Kidney Cancer Trials

This trial tests the target therapy drug INC280 for patients with either hereditary or sporadic papillary renal cell carcinoma. Some patients with papillary renal cell carcinoma are affected by a MET mutation that makes the cancer more aggressive, makes it resistant to chemotherapy, and increases its tendency to spread and become metastatic. INC280 is a MET inhibitor whose effect on the cancer is being evaluated in this study. Participants eligible for this study must have papillary renal cell carcinoma and either bilateral multifocal disease or visible disease that is considered unresectable. Participants will take INC280 as an oral medication twice daily.

Currently, there is no effective treatment for papillary renal cell carcinoma (PRCC) once it has metastasized or spread. PRCC is a particularly aggressive form of kidney cancer that has a lower survival rate, can be resistant to chemotherapy, and has a much higher tendency to metastasize. PRCC can either be hereditary (HLRCC) or sporadic (SPRCC). This combination of targeted therapies using bevacizumab and erlotinib is an attempt to exploit the higher energy requirements of PRCC compared to other forms of kidney cancer. Erlotinib can slow or stop the growth and spread of cancer by blocking a specific protein expressed in cancer cells, and bevacizumab restricts the cancer's access to oxygen and nutrients by preventing it from forming new blood vessels.  During this study, the effectiveness of the treatment will be evaluated for both HLRCC and SPRCC. Treatment will consist of 28-day cycles. IV bevacizumab will be administered every two weeks and oral erlotinib will be administered once daily.

There is currently no approved treatment for advanced forms of hereditary leiomyomatosis and renal cell cancer (HLRCC), succinate dehydrogenase renal cell carcinoma (SDH-RCC), or sporadic papillary renal cell carcinoma. This trials aims to determine whether a combination of vandetanib plus metformin is a potential treatment for persons with advanced forms of these three cancers. Metformin is most commonly prescribed for type 2 diabetics, but in a recent study it was shown to improve progression-free and overall survival in cancer patients when given in combination with surgery. Vandetanib is a targeted therapy, currently used to treat thyroid cancer, that stops cancer cell growth and slows its spread to the rest of the body. This study will be conducted in two stages. Stage one is to determine the safe dose of the combination treatment. In stage two, participants will be given both vandetanib and metformin as oral medications to be taken daily for up to a year. Participants in stage two will be evaluated based upon which of the three types of cancer they have.

This is a Phase I/II, open-label, multi-center study of axitinib (Inlyta, a type of targeted therapy) in combination with nivolumab (Opdivo, a type of immunotherapy) in patients with previously treated and untreated advanced renal cell carcinoma (RCC). This clinical study will be composed of a dose finding phase (Phase I) and two parallel dose expansion phases (Phase II). The dose finding phase will assess the safety of the combination and establish a recommended phase II dose in patients with advanced RCC who have received prior systemic therapy for metastatic disease. Phase II will evaluate the effectiveness of the combination in two parallel expansion cohorts in both previously treated and treatment naïve patients. All patients in all phases of this study will receive both drugs, at various doses. Axitinib is taken orally (by mouth) twice daily, although dose and dosing schedule may vary. Nivolumab is given intravenously (IV), dose and dosing schedule may vary.

This is a phase II trial of nivolumab (Opdivo, an immunotherapy) in treatment-naïve patients with clear cell renal cancer. Nivolumab has been shown to have anti-tumor activity in renal cell patients. It is hypothesized that patients may still respond (have anti-tumor activity) by giving ipilimumab with nivolumab when the patient is no longer responding to nivolumab alone.

In Part A, nivolumab 240 mg will be given intravenously (IV) in clinic once every two weeks for six doses. Patients who remain on study after re-evaluation will receive nivolumab 360 mg IV in clinic once every three weeks.

In Part B, nivolumab 3 mg/kg AND ipilimumab (Yervoy, an immunotherapy) will both be given IV in clinic once every three weeks for four doses. Patients who remain on study after re-evaluation will receive nivolumab 360 mg IV in clinic once every three weeks.

