Urothelial CarcinomaPhase 3RANGENCT02426125
A Study of Ramucirumab (LY3009806) Plus Docetaxel in Participants With Urothelial Cancer
A Phase 3 study testing Ramucirumab and Docetaxel in people with Urothelial Carcinoma, run by Eli Lilly and Company at 141 sites in 23 countries.
Trial summary
The main purpose of this study is to evaluate the safety and efficacy of the study drug ramucirumab in combination with docetaxel in participants with urothelial cancer who failed prior platinum-based therapy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Urothelial Carcinoma
- What is being tested?
- Ramucirumab and Docetaxel
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 530 participants
- Where
- 141 sitesin 23 countries
- Study dates
- 13 Jul 2015to 26 Jul 2022
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Have histologically or cytologically confirmed, locally advanced or unresectable or metastatic urothelial (transitional cell) carcinoma of the bladder, urethra, ureter, or renal pelvis.
- Had disease progression while on a platinum containing regimen in the first-line setting or within 14 months after completing the first-line platinum regimen. Participants who received treatment with one immune checkpoint inhibitor regimen are eligible (for example Programmed death 1 (PD-1), Programmed death-ligand 1 (PDL1), or CTLA4) and may have a longer interval since prior platinum-containing therapy (≤24 months).
- Have a life expectancy of ≥3 months.
- Have received no more than one prior systemic chemotherapy regimen in the relapsed or metastatic setting. Prior treatment with no more than one prior immune checkpoint inhibitor is permitted and will not be considered as a line of systemic chemotherapy.
- Have measurable disease or nonmeasurable but evaluable disease as defined by Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST 1.1).
- Have an Eastern Cooperative Oncology Group (ECOG) of 0 or 1.
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- Have adequate hematologic function.
- Have adequate coagulation function.
- Have adequate hepatic function.
- The participant does not have:
- cirrhosis at a level of Child-Pugh B (or worse)
- cirrhosis (any degree) and a history of hepatic encephalopathy or clinically meaningful ascites resulting from cirrhosis
- Have adequate renal function as defined by creatinine clearance >30 milliliters/minute.
- Have urinary protein ≤1+ on dipstick or routine urinalysis.
- The participant is willing to provide blood, urine, and tissue samples for research purposes.
Who cannot join
- Have received more than one prior systemic chemotherapy regimen for metastatic disease.
- Have received prior systemic taxane therapy for transitional cell carcinoma (TCC) of the bladder, urethra, ureter, or renal pelvis in any setting (neoadjuvant, adjuvant, metastatic).
- Have received more than one prior antiangiogenic agent (that is, bevacizumab, sorafenib, sunitinib) for TCC of the urothelium.
- Have received radiation therapy within 4 weeks (≤4 weeks) prior to randomization or has not recovered from toxic effects of the treatment that was given >4 weeks prior to randomization.
- Have a history of uncontrolled hereditary or acquired bleeding or thrombotic disorders.
- Have experienced a Grade ≥3 bleeding event within 3 months (≤3 months) prior to randomization.
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- Have uncontrolled intercurrent illness, including, but not limited to symptomatic anemia, uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, symptomatic or poorly controlled cardiac arrhythmia, psychiatric illness, or any other serious uncontrolled medical disorders.
- Have experienced any arterial or venothrombotic or thromboembolic events, including, but not limited to myocardial infarction, transient ischemic attack, or cerebrovascular accident, within 6 months (≤6 months) prior to randomization.
- Have known untreated brain metastases, uncontrolled spinal cord compression, or leptomeningeal disease.
- Have human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome-related illness.
- Have undergone major surgery within 28 days (≤28 days) prior to randomization or subcutaneous venous access device placement within 7 days (≤7 days) prior to randomization.
- The participant is pregnant prior to randomization or lactating.
- Have a concurrent malignancy or had another malignancy within 5 years (≤5 years) of study enrollment.
Trial locations and contacts
141 sites in 23 countries.
