The film gives the main points. The full list below is copied from the registry; the study team makes the final decision.
- Age18 Years to no maximum
- SexAll
- Healthy volunteersNo
You may be able to join if
- Histological confirmation of RCC with a clear cell component
- Advanced (not amenable to curative surgery or radiation therapy) or metastatic (American Joint Committee on Cancer [AJCC] stage IV) RCC
- Patient can comprehend and sign the study informed consent form
- Male or female >= 18 years of age at the time of informed consent
- Karnofsky performance status (KPS) of >= 70%
- No prior systemic therapy for RCC in the neoadjuvant, adjuvant or metastatic setting
- At least one measurable lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
- Tumor tissue for ribonucleic acid (RNA)-sequencing (tumor tissue from bony metastasis is not suitable but a soft tissue component around bone is acceptable)
- Screening tissue consent- Patient must be assigned to either Cluster 1/2 or 4/5. Patients assigned to cluster 3/6/7 will not be eligible for the treatment study
- Adequate renal function defined as calculated creatinine clearance >= 30 mL/min per the Cockcroft and Gault formula
- Adequate liver function defined by:
- Total bilirubin =< 1.5 times the upper limit of normal (ULN) except for unconjugated hyperbilirubinemia of Gilbert's syndrome
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 3 x ULN
- Women of childbearing potential (WOCBP) must have a negative serum pregnancy test during screening and prior to receiving first dose of protocol-indicated treatment
- Women of childbearing potential (WOCBP) is defined as any female who has experienced menarche who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or is not postmenopausal
- Menopause is defined clinically as 12 months of amenorrhea in a woman over 45 years of age in the absence of other biological or physiological causes
You cannot join if
- =< 14 days before first dose of protocol-indicated treatment:
- Major surgery requiring general anesthesia
- Inadequately controlled hypertension (systolic blood pressure [SBP] > 160/90 mmHg)
- Anti-hypertensive medications are permitted.
- Active infection requiring infusional treatment
- Has preexisting gastrointestinal or non-gastrointestinal fistula
- Proteinuria > 2 g/ 24 hours (hrs)
- If patient has 1+ protein on urine dipstick then a 24 hr urine collection is required
- Non-healing wounds on any part of the body (for patients assigned to Cabo/Nivo only)
- Known clinically significant active bleeding including hemoptysis
- Inability to swallow oral medication; or the presence of a poorly controlled gastrointestinal disorder that could significantly affect the absorption of oral study drug (for patients assigned to Cabo/Nivo only) - e.g., Crohn's disease, ulcerative colitis, chronic diarrhea (defined as > 4 loose stools per day), malabsorption, or bowel obstruction
- Significant cardiovascular disease or condition including:
- Class III or IV cardiovascular disease according to the New York Heart Association (NYHA) functional criteria
- Unstable angina pectoris (i.e., last episode =< 3 months prior to first dose of protocol-indicated treatment)
- Myocardial infarction within 3 months prior to starting treatment
- Subjects with central nervous system (CNS) metastases are eligible after they have completed local therapy (e.g., whole brain radiation therapy [WBRT], surgery or radiosurgery)
- Any condition requiring systemic treatment with either systemic corticosteroids (> 10 mg/day prednisone or equivalent daily) or other immunosuppressive medications within 14 days prior to initiating protocol-indicated treatment
- In the absence of active autoimmune disease: Subjects are permitted the use of corticosteroids with minimal systemic absorption (e.g., topical, ocular, intra-articular, intranasal, and inhalational), =< 10 mg/day prednisone or equivalent daily; and physiologic replacement doses of systemic corticosteroids =< 10 mg/day prednisone or equivalent daily (e.g., hormone replacement therapy needed in patients with hypophysitis)
Triangle