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Metastatic Renal Cell CarcinomaPhase 2CYTOSHRINKNCT04090710

SBRT With Combination Ipilimumab/Nivolumab for Metastatic Kidney Cancer

A Phase 2 study testing Ipilimumab/ Nivolumab and SBRT + Ipilimumab/Nivolumab in people with Metastatic Renal Cell Carcinoma, run by Ontario Clinical Oncology Group (OCOG) at 7 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This trial will evaluate the addition of cytoreductive stereotactic body radiation therapy (SBRT) to standard of care combination ipilimumab and nivolumab (I/N) versus I/N alone for the treatment of metastatic kidney cancer. Read more about this study

Who is it for?
Any age
Conditions the study is for
Metastatic Renal Cell Carcinoma
What is being tested?
Ipilimumab/ Nivolumab and SBRT + Ipilimumab/Nivolumab
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
66 participants
Where
7 sitesin 2 countries
Study dates
29 Jan 2020to 30 Jun 2026
Phase
Phase 2
Are there results?
None posted in the registry

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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Biopsy proven renal cell carcinoma of any histology.
  • Imaging proven metastatic disease based on CT or MRI within 10 weeks of screening.
  • Intermediate/poor risk disease based on IMDC criteria (see Appendix II).
  • Primary kidney lesion amenable to SBRT.
  • Eligible for standard of care delivery of ipilimumab and nivolumab (I/N) according to approved product monograph.

Who cannot join

  • A maximum primary renal lesion size of 20 cm or greater.
  • Candidate for cytoreductive nephrectomy, unless a patient has refused cytoreductive nephrectomy (in this case, a discussion of cytoreductive nephrectomy and patient refusal must be documented).
  • Treatment with prior systemic therapy in the adjuvant or metastatic setting for renal cell carcinoma.
  • Previous abdominal radiation precluding SBRT.
  • Kanofsky Performance (KPS) score below 60 (see Appendix III).
  • History of auto-immune disorder precluding treatment with ipilimumab or nivolumab.
Show all 13Show fewer
  • History of ataxia telangiectasia or other radiation sensitivity disorders.
  • Chronic corticosteroid use or other chronic immune suppressive therapy. (Participants are permitted the use of topical, ocular, intra-articular, intranasal, and inhalational corticosteroids (with minimal systemic absorption). Adrenal replacement steroid doses of prednisone ≤ 10 mg daily are permitted).
  • Use of medicinal herbal preparations (not including medical cannabis) unless prescribed by a treating physician.
  • Inability to lie flat for at least 30 minutes without moving.
  • Pregnant or lactating women.
  • Geographic inaccessibility for follow-up.
  • Inability to provide informed consent.

Trial locations and contacts

7 sites in 2 countries.

7 sites in 2 countries

Canada6 sites
  • Cross Cancer Institute

    Edmonton, Alberta, T6G 1Z2

  • Juravinski Cancer Centre

    Hamilton, Ontario

  • Grand River Regional Cancer Centre

    Kitchener, Ontario, N2G1G3

  • London Regional Cancer Centre

    London, Ontario, N2G1G3

  • The Ottawa Regional Cancer Centre

    Ottawa, Ontario, K1H8L6

  • Sunnybrook Health Sciences Centre- Odette Cancer Centre

    Toronto, Ontario, M4N3M5

Other trials in Canada

Australia1 site
  • Peter MacCallum Cancer Centre

    Melbourne, 3000

Other trials in Australia

About this study

Official title: Cytoreductive Stereotactic Hypofractionated Radiotherapy With Combination Ipilimumab/Nivolumab for Metastatic Kidney Cancer

This trial will evaluate the addition of cytoreductive stereotactic body radiation therapy (SBRT) to standard of care combination ipilimumab and nivolumab (I/N) versus I/N alone for the treatment of metastatic kidney cancer.