141 sites in 23 countries
United States33 sites
University of Colorado
Aurora, Colorado, 80045
University of Maryland- Biological Sciences
Baltimore, Maryland, 21201
Oncology Hematology Care Inc.
Cincinnati, Ohio, 45242
Pharmatech Oncology Inc
Denver, Colorado, 80203
Karmanos Cancer Institute
Detroit, Michigan, 48201
Inova Comprehensive Cancer Care & Research Institute
Fairfax, Virginia, 22031
Highlands Oncology Group
Fayetteville, Arkansas, 72703
Southeast Florida Hematology/Oncology
Fort Lauderdale, Florida, 33308
Florida Cancer Specialists
Fort Myers, Florida, 33916
Fort Wayne Oncology & Hematology
Fort Wayne, Indiana, 46845
The Center for Cancer and Blood Disorders
Fort Worth, Texas, 76104
St. Jude Medical Center
Fullerton, California, 92835
St Mary's Hospital Regional Cancer Center
Grand Junction, Colorado, 81501
The Queen's Medical Center
Honolulu, Hawaii, 96813
Lakeland Regional Cancer Center
Lakeland, Florida, 33805
UCLA Medical Center
Los Angeles, California, 90024
USC Norris Cancer Hospital
Los Angeles, California, 90033
SMO TRIO -Translational Research
Los Angeles, California, 90095
Sylvester Comprehensive Cancer Center
Miami, Florida, 33136
SMO Sarah Cannon Research Inst.
Nashville, Tennessee, 37203
Yale University School of Medicine
New Haven, Connecticut, 06520
Alton Ochsner Medical Center
New Orleans, Louisiana, 70121
Cornell University Medical College
New York, New York, 10021
Southeastern Regional Medical Center
Newnan, Georgia, 30265
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
University of Nebraska Medical Center
Omaha, Nebraska, 68198-7680
Cancer Care Associates Medical Group
Redondo Beach, California, 90277
Mayo Clinic
Rochester, Minnesota, 55902
University of California, Davis - Health Systems
Sacramento, California, 95817
Central Coast Medical Oncology Corporation
Santa Monica, California, 93454
University of Washington Medical Center
Seattle, Washington, 98109
Florida Cancer Specialists
St. Petersburg, Florida, 33705
SUNY at Stony Brook
Stony Brook, New York, 11794
Japan17 sites
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Bunkyō City, 113-8431
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Chiba, 260-8717
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Fukuoka, 812-8582
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Hidaka, 350-1298
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Hirosaki, 036-8563
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Kashiwa, 277-8577
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Kita-gun, 761-0793
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Kobe, 650-0047
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Matsuyama, 791-0280
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Morioka, 020-8505
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Niigata, 951-8520
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Osaka, 541-8567
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Sapporo, 060-8543
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Sendai, 980-8574
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Suita-shi, 565-0871
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Tokyo, 135-8550
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Tsukuba, 305-8576
South Korea7 sites
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Daejeon, 35015
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Seongnam, 463-707
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Seongnam-si, 13620
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Seoul, 03181
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Seoul, 03722
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Seoul, 05505
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Seoul, 06351
France6 sites
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Caen, 14076
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Lille, 59020
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Lyon, 69373
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Montpellier, 34070
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Paris, 75015
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Rennes, 35062
Germany6 sites
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Düsseldorf, 40225
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Freiburg im Breisgau, 79106
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Homburg, 66421
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Jena, 07740
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Marburg, 35043
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Tübingen, 72076
Israel6 sites
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Haifa, 3525408
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Kfar Saba, 4428164
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Petah Tikva, 4941492
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Tel Aviv, 6423906
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Tel HaShomer, 5265601
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Tsrifin, 6093000
Italy6 sites
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Arezzo, 52100
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Bologna, 40138
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Milan, 20133
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Orbassano, 10043
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Rome, 00152
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Verona, 37134
United Kingdom6 sites
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Bebington, CH63 4JY
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Chelsea, W6 8RF
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London, EC1A 7BE
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Nottingham, NG5 1PB
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Southampton, SO16 6YD
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Sutton, SM2 5PT
Mexico5 sites
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Aguascalientes, 20230
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Culiacán, 80020
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México, 06760
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Monterrey, 64570
