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NCT00326898: ASSURE

Sunitinib Malate or Sorafenib Tosylate in Treating Patients With Kidney Cancer That Was Removed By Surgery

Completed Phase 3 Results posted Last updated 8 February 2022
What this trial tests

Phase 3 trial testing Laboratory Biomarker Analysis in Clear Cell Renal Cell Carcinoma in 1,943 participants. Completed in 1 September 2021.

Timeline
24 April 2006
Primary endpoint
27 August 2015
1 September 2021

Quick facts

Lead sponsorNational Cancer Institute (NCI)
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment1,943
Start date24 April 2006
Primary completion27 August 2015
Estimated completion1 September 2021
Sites987 locations across Canada, United States, Puerto Rico

Drugs / interventions tested

Conditions studied

Sponsor

National Cancer Institute (NCI)

Who can join

18 and older, any sex, with Clear Cell Renal Cell Carcinoma or Stage I Renal Cell Cancer AJCC v6 and v7. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Disease-free Survival (DFS) Primary · Assessed every 3 months if patient is < 2 years from study entry; every 6 months if patient is 2 - 5 years from study entry; then annually if patient is 5 - 10 years from study entry

Disease-free survival (DFS) is defined as time from randomization to recurrence, development of second primary cancer (except localized breast or prostate cancer or nonmelanoma skin cancer), or death from any cause. Patients who were alive without recurrence or qualifying second primary cancer were censored at the date of last disease evaluation.

GroupValue95% CI
Arm A (Sunitinib + Sorafenib Placebo)5.85.0 – NA
Arm B (Sorafenib + Sunitinib Placebo)6.14.8 – NA
Arm C (Sunitinib Placebo + Sorafenib Placebo)6.65.3 – 7.8
5-year Overall Survival Rate Secondary · Assessed every 3 months if patient is < 2 years from study entry; every 6 months if patient is 2 - 5 years from study entry

Overall survival is defined as the time from randomization to death from any cause. Patients without a date of death were censored at the date of last contact. Kaplan-Meier method was used to estimate 5-year survival rate.

GroupValue95% CI
Arm A (Sunitinib + Sorafenib Placebo)0.7790.741 – 0.819
Arm B (Sorafenib + Sunitinib Placebo)0.8050.768 – 0.842
Arm C (Sunitinib Placebo + Sorafenib Placebo)0.8030.767 – 0.840
Proportion of Patients With Cardiac Events Secondary · Assessed every 3 months if patient is < 2 years from study entry; every 6 months if patient is 2 - 5 years from study entry

Cardiac event is defined as left ventricular ejection fraction (LVEF) below the institutional lower limit of normal, where the decrease was \>15% absolute percentage points from baseline within 6 months.

GroupValue95% CI
Arm A (Sunitinib + Sorafenib Placebo)0.0170.009 – 0.030
Arm B (Sorafenib + Sunitinib Placebo)0.0130.006 – 0.026
Arm C (Sunitinib Placebo + Sorafenib Placebo)0.0080.003 – 0.018
5-year Disease-free Survival (DFS) Rate Among Patients With Clear Cell Histology Secondary · Assessed every 3 months if patient is < 2 years from study entry; every 6 months if patient is 2 - 5 years from study entry; then annually if patient is 5 - 10 years from study entry

Disease-free survival (DFS) is defined as time from randomization to recurrence, development of second primary cancer (except localized breast or prostate cancer or nonmelanoma skin cancer), or death from any cause. Patients who were alive without recurrence or qualifying second primary cancer were censored at the date of last disease evaluation. 5-year DFS rate is the proportion of patients who are alive and disease-free at 5 years based on the Kaplan-Meier estimate.

GroupValue95% CI
Arm A (Sunitinib + Sorafenib Placebo)0.5340.484 – 0.590
Arm B (Sorafenib + Sunitinib Placebo)0.5270.478 – 0.582
Arm C (Sunitinib Placebo + Sorafenib Placebo)0.5600.511 – 0.614

Adverse events — posted to ClinicalTrials.gov

Time frame: Assessed every 6 weeks while on treatment and for 30 days after the end of treatment. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Arm A (Sunitinib + Sorafenib Placebo)
Serious: 368/625 (59%)
Deaths:
Arm B (Sorafenib + Sunitinib Placebo)
Serious: 424/628 (68%)
Deaths:
Arm C (Sunitinib Placebo + Sorafenib Placebo)
Serious: 81/626 (13%)
Deaths:

Serious adverse events (147 terms)