Read the detailed description

This is a multi-centre, open label, phase II randomized clinical trial evaluating SBRT as upfront cytoreductive therapy to the primary renal mass along with combination I/N therapy in patients with intermediate/poor risk mRCC who are not candidates for cytoreductive nephrectomy. Eligible and consenting, newly diagnosed and histologically confirmed intermediate/poor risk mRCC patients based on IMDC criteria with primary disease in-situ will be randomized in a 2:1 fashion to either induction I/N followed by SBRT prior to the second cycle (experimental arm) versus I/N alone (standard arm). Patients will be stratified based on IMDC criteria (intermediate 1-2 versus poor 3-6).

  • Standard Arm: induction ipilimumab 1 mg/kg combined with nivolumab 3 mg/kg (I/N) every 3 weeks for cycles 1-4 followed by maintenance treatment with nivolumab 240mg every 2 weeks or 480mg every 4 weeks until disease progression (as determined by RECIST 1.1), intolerance, or patient/physician decision to stop treatment.
  • Experimental Arm: induction ipilimumab 1 mg/kg combined with nivolumab 3 mg/kg (I/N) every 3 weeks for one cycle, followed by SBRT to the primary disease in-situ, prior to cycle 2-4 of I/N. Patients randomized to SBRT will undergo radiation planning during the first cycle of I/N to their primary kidney mass, and then the radiation will be delivered between cycles 1 and 2 to a dose of 30-40 Gy in 5 fractions every other day over 1.5 weeks. Approximately one week following completion of SBRT, patients will start cycle 2 of I/N as per standard of care. The total time elapsed between the start of cycle 1 and 2 of I/N should be no more than 6 weeks. After completion of up to four cycles of I/N, patients will proceed to standard of care maintenance treatment with nivolumab 240mg every 2 weeks or 480mg every 4 weeks until disease progression (as determined by RECIST 1.1), intolerance, or patient/physician decision to stop treatment.

During treatment (standard and experimental arm) participants will be assessed for radiation toxicity and the occurrence of adverse events. Following treatment, participants will be assessed at a clinic visit every 3 months, for a period of 1 year. Progression free survival will be assessed by CT scan (chest; abdomen and pelvis), which is performed after the final I/N treatment and every 3 months as per standard of care. Participants will be followed for one additional year, seen at 18 and 24 months to assess survival. The planned sample size is 78 study participants.

Being tested
Ipilimumab/ Nivolumab, SBRT + Ipilimumab/Nivolumab
Keywords
SBRT, Ipilimumab, Nivolumab
Medical subject headings
Carcinoma, Renal Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ipilimumab/ NivolumabDrug

    Also called Yervoy/Opdivo

    induction ipilimumab 1 mg/kg combined with nivolumab 3 mg/kg (I/N) every 3 weeks for cycles 1-4 followed by maintenance treatment with nivolumab 240mg every 2 weeks or 480mg every 4 weeks until disease progression

  • SBRT + Ipilimumab/NivolumabRadiation

    SBRT to the primary disease in-situ, prior to cycle 2-4 of I/N. Patients randomized to SBRT will undergo radiation planning during the first cycle of I/N to their primary kidney mass, and then the radiation will be delivered between cycles 1 and 2 to a dose of 30-40 Gy in 5 fractions every other day over 1.5 weeks.

Study groups in NCT04090710
Study groupRoleWhat they receive
Standard of Care I/N aloneActive comparatorinduction ipilimumab 1 mg/kg combined with nivolumab 3 mg/kg (I/N) every 3 weeks for cycles 1-4 followed by maintenance treatment with nivolumab 240mg every 2 weeks or 480mg every 4 weeks until disease progression (as determined by RECIST 1.1), intolerance, or patient/physician decision to stop treatment.
Receives: Drug: Ipilimumab/ Nivolumab
Standard of Care I/N plus primary disease SBRTExperimentalinduction ipilimumab 1 mg/kg combined with nivolumab 3 mg/kg (I/N) every 3 weeks for one cycle, followed by SBRT to the primary disease in-situ, prior to cycle 2-4 of I/N. Patients randomized to SBRT will undergo radiation planning during the first cycle of I/N to their primary kidney mass, and then the radiation will be delivered between cycles 1 and 2 to a dose of 30-40 Gy in 5 fractions every other day over 1.5 weeks. Approximately one week following completion of SBRT, patients will start cycle 2 of immunotherapy as per standard of care. The total time elapsed between the start of cycle 1 and 2 of I/N should be no more than 6 weeks. After completion of up to four cycles of I/N, patients will proceed to standard of care maintenance treatment with nivolumab 240mg every 2 weeks or 480mg every 4 weeks until disease progression (as determined by RECIST 1.1), intolerance, or patient/physician decision to stop treatment.
Receives: Radiation: SBRT + Ipilimumab/Nivolumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression free survival (PFS)