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Morelia, 58260
Netherlands5 sites
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Amsterdam, 1066 CX
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Arnhem, 6815 AD
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Maastricht, 6229 HX
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Rotterdam, 3075 EA
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Sittard, 6162 BG
Russia5 sites
Ivanovo regional clinical oncology dispensary
Ivanovo, 153040
Republic Oncology Dispensary of MoH of Republic Tatarstan
Kazan', 420029
Scientific research oncology institute n.a. P. A. Herzen
Moscow, 125284
Saint-Petersburg city clinical oncology dispensary
Saint Petersburg, 198255
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Saratov, 410054
Turkey (Türkiye)5 sites
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Ankara, 06100
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Antalya, 07059
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Edirne, 22030
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Istanbul, 34098
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Malatya, 44280
Australia4 sites
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Adelaide, 5000
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Footscray, 3011
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Randwick, 2031
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Subiaco, 6008
Greece4 sites
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Athens, 11528
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Heraklion, 71110
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Pátrai, 26504
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Thessaloniki, 56403
Poland4 sites
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Gdansk, 80-219
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Poznan, 60-569
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Warsaw, 04-125
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Wieliszew, 05-135
Taiwan4 sites
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Kaohsiung City, 83301
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Taichung, 40705
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Tainan, 71004
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Taipei, 100
Belgium3 sites
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Brussels, 1200
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Leuven, 3000
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Wilrijk, 2610
Romania3 sites
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Baia Mare, 430110
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Cluj-Napoca, 400058
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Craiova, 200347
Spain3 sites
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Badajoz, 06080
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Barcelona, 08907
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Madrid, 28034
Ukraine3 sites
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Dnipropetrovsk, 49102
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Kyiv, 04107
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Lutsk, 63000
Canada2 sites
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Toronto, M4N 3M5
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Vancouver, V5Z 4E6
Denmark2 sites
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Herlev, 2730
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Odense, 5000
Hungary2 sites
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Budapest, 1122
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Miskolc, 3526
About this study
Official title: A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of Ramucirumab Plus Docetaxel Versus Placebo Plus Docetaxel in Patients With Locally Advanced or Unresectable or Metastatic Urothelial Carcinoma Who Progressed on or After Platinum-Based Therapy
The main purpose of this study is to evaluate the safety and efficacy of the study drug ramucirumab in combination with docetaxel in participants with urothelial cancer who failed prior platinum-based therapy.
- Conditions
- Urothelial Carcinoma
- Being tested
- Ramucirumab, Docetaxel, Placebo
- Keywords
- carcinoma of the bladder, carcinoma of the urethra, carcinoma the of ureter, carcinoma of the renal pelvis, transitional cell carcinoma, transitional cell tumor, RANGE, bladder cancer
- Medical subject headings
- Carcinoma, Transitional Cell, Urinary Bladder Neoplasms, Urethral Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RamucirumabDrug
Also called LY3009806
Administered IV
DocetaxelDrug
Administered IV
PlaceboDrug
Administered IV
| Study group | Role | What they receive |
|---|---|---|
| Ramucirumab + Docetaxel | Experimental | Ramucirumab (10 milligram/kilogram [mg/kg]) intravenously (IV) plus docetaxel (75 milligram/square meter [mg/m²]) IV on day 1 of each 21-day cycle. Participants may continue to receive treatment until discontinuation criteria are met. Receives: Drug: Ramucirumab; Drug: Docetaxel |
| Placebo + Docetaxel | Placebo comparator | Placebo IV plus docetaxel (75 mg/m²) IV on day 1 of each 21-day cycle. Participants may continue to receive treatment until discontinuation criteria are met. Receives: Drug: Docetaxel; Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression Free Survival (PFS)
PFS defined as time from first day of therapy to first evidence of disease progression defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) or death from any cause. Progressive Disease (PD) is at least 20% increase in sum of diameters of target lesions, with reference being the smallest sum on study and plus absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. If participant does not have complete baseline disease assessment, then PFS time was censored at date of first dose, regardless of whether or not objectively determined disease progression or death has been observed for participant. If participant is not known to have died or have objective progression as of data inclusion cutoff date for analysis, PFS time was censored at last adequate tumor assessment date.