In this four part study, NKTR-214 (a type of immunotherapy) will be administered in combination with nivolumab (Opdivo, a type of immunotherapy) in Parts 1 & 2, and with nivolumab and ipilimumab (Yervoy, a type of immunotherapy) in Parts 3 & 4. In Part 1, the safety, effectiveness and recommended dose of NKTR-214 in combination with nivolumab will be determined. In Part 2, the clinical benefit, safety, and tolerability of combining NKTR-214 with nivolumab Renal Cell Carcinoma and Urothelial Carcinoma. In Part 3, the safety, effectiveness and dose level of NKTR-214 in combination with nivolumab and ipilimumab will be determined. In Part 4, the clinical benefit, safety, and tolerability of the combination of all three drugs will be evaluated in select patients with renal cell carcinoma. All three drugs target the immune system and may act together to promote anti-cancer effects. This study has 2 arms: All drugs are given intravenously (IV) in clinic. Arm A: Combination of NKTR-214 + nivolumab Part 1: Patients with select tumor types will receive NKTR-214 doses administered either once every 2 weeks or once every 2 weeks, in combination with 360 mg of nivolumab once every 3 weeks or 240 mg nivolumab once every 2 weeks. Part 2: Additional patient cohorts with select tumor types will be dosed at the dose/schedule of NKTR-214 and nivolumab (as determined by Part 1 of the trial). Arm B: Combination of NKTR-214 + nivolumab + ipilimumab Part 3: The first schedule to be evaluated, Cohort A, is NKTR-214 0.006 mg/kg and nivolumab 360 mg once every 3 weeks with the addition of ipilimumab 1 mg/kg (kilogram, based on your weight) once every 6 weeks. Upon review of safety, tolerability, and other data collected in Cohort A, alternative doses/schedules may be considered where ipilimumab will be administered at a later cycle. Part 4: Additional patient cohorts with select tumor types will be dosed at the dose/schedule of NKTR-214 in combination with nivolumab and ipilimumab (as determined by Part 3 of the trial).

The purpose of this study is to determine whether nivolumab (Opdivo, an immunotherapy) in combination with other therapies is more effective than nivolumab in combination with ipilimumab (Yervoy, an immunotherapy) in treating patients with advanced renal cell carcinoma. It is hypothesized that patients will have an increased clinical response (decrease in tumor size) when given a combination of nivolumab and BMS-986016 (an immunotherapy) than when given a combination of nivolumab and ipilumumab.

Nivolumab, ipilimumab, and the experimental drug BMS-986016 are all given intravenously (IV) in clinic. The dosing schedule will be either:

1. Nivolumab is given intravenously IV at 3mg/kg PLUS ipilimumab given IV at 1mg/kg once every 3weeks for 4 doses. Six weeks after the last dose of combination study, nivolumab will be given IV at 480 mg one every 4 weeks for 3 doses OR

2. Nivolumab is given IV at 240 mg PLUS BMS-986016 is given IV at 80 mg once every 2 weeks for 12 doses.

This is a single arm, single site, open-label Phase II study of the effects of oral olaparib (Lynparza, a type of targeted therapy, a PARP inhibitor) in participants with metastatic renal cell carcinoma that harbor an inactivating mutation in BAP-1, ATM, BRCA1, BRCA2, PALB2, CHEK2, BRIP1, RAD51C, BARD1, CDK12, CHEK1, FANCL, PP2R2A, RAD51B, RAD51D, or RAD54L who have had prior treatment with at least one immune checkpoint inhibitor (immunotherapy) or anti-VEGF therapy (targeted therapy). This study has 1 arm: Olaparib: Participants will be initially treated with olaparib 150 mg by mouth (PO) twice daily for one month. After one month of therapy, the dose will be increased to 300mg by mouth twice daily, if tolerated. Treatment will be continued until clinical and/or radiographic progression or unmanageable side effects requiring discontinuation of the drug.