ReactionSystemArm A (Sunitinib + Sorafen…Arm B (Sorafenib + Sunitin…Arm C (Sunitinib Placebo +…
Hand-foot reactionSkin and subcutaneous tissue disorders
FatigueGeneral disorders
HypertensionVascular disorders
Rash/desquamationSkin and subcutaneous tissue disorders
Diarrhea w/o prior colostomyGastrointestinal disorders
Muco/stomatitis (symptom) pharynxRespiratory, thoracic and mediastinal disorders
NauseaGastrointestinal disorders
DyspepsiaGastrointestinal disorders
Platelets decreasedInvestigations
Neuropathy-sensoryNervous system disorders
Pruritus/itchingSkin and subcutaneous tissue disorders
AnorexiaMetabolism and nutrition disorders
VomitingGastrointestinal disorders
DehydrationMetabolism and nutrition disorders
Abdomen, painGastrointestinal disorders
Joint, painMusculoskeletal and connective tissue disorders
Muscle, painMusculoskeletal and connective tissue disorders
Neutrophils decreasedInvestigations
Aspartate aminotransferase increasedInvestigations
Head/headacheNervous system disorders
Renal failureRenal and urinary disorders
HyponatremiaMetabolism and nutrition disorders
Thrombosis/thrombus/embolismVascular disorders
Cardiac-ischemiaCardiac disorders
Left ventricular systolic dysfunctionCardiac disorders
Other adverse events (6 terms — click to expand)

ReactionSystemArm A (Sunitinib + Sorafen…Arm B (Sorafenib + Sunitin…Arm C (Sunitinib Placebo +…
FatigueGeneral disorders
Hand-foot reactionSkin and subcutaneous tissue disorders
Rash/desquamationSkin and subcutaneous tissue disorders
Diarrhea w/o prior colostomyGastrointestinal disorders
HypertensionVascular disorders
NauseaGastrointestinal disorders

Most-reported serious reactions: Hand-foot reaction, Fatigue, Hypertension, Rash/desquamation, Diarrhea w/o prior colostomy, Muco/stomatitis (symptom) pharynx, Nausea, Dyspepsia.

Data from ClinicalTrials.gov NCT00326898 adverse events section.

Sponsor's own description

This randomized phase III trial studies sunitinib malate to see how well it works compared to sorafenib tosylate or placebo in treating patients with kidney cancer that has been removed by surgery. Sunitinib malate and sorafenib tosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving sunitinib malate or sorafenib tosylate after surgery may kill any tumor cells that remain after surgery. It is not yet known whether sunitinib malate is more effective than sorafenib tosylate or placebo in treating kidney cancer.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Renal cell carcinoma.
    Jonasch E, Gao J, Rathmell WK. · · 2014 · cited 518× · PMID 25385470 · DOI 10.1136/bmj.g4797
  2. Adjuvant sunitinib or sorafenib for high-risk, non-metastatic renal-cell carcinoma (ECOG-ACRIN E2805): a double-blind, placebo-controlled, randomised, phase 3 trial.
    Haas NB, Manola J, Uzzo RG, Flaherty KT, et al · · 2016 · cited 450× · PMID 26969090 · DOI 10.1016/s0140-6736(16)00559-6
  3. Adjuvant Treatment for High-Risk Clear Cell Renal Cancer: Updated Results of a High-Risk Subset of the ASSURE Randomized Trial.
    Haas NB, Manola J, Dutcher JP, Flaherty KT, et al · · 2017 · cited 123× · PMID 28278333 · DOI 10.1001/jamaoncol.2017.0076
  4. Adjuvant Sorafenib for Renal Cell Carcinoma at Intermediate or High Risk of Relapse: Results From the SORCE Randomized Phase III Intergroup Trial.
    Eisen T, Frangou E, Oza B, Ritchie AWS, et al · · 2020 · cited 89× · PMID 33052759 · DOI 10.1200/jco.20.01800
  5. Adjuvant therapy in renal cell carcinoma-past, present, and future.
    Janowitz T, Welsh SJ, Zaki K, Mulders P, et al · · 2013 · cited 73× · PMID 23972712 · DOI 10.1053/j.seminoncol.2013.05.004
  6. Tuning Cancer Fate: Tumor Microenvironment's Role in Cancer Stem Cell Quiescence and Reawakening.
    Sistigu A, Musella M, Galassi C, Vitale I, et al · · 2020 · cited 72× · PMID 33193295 · DOI 10.3389/fimmu.2020.02166
  7. Recent developments in the treatment of renal cell carcinoma.
    Dutcher JP. · · 2013 · cited 62× · PMID 24294292 · DOI 10.1177/1756287213505672
  8. Sorafenib has soluble epoxide hydrolase inhibitory activity, which contributes to its effect profile in vivo.
    Liu JY, Park SH, Morisseau C, Hwang SH, et al · · 2009 · cited 62× · PMID 19671760 · DOI 10.1158/1535-7163.mct-09-0119

Verify or expand the search:

Other trials of Laboratory Biomarker Analysis

Trials testing the same drug.

Other recruiting trials for Clear Cell Renal Cell Carcinoma

Currently open trials in the same condition.

Other National Cancer Institute (NCI) trials

Trials by the same sponsor.

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