Measured: Randomization to Radiological Disease Progression or Death from Any Cause (Up to 18 Months)
Secondary outcomes (10)
Overall Survival (OS)
OS is the time from the date of randomization to the date of death from any cause. For each participant who is not known to have died as of the data inclusion cutoff date for a particular analysis, OS was censored for that analysis at the last known alive date prior to the data inclusion cutoff date.
Measured: Randomization to Date of Death from Any Cause (Up to 31.1 Months)
Percentage of Participants With an Objective Response Rate (ORR)
ORR is defined as the percentage of participants who achieve a best overall response of complete response (CR) + partial response (PR). ORR = CR + PR. CR is defined as disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to < 10 millimeter (mm). Tumor-marker results must have normalized. PR is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Best overall response is classified based on the overall responses assessed by study investigators according to RECIST v1.1.
Measured: Randomization to Disease Progression (Up to 29.7 Months)
Percentage of Participants With Disease Control Rate (DCR)
DCR is the percentage of participants with a best overall response of CR, PR, or Stable Disease (SD) as per Response using RECIST v1.1. Target lesions - CR: Disappearance of all lesions; any pathological lymph nodes must have reduction in short axis to <10 mm. PR: At least a 30% decrease in the sum of diameters of lesions vs the baseline sum. Progressive Disease (PD): At least a 20% increase in the sum of diameters of lesions vs the smallest sum on study (the sum must also demonstrate an absolute increase of at least 5 mm); or the appearance of new lesion(s). SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Non target lesions - CR: Disappearance of all lesions and normalization of tumor marker levels; all lymph nodes must be non-pathological in size. Non-CR/Non-PD: Persistence of lesion(s) and/or maintenance of abnormal tumor marker levels. PD: Unequivocal progression of existing lesions or the appearance of new lesion(s).
Measured: Randomization to Disease Progression (Up to 29.7 Months)
Duration of Response (DoR)
Objective response was achieved if they had a best overall response of CR or PR. Target lesions- CR: Disappearance of all lesions; any pathological lymph nodes have reduction in short axis to <10 mm. PR: At least a 30% decrease in the sum of diameters of lesions vs the baseline sum. PD: At least a 20% increase in the sum of diameters of lesions vs the smallest sum on study(the sum must also demonstrate an absolute increase of at least 5 mm); or the appearance of new lesion(s). Non target lesions - CR: Disappearance of all lesions and normalization of tumour marker levels; all lymph nodes must be non-pathological in size. Non-CR/Non-PD: Persistence of lesion(s) and/or maintenance of abnormal tumor marker levels. PD: Unequivocal progression of existing lesions or the appearance of new lesion(s). If a participant was not known to have died or have radiographically documented PD as of the data inclusion cutoff date, DOR was censored at the date of the last adequate tumor assessment.
Measured: Date of Complete Response (CR) or Partial Response (PR) to Date of Objective Disease Progression or Death Due to Any Cause (Up to 28.4 Months)
Time to Deterioration in Quality of Life (QoL) on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) - Global Health Status/ QoL Scale
Time to sustained deterioration was defined as time from randomization to first worsening in QoL with no subsequent non-worsened assessment. Worsening in global health status/QoL was defined as a decrease of ≥10 points on a 100-point scale. If a participant did not report worsening, time to sustained deterioration was censored at date of last non-worsened assessment. Scores for global health status/QoL range from 0 to 100 with; higher scores representing better QoL.
