trials. The primary end point of feasibility or biomarker analysis, progression-free survival, or overall survival was noted in 27.8%, 51.5%, and 2.1% of TT CTs (27, 50, 2 trials, respectively) and 42.9%, 35.7%, and 14.3% of IT CTs (6, 5, 2 trials respectively; P = .037). Biomarkers were assessed in 45% (76) of CTs overall and were more frequently examined in TT and IT CTs (53.6% [52/97] and 64.3% [9/14]) than in surgery and other CTs (22.2% [4/18] and 27.5% [11/40]; P = .002). Sponsorship differed according to treatment type (P = .003). CONCLUSION: Clinical trials in RCC are largely nonrandomized, single-arm, with minimal focus on non-clear-cell RCC. Significant differences were noted in the primary end point, sponsorship, and biomarker assessment between treatment types.
INTRODUCTION: The treatment of renal cell carcinoma (RCC) has undergone a major shift over the past 10 years and continues to evolve. The objective of this study was to assess the current landscape of clinical trials (CTs) in RCC to identify areas of strength and opportunities for improvement. MATERIALS AND METHODS: ClinicalTrials.gov was queried using 17 prespecified search criteria. Only open, RCC-dedicated, interventional CTs in adult patients were included. Descriptive statistics and Fisher exact tests were used to compare features of CTs. RESULTS: The study cohort consisted of 169 trials. Phase II trials were the most common (67, 39.6%) and 52.7% (89) of CTs examined patients with stage IV disease. Only 26.6% (45) were randomized and 64.5% (109) were single-arm. Targeted therapies (TTs) were studied in 47.9% (81) of CTs overall and 71.1% (81 of 114) of the systemic therapy trials. Immunotherapies (ITs) were the next most common systemic therapy accounting for 5.9% (10) of trials. The primary end point of feasibility or biomarker analysis, progression-free survival, or overall survival was noted in 27.8%, 51.5%, and 2.1% of TT CTs (27, 50, 2 trials, respectively) and 42.9%, 35.7%, and 14.3% of IT CTs (6, 5, 2 trials respectively; P = .037). Biomarkers were assessed in 45% (76) of CTs overall and were more frequently examined in TT and IT CTs (53.6% [52/97] and 64.3% [9/14]) than in surgery and other CTs (22.2% [4/18] and 27.5% [11/40]; P = .002). Sponsorship differed according to treatment type (P = .003). CONCLUSION: Clinical trials in RCC are largely nonrandomized, single-arm, with minimal focus on non-clear-cell RCC. Significant differences were noted in the primary end point, sponsorship, and biomarker assessment between treatment types.
Authors: Susanne Unverzagt; Ines Moldenhauer; Monika Nothacker; Dorothea Roßmeißl; Andreas V Hadjinicolaou; Frank Peinemann; Francesco Greco; Barbara Seliger Journal: Cochrane Database Syst Rev Date: 2017-05-15
Authors: Pooja Ghatalia; Rebecca Koenigsberg; David Pisarcik; Elizabeth A Handorf; Daniel M Geynisman; Matthew Zibelman Journal: Kidney Cancer Date: 2017-11-27
Authors: Jii Bum Lee; Hyung Soon Park; Sejung Park; Hyo Jin Lee; Kyung A Kwon; Young Jin Choi; Yu Jung Kim; Chung Mo Nam; Nam Hoon Cho; Beodeul Kang; Hyun Cheol Chung; Sun Young Rha Journal: Cancer Res Treat Date: 2019-04-16 Impact factor: 4.679