Cancer treatments that couple pharmacological activation (activation through the use of drugs) of tumor antigen presentation with activation and expansion of CD8+ T and natural killer (NK) cells in the tumor environment have the potential to induce an effective anti-tumor immune response in patients. NKTR-262 (a type of immunotherapy) is designed to be retained in the tumor micro-environment (meaning it stays within the tumor) in order to activate antigen-presenting cells, such as dendritic cells, to create new antigen-specific cancer killing T cells. Bempegaldesleukin (a type of immunotherapy) monotherapy increases newly proliferative CD8+ T cells in tumors. NKTR-262 plus bempegaldesleukin is expected to increase expansion of antigen-specific CD8+ T cells. In preclinical studies, a single intrathecal (IT, directly in to the spinal canal) injection of NKTR-262 plus intravenous (IV) bempegaldesleukin resulted in complete abscopal effects in tumor models (where although treatment is given locally to one tumor, other tumors outside that area also respond to the treatment). Preliminary clinical data show bempegaldesleukin plus nivolumab (Opdivo, a type of immunotherapy) enhances immune-stimulatory responses. This trial will assess safety and anti-tumor activity of NKTR-262 with bempegaldesleukin +/- nivolumab for the treatment of selected cancers.

This is a multicenter, randomized, double-blinded, controlled Phase 3 trial of cabozantinib (Cabometyx, a type of targeted therapy) in combination with nivolumab (Opdivo, a type of immunotherapy) and ipilimumab (Yervoy, a type of immunotherapy) versus nivolumab and ipilimumab in combination with matched placebo. The primary objective of this study is to evaluate the effect of cabozantinib in combination with nivolumab and ipilimumab ("triplet") on the duration of progression-free survival (PFS) versus nivolumab and ipilimumab. A secondary objective is to evaluate the effect of triplet combination on the duration of overall survival (OS).

Metastatic renal cell carcinoma (RCC) is an incurable condition. Current therapy for this disease consists of targeted therapies and immunotherapies. Long-term survival can be achieved however, of those patients treated with immunotherapy, three quarters will not respond at all and only 5-8% will achieve a complete and long term response. Gene transfer is a new cancer therapy that takes white blood cells from a person and grows them in a lab. The cells are changed with a virus to attack tumor cells, then returned to the person. Researchers want to see if this therapy fights kidney cancer cells. Our team isolated a tumor-specific cytotoxic T lymphocyte (CTL, a type of white blood cell that kills cancer cells) line from peripheral blood obtained after an allogeneic transplant from a patient who showed prolonged tumor regression. We identified a HERV-E derived antigen expressed in the patient s ccRCC cells to be the target of this T-cell clone. Remarkably, we found this HERV-E was expressed in the majority of ccRCC cells with no expression in normal tissues. This research protocol is designed to evaluate the safety and effectiveness of the infusion of HERV-E T cells. Treatment: • Participants will have leukapheresis. Blood will be removed by a needle in an arm. It will go through a machine that removes white blood cells. Plasma and red cells will be returned through a needle in the participant’s other arm. • Participants cells will be grown in the lab and genetically changed. • Participants will stay in the hospital 2-3 weeks. In the hospital participants will: • Get 2 chemotherapy drugs by catheter (thin plastic tube) inserted into a vein in the chest. • Get the changed cells via catheter. • Get a drug to increase white blood cell count and one to make the cells active. • Recover for about a week. • Have lab and blood tests. After leaving the hospital, participants will: • Take an antibiotic for several months. • Have leukapheresis. • Have one- or two-day clinic visits every few weeks for 2 years, and then as determined by their doctor. These will include blood and lab tests, imaging studies, and physical exam. • Participants will have follow-up checks for up to 15 years.

This randomized phase II trial studies how well cabozantinib-s-malate (Cabometyx, a type of targeted therapy), crizotinib (Xalkori, a type of targeted therapy), volitinib (Savolitinib, a type of targeted therapy), or sunitinib malate (Sutent, a type of targeted therapy) work in treating patients with kidney cancer that has spread from where it started to nearby tissue or lymph nodes or to other places in the body (metastatic disease). Cabozantinib-s-malate, crizotinib, volitinib, and sunitinib malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Patient will be randomized to one of four arms:

Arm I: Sunitinib

Patients receive sunitinib malate taken orally (at home) once daily on days 1-28, followed by a rest period (where you do not take the study drug) days 29-42. Courses repeat every 42 days.

Arm II: Cabozantinib

Patients receive cabozantinib-s-malate taken orally (at home) once daily on days 1-42. Courses repeat every 42 days.

Arm III: Crizotinib

Patients receive crizotinib taken orally (at home) twice daily on days 1-42. Courses repeat every 42 days.