Measured: Randomization, 30 Days After Treatment Discontinuation (Up to 18 Months)
Change From Baseline on the EuroQol 5-Dimension, 5-Level Questionnaire (EQ-5D-5L) Index Score
The EQ-5D-5L is a standardized instrument for use as a measure of self-reported health status. Participants completed the 5-level (no problem, slight problem, moderate problem, severe problem, and inability or extreme problem), 5-dimension (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) questionnaire concerning their current health state. A unique EQ-5D health state is defined by combining 1 level from each of the 5 dimensions. Scores range from 0 (death) to 1 (perfect health), but scores <0 are possible based on the algorithm.
Measured: Randomization, 30 Days After Treatment Discontinuation (Up to 18 Months)
Change From Baseline on the EuroQol 5-Dimension, 5-Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS)
The EQ-5D-5L is a standardized instrument for use as a measure of self-reported health status. A unique EQ-5D health state is defined by combining 1 level from each of the 5 dimensions. Participants indicated their current health status by marking on a VAS ranging from 100 (best imaginable health state) to 0 (worst imaginable health state).
Measured: Randomization, 30 Days After Treatment Discontinuation (Up to 18 Months)
Pharmacokinetics (PK): Maximum Concentration (Cmax) of Ramucirumab
Cmax of Ramucirumab at the end of ramucirumab infusion.
Measured: Cycle 1 and Cycle 9, Day 1: Predose, Postdose
PK: Minimum Concentration (Cmin) of Ramucirumab
Cmin of Ramucirumab following administration every 3 weeks.
Measured: Day 1 of Cycle 2, 3, 5 and 9 (Predose and Postdose)
Number of Participants With Anti-Ramucirumab Antibodies
Number of participants with positive treatment emergent anti-ramucirumab antibodies was summarized by treatment group.
Measured: 29.7 Months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Apr 2015 (estimated)
- Study start13 Jul 2015
- Primary completion21 Apr 2017
- Study completion26 Jul 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Urothelial CarcinomaStudies of the same condition, open and under way.
- More trials run by Eli Lilly and CompanyThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 530 participants (actual)
Sponsor and investigators
- Lead sponsor
- Eli Lilly and Company
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Study director, Eli Lilly and Company
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02426125
- Sponsor's protocol ID
- 15679
- Other IDs
- I4T-MC-JVDC, 2014-003655-66, 2014
- Acronym
- RANGE
- Status last verified
- Aug 2023
- First submitted
- 21 Apr 2015
- Last updated
- 21 Aug 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
Publications
van der Heijden MS, Powles T, Petrylak D, de Wit R, Necchi A, Sternberg CN, Matsubara N, Nishiyama H, Castellano D, Hussain SA, Bamias A, Gakis G, Lee JL, Tagawa ST, Vaishampayan U, Aragon-Ching JB, Eigl BJ, Hozak RR, Rasmussen ER, Xia MS, Rhodes R, Wijayawardana S, Bell-McGuinn KM, Aggarwal A, Drakaki A. Predictive biomarkers for survival benefit with ramucirumab in urothelial cancer in the RANGE trial. Nat Commun. 2022 Apr 6;13(1):1878. doi: 10.1038/s41467-022-29441-y.
PubMed 35388003Mitani S, Chen Y, Inoue K, Mori J, Gao L, Long A, Wakabayashi S. Clinical Impact of a Shortened Infusion Duration of Ramucirumab in Japanese Patients -A Model-Based Approach. Gan To Kagaku Ryoho. 2021 Nov;48(11):1381-1387.
PubMed 34795131Necchi A, Nishiyama H, Matsubara N, Lee JL, Petrylak DP, de Wit R, Drakaki A, Liepa AM, Mao H, Bell-McGuinn K, Powles T. Health-related quality of life in the randomized phase 3 study of ramucirumab plus docetaxel versus placebo plus docetaxel in platinum-refractory advanced urothelial carcinoma (RANGE). BMC Urol. 2020 Nov 7;20(1):181. doi: 10.1186/s12894-020-00752-w.
