RecruitingPhase 2NCT04318730

Phase II Study for Combination of Camrelizumab and Apatinib in the Second-line Treatment of Recurrent or Metastatic Adrenocortical Carcinoma

Sponsor

West China Hospital

Enrollment

21 participants

Start Date

Oct 1, 2020

Study Type

INTERVENTIONAL

Conditions

Adrenocortical Carcinoma

Summary

Adrenocortical carcinoma (ACC) is a rare aggressive malignant tumor. According to the literature, the 5-year survival rate of ACC is 12%-47%. For patients with advanced ACC, mitotane alone or combined with traditional chemotherapy was the first-line standard treatment, but its progression-free survival was only about 1 year. However, for patients who fail the first-line treatment, there is a lack of effective treatment. For ACC patients who had failed first-line chemotherapy, a phase II clinical trial found that the objective response rate and the disease control rate of PD-1 inhibitor Keytruda were 14% and 64% respectively, and no grade 3 or 4 adverse events were observed. Anti-tumor angiogenic drugs combined with PD-1 inhibitors have shown impressive clinical data in many solid tumors. This study is aimed to evaluate the efficacy and safety of PD-1 inhibitor camrelizumab combined with apatinib in patients with recurrent or metastatic ACC after standard treatment failure, and to seek new treatment for this population.

Eligibility

Min Age: 18 Years

Inclusion Criteria8

Histologically confirmed diagnosis of adrenocortical carcinoma;
Patients with metastatic or inoperable adrenocortical carcinoma that has progressed, metastasized, or recurred after first-line standard treatment (mitotane monotherapy, chemotherapy alone, mitotane combined chemotherapy);
Aged \>=18 years;
Eastern Cooperative Oncology Group (ECOG) performance status 0-1;
At least one measurable lesion, according to RECIST 1.1;
Major organ functions within 28 days prior to treatment meet the following criteria(14 days without transfusion): HB≥80g/L, ANC≥1.5x10\^9/L, PLT ≥80x10\^9/L; TBIL≤1.5 ULN, ALT and AST ≤2.5 ULN, if there exists hepatic metastases, ALT and AST ≤5 ULN, Cr ≤1.5 ULN or CCr ≥60ml/min; INR or PT ≤1.5 ULN, APTT ≤1.5 ULN (if the patient is receiving anticoagulant therapy, PT and APTT should be within the expected treatment range); Cardiac Markers and BNP≤ULN；TSH≤ULN (If TSH is abnormal, T3 and T4 should be normal)
Appropriate contraception should be used from the start of treatment to 120 days after the end of treatment;
Have signed consent form.

Exclusion Criteria21

Patients with another primary malignancy within 5 years prior to starting the study drug, except for cured in situ cervical carcinoma and cured non-melanoma skin cancer;
Have central nervous system metastasis with symptoms and need hormonal intervention;
Had received strong CYP3A4 inhibitors within one week prior to enrollment or received strong CYP3A4 inducers within two weeks prior to enrollment;
Poor control of high blood pressure (SBP\>140mmHg or DBP\>90mmHg);
Congestive heart failure of New York Heart Association (NYHA) Class III or IV;
Thromboembolic events occurred within 1 year prior to enrollment;
ECG QT interval \>500ms;
Previous systemic immunosuppressive therapy;
Previous anti-PD-1, anti-PD-L1 antibody or anti- CTLA-4 antibody treatment;
Received TKI treatment within 2 weeks prior to starting the study drug;
Participate in clinical trials of other interventional drugs within 4 weeks prior to starting the study drug;
Received systemic therapy with corticosteroids or other immunosuppressants within 2 weeks prior to starting the study drug;
An anti-tumor vaccine or a live vaccine was given within 4 weeks prior to starting the study drug;
Major surgery or severe trauma within 4 weeks prior to starting the study drug;
Severe infections occurred within 4 weeks prior to starting the study drug;
Have an active autoimmune disease or a history of autoimmune diseases;
Have a history of immunodeficiency;
Have an active tuberculosis infection;
Have active hepatitis;
Patients with symptoms of gastrointestinal bleeding or risk of bleeding;
Active infection, or patients are pregnant or breast-feeding.