Arm IV: Volitinib

Patients receive volitinib taken orally (at home) once daily on days 1-42. Courses repeat every 42 days.

The main purpose of this study is to compare the overall response rate (ORR) and overall survival (OS) of NKTR-214 (a type of immunotherapy) combined with nivolumab (a type of immunotherapy) to that of a tyrosine kinase inhibitor (TKI, a type of targeted therapy) monotherapy in intermediate and poor-risk participants with previously untreated advanced renal cell carcinoma (RCC). This study has 2 arms: specific doses and dosing schedules to be provider by the participating site. Arm 1: Combination of NKTR-214 + Nivolumab Participants will receive NKTR-214 in combination with Nivolumab given intravenously (IV). Arm 2: Sunitinib (Sutent) or Cabozantinib (Cabometyx) Participants will receive the treating physician’s choice of either one of these two treatment options. Both drugs are taken by mouth.

This is a Phase II, open-label, safety, pharmacodynamic (how the drugs work in the body) and effectiveness study of entinostat (at type of targeted therapy) in combination with nivolumab (Opdivo, a type of immunotherapy) and ipilimumab (Yervoy, a type of immunotherapy) in subjects with metastatic renal cell carcinoma (RCC) who have progressed on ipilimumab + nivolumab regimen. It is thought that adding entinostat to the ipilimumab + nivolumab regimen will help the regimen work better or help it start working again. This study has 1 arm: Entinostat, Nivolumab and Ipilimumab: Entinostat is given at 5mg, 3mg, or 2mg orally (by mouth) on days 1, 8, 15 of each cycle, plus Nivolumab 3 mg/kg IV (intravenously) on day1 and Ipilimumab 1 mg/kg IV on day 1. Each cycle is 21 days.

The purpose of this study is to determine whether the combination of nivolumab (Opdivo, a type of immunotherapy) and ipilimumab (Yervoy, a type of immunotherapy) is safe and effective for delaying or preventing recurrence of cancer in patients who have experienced the partial or entire removal of a kidney.

Patients will be randomized to one of two arms:

Arm A Nivolumab + Ipilimumab

Nivolumab is given intravenously (IV, in clinic) at 240 mg once every 2 weeks for 12 doses total. Ipilimumab is given IV (in clinic) at 1mg/kg once every 2 weeks starting at Week 6.

Arm B Placebo

The placebo (a benign fluid with no therapeutic effect) will be given IV (in clinic) on the same schedule as the treatment arm (Arm A).

This randomized phase III trial compares nephrectomy (surgery to remove a kidney or part of a kidney) with or without nivolumab (Opdivo, a type of immunotherapy) in treating patients with kidney cancer that is limited to a certain part of the body (localized). Monoclonal antibodies, such as nivolumab, may interfere with the ability of tumor cells to grow and spread. Giving nivolumab before nephrectomy may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. After nephrectomy, it may increase survival. It is not yet known whether nivolumab and nephrectomy is more effective than nephrectomy alone in treating patients with kidney cancer.

Patients will be randomized to one of two arms:

Arm A Nivolumab + nephrectomy – Patients receive nivolumab intravenously (IV) over 60 minutes every 14 days for 2 cycles. Each cycle is 28 days. Patients then undergo partial or radical nephrectomy. After surgery, patients then receive nivolumab IV every 14 days for 6 cycles, and then once every 28 days for 6 cycles in the absence of disease progression or unacceptable toxicity.

Arm B – Patients undergo partial or radical nephrectomy followed by observation.

After completion of study treatment, all patients are followed up every 3 months for 2 years, every 6 months for 3 years, and every 12 months for 5 years.

This study is a randomized Phase 2 evaluation of CB-839 (a type of targeted therapy) in combination with cabozantinib (Cabometyx, a type of targeted therapy) versus placebo with cabozantinib in Renal Cell Carcinoma patients with at least one and not more than 2 prior therapies in the advanced or metastatic setting. The study has 2 arms: Arm A: CB-839 + Cabozantinib CB-839 taken orally twice daily + cabozantinib taken orally once daily. Arm B: Placebo + Cabozantinib Placebo taken orally twice daily + cabozantinib taken orally once daily.