    The primary outcome of this study is the hazard ratio for progression-free survival (PFS), defined from the date of randomization until the date of progression (PFS truncated at subsequent systemic therapy) as determined by RECIST 1.1, or death due to any cause, whichever comes first. All attempts will be made to follow-up patients for the primary outcome measure for at least one year, even if a patient stops treatment. Patients who do not have a primary outcome event at the time of analysis will be censored on the last date the patient can be confirmed as alive and progression-free.

    Measured: 2 years

Secondary outcomes (9)
  1. Subject safety

    Incidence and attribution of deaths

    Measured: Date of randomization until 1year post treatment

  2. Overall Survival

    • Overall survival, defined from the date of randomization to the date of death due to any cause. Patients with no known death date at the time of analysis will be censored on the last date they are confirmed alive.

    Measured: 2 years

  3. Objective response rate

    • Objective response rate, which is defined as the proportion of randomized subjects who achieve a best response of complete response (CR) or partial response (PR) using the RECIST 1.1 criteria.

    Measured: 1 year

  4. Quality of Life: EORTC QLQ-C30 questionnaire

    • Quality of life, which will be evaluated using the EORTC QLQ-C30 questionnaire.

    Measured: 1 year

  5. Subject safety

    Number of Adverse Events and Serious Adverse Events using NCI CTCAE v5.0

    Measured: 1 Year

  6. Ipilimumab/ Nivolumab drug tolerability

    Ipilimumab/Nivolumab treatment discontinuation rates

    Measured: From the date of randomization until date of first documented disease progression up to 1 year.

  7. Ipilimumab/ Nivolumab drug tolerability

    Number of doses of Ipilimumab/Nivolumab combination treatment

    Measured: From the date of randomization until date of first documented disease progression, up to 1 year.

  8. Ipilimumab/ Nivolumab drug tolerability

    Number of Nivolumab maintenance doses

    Measured: From the date of randomization until date of first documented disease progression, up to 1 year.

  9. Ipilimumab/ Nivolumab drug tolerability

    Time to treatment discontinuation from the date of randomization

    Measured: From the date of randomization until date of first documented disease progression, up to 1 year.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Sep 2019
  2. Study start29 Jan 2020
  3. Primary completion23 Apr 2026
  4. Study completion30 Jun 2026

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Eligible and consenting, newly diagnosed and histologically confirmed intermediate/poor risk metastatic renal cell carcinoma patients with primary disease in-situ will be randomized in a 2:1 fashion to either induction I/N followed by SBRT prior to the second cycle (experimental arm) versus I/N alone (standard arm). Patients will be stratified based on IMDC criteria (intermediate 1-2 versus poor 3-6).
Masking
None (open label)
Enrolment
66 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04090710
Sponsor's protocol ID
OCOG-2019-CYTOSHRINK
Other IDs
CA209-7DR
Acronym
CYTOSHRINK
Status last verified
Jun 2026
First submitted
9 Sep 2019
Last updated
28 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ipilimumab/ Nivolumab and SBRT + Ipilimumab/Nivolumab in people with Metastatic Renal Cell Carcinoma, run by Ontario Clinical Oncology Group (OCOG) at 7 sites in 2 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 5 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 28 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Canada, Australia. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 28 Aug 2026.

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