PubMed 33160359Petrylak DP, de Wit R, Chi KN, Drakaki A, Sternberg CN, Nishiyama H, Castellano D, Hussain SA, Flechon A, Bamias A, Yu EY, van der Heijden MS, Matsubara N, Alekseev B, Necchi A, Geczi L, Ou YC, Coskun HS, Su WP, Bedke J, Gakis G, Percent IJ, Lee JL, Tucci M, Semenov A, Laestadius F, Peer A, Tortora G, Safina S, Garcia Del Muro X, Rodriguez-Vida A, Cicin I, Harputluoglu H, Tagawa ST, Vaishampayan U, Aragon-Ching JB, Hamid O, Liepa AM, Wijayawardana S, Russo F, Walgren RA, Zimmermann AH, Hozak RR, Bell-McGuinn KM, Powles T; RANGE study investigators. Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): overall survival and updated results of a randomised, double-blind, phase 3 trial. Lancet Oncol. 2020 Jan;21(1):105-120. doi: 10.1016/S1470-2045(19)30668-0. Epub 2019 Nov 18.
PubMed 31753727Petrylak DP, de Wit R, Chi KN, Drakaki A, Sternberg CN, Nishiyama H, Castellano D, Hussain S, Flechon A, Bamias A, Yu EY, van der Heijden MS, Matsubara N, Alekseev B, Necchi A, Geczi L, Ou YC, Coskun HS, Su WP, Hegemann M, Percent IJ, Lee JL, Tucci M, Semenov A, Laestadius F, Peer A, Tortora G, Safina S, Del Muro XG, Rodriguez-Vida A, Cicin I, Harputluoglu H, Widau RC, Liepa AM, Walgren RA, Hamid O, Zimmermann AH, Bell-McGuinn KM, Powles T; RANGE study investigators. Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial. Lancet. 2017 Nov 18;390(10109):2266-2277. doi: 10.1016/S0140-6736(17)32365-6. Epub 2017 Sep 12.
PubMed 28916371
Study at a glance
From the registry record, last updated by the sponsor on 21 Aug 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of Ramucirumab Plus Docetaxel Versus Placebo Plus Docetaxel in Patients With Locally Advanced or Unresectable or Metastatic Urothelial Carcinoma Who Progressed on or After Platinum-Based Therapy
- ClinicalTrials.gov ID
- NCT02426125
- Acronym / sponsor ID
- RANGE / 15679
- Conditions
- Urothelial Carcinoma
- Keywords
- carcinoma of the bladder, carcinoma of the urethra, carcinoma the of ureter, carcinoma of the renal pelvis, transitional cell carcinoma, transitional cell tumor, RANGE, bladder cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 530 participants (actual)
- Lead sponsor
- Eli Lilly and CompanyIndustry (pharma, biotech, devices)
- Study start
- 13 Jul 2015 (actual)
- Primary completion
- 21 Apr 2017 (actual)
- Study completion
- 26 Jul 2022 (actual)
- First posted
- 24 Apr 2015 (estimated)
- Results
- Posted 8 Mar 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main purpose of this study is to evaluate the safety and efficacy of the study drug ramucirumab in combination with docetaxel in participants with urothelial cancer who failed prior platinum-based therapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Ramucirumab + Docetaxel | Experimental | Drug: Ramucirumab, Drug: DocetaxelRamucirumab (10 milligram/kilogram [mg/kg]) intravenously (IV) plus docetaxel (75 milligram/square meter [mg/m²]) IV on day 1 of each 21-day cycle. Participants may continue to receive treatment until discontinuation criteria are met. |
| Placebo + Docetaxel | Placebo comparator | Drug: Docetaxel, Drug: PlaceboPlacebo IV plus docetaxel (75 mg/m²) IV on day 1 of each 21-day cycle. Participants may continue to receive treatment until discontinuation criteria are met. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (15 listed)
- Have histologically or cytologically confirmed, locally advanced or unresectable or metastatic urothelial (transitional cell) carcinoma of the bladder, urethra, ureter, or renal pelvis.
- Had disease progression while on a platinum containing regimen in the first-line setting or within 14 months after completing the first-line platinum regimen. Participants who received treatment with one immune checkpoint inhibitor regimen are eligible (for example Programmed death 1 (PD-1), Programmed death-ligand 1 (PDL1), or CTLA4) and may have a longer interval since prior platinum-containing therapy (≤24 months).
- Have a life expectancy of ≥3 months.
- Have received no more than one prior systemic chemotherapy regimen in the relapsed or metastatic setting. Prior treatment with no more than one prior immune checkpoint inhibitor is permitted and will not be considered as a line of systemic chemotherapy.
- Have measurable disease or nonmeasurable but evaluable disease as defined by Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST 1.1).
Key exclusion criteria (13 listed)
- Have received more than one prior systemic chemotherapy regimen for metastatic disease.
- Have received prior systemic taxane therapy for transitional cell carcinoma (TCC) of the bladder, urethra, ureter, or renal pelvis in any setting (neoadjuvant, adjuvant, metastatic).
- Have received more than one prior antiangiogenic agent (that is, bevacizumab, sorafenib, sunitinib) for TCC of the urothelium.
- Have received radiation therapy within 4 weeks (≤4 weeks) prior to randomization or has not recovered from toxic effects of the treatment that was given >4 weeks prior to randomization.
- Have a history of uncontrolled hereditary or acquired bleeding or thrombotic disorders.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RamucirumabAlso: LY3009806Administered IV | Drug | Ramucirumab + Docetaxel |
| DocetaxelAdministered IV | Drug | Placebo + Docetaxel, Ramucirumab + Docetaxel |
| PlaceboAdministered IV | Drug | Placebo + Docetaxel |
Primary outcome
Progression Free Survival (PFS)
Time frame: Randomization to Radiological Disease Progression or Death from Any Cause (Up to 18 Months)
PFS defined as time from first day of therapy to first evidence of disease progression defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) or death from any cause. Progressive Disease (PD) is at least 20% increase in sum of diameters of target lesions, with reference being the smallest sum on study and plus absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. If participant does not have complete baseline disease assessment, then PFS time was censored at date of first dose, regardless of whether or not objectively determined disease progression or death has been observed for participant. If participant is not known to have died or have objective progression as of data inclusion cutoff date for analysis, PFS time was censored at last adequate tumor assessment date.
10 secondary outcomes
Overall Survival (OS)
Time frame: Randomization to Date of Death from Any Cause (Up to 31.1 Months)
Percentage of Participants With an Objective Response Rate (ORR)
Time frame: Randomization to Disease Progression (Up to 29.7 Months)
Percentage of Participants With Disease Control Rate (DCR)
Time frame: Randomization to Disease Progression (Up to 29.7 Months)
Duration of Response (DoR)
Time frame: Date of Complete Response (CR) or Partial Response (PR) to Date of Objective Disease Progression or Death Due to Any Cause (Up to 28.4 Months)
Time to Deterioration in Quality of Life (QoL) on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) - Global Health Status/ QoL Scale
Time frame: Randomization, 30 Days After Treatment Discontinuation (Up to 18 Months)
Change From Baseline on the EuroQol 5-Dimension, 5-Level Questionnaire (EQ-5D-5L) Index Score
Time frame: Randomization, 30 Days After Treatment Discontinuation (Up to 18 Months)
Change From Baseline on the EuroQol 5-Dimension, 5-Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS)
Time frame: Randomization, 30 Days After Treatment Discontinuation (Up to 18 Months)
Pharmacokinetics (PK): Maximum Concentration (Cmax) of Ramucirumab
Time frame: Cycle 1 and Cycle 9, Day 1: Predose, Postdose
PK: Minimum Concentration (Cmin) of Ramucirumab
Time frame: Day 1 of Cycle 2, 3, 5 and 9 (Predose and Postdose)
Number of Participants With Anti-Ramucirumab Antibodies
Time frame: 29.7 Months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Aug 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 35388003van der Heijden MS, Powles T, Petrylak D, de Wit R, Necchi A, Sternberg CN, Matsubara N, Nishiyama H, Castellano D, Hussain SA, Bamias A, Gakis G, Lee JL, Tagawa ST, Vaishampayan U, Aragon-Ching JB, Eigl BJ, Hozak RR, Rasmussen ER, Xia MS, Rhodes R, Wijayawardana S, Bell-McGuinn KM, Aggarwal A, Drakaki A. Predictive biomarkers for survival benefit with ramucirumab in urothelial cancer in the RANGE trial. Nat Commun. 2022 Apr 6;13(1):1878. doi: 10.1038/s41467-022-29441-y.
- Derived from this study: PubMed 34795131Mitani S, Chen Y, Inoue K, Mori J, Gao L, Long A, Wakabayashi S. Clinical Impact of a Shortened Infusion Duration of Ramucirumab in Japanese Patients -A Model-Based Approach. Gan To Kagaku Ryoho. 2021 Nov;48(11):1381-1387.
- Derived from this study: PubMed 33160359Necchi A, Nishiyama H, Matsubara N, Lee JL, Petrylak DP, de Wit R, Drakaki A, Liepa AM, Mao H, Bell-McGuinn K, Powles T. Health-related quality of life in the randomized phase 3 study of ramucirumab plus docetaxel versus placebo plus docetaxel in platinum-refractory advanced urothelial carcinoma (RANGE). BMC Urol. 2020 Nov 7;20(1):181. doi: 10.1186/s12894-020-00752-w.
- Derived from this study: PubMed 31753727Petrylak DP, de Wit R, Chi KN, Drakaki A, Sternberg CN, Nishiyama H, Castellano D, Hussain SA, Flechon A, Bamias A, Yu EY, van der Heijden MS, Matsubara N, Alekseev B, Necchi A, Geczi L, Ou YC, Coskun HS, Su WP, Bedke J, Gakis G, Percent IJ, Lee JL, Tucci M, Semenov A, Laestadius F, Peer A, Tortora G, Safina S, Garcia Del Muro X, Rodriguez-Vida A, Cicin I, Harputluoglu H, Tagawa ST, Vaishampayan U, Aragon-Ching JB, Hamid O, Liepa AM, Wijayawardana S, Russo F, Walgren RA, Zimmermann AH, Hozak RR, Bell-McGuinn KM, Powles T; RANGE study investigators. Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): overall survival and updated results of a randomised, double-blind, phase 3 trial. Lancet Oncol. 2020 Jan;21(1):105-120. doi: 10.1016/S1470-2045(19)30668-0. Epub 2019 Nov 18.
- Derived from this study: PubMed 28916371Petrylak DP, de Wit R, Chi KN, Drakaki A, Sternberg CN, Nishiyama H, Castellano D, Hussain S, Flechon A, Bamias A, Yu EY, van der Heijden MS, Matsubara N, Alekseev B, Necchi A, Geczi L, Ou YC, Coskun HS, Su WP, Hegemann M, Percent IJ, Lee JL, Tucci M, Semenov A, Laestadius F, Peer A, Tortora G, Safina S, Del Muro XG, Rodriguez-Vida A, Cicin I, Harputluoglu H, Widau RC, Liepa AM, Walgren RA, Hamid O, Zimmermann AH, Bell-McGuinn KM, Powles T; RANGE study investigators. Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial. Lancet. 2017 Nov 18;390(10109):2266-2277. doi: 10.1016/S0140-6736(17)32365-6. Epub 2017 Sep 12.
- A Study of Ramucirumab (LY3009806) Plus Docetaxel in Participants With Urothelial CancerLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST) study director
Eli Lilly and Company
141 sites in 23 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Ramucirumab and Docetaxel in people with Urothelial Carcinoma, run by Eli Lilly and Company at 141 sites in 23 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 15 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 141 sites in United States, Japan, South Korea, France, Germany and 18 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Mar 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression Free Survival (PFS) (time frame: Randomization to Radiological Disease Progression or Death from Any Cause (Up to 18 Months)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02426125, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Aug 2023.