Trial of Cabozantinib for Metastatic Kidney Cancer and Neuroendocrine Tumors
This study is testing a new way to give the drug cabozantinib to people with metastatic renal cell carcinoma (a type of kidney cancer that has spread) or neuroendocrine tumors (cancers that start in hormone-producing cells). Some participants will receive cabozantinib alone, while others will receive cabozantinib with nivolumab (an immunotherapy drug). The study aims to see if this new dosing schedule helps patients take cabozantinib more consistently, improves how long patients live without their cancer getting worse, or reduces severe side effects. The study is looking for 111 participants, including those with advanced kidney cancer (clear cell or non-clear cell) who may or may not have had prior treatments, and those with pancreatic or other neuroendocrine tumors. The study's status is currently unclear.
- Study design
- This is a multi-site, Phase II study with three groups of participants, totaling 111 people. It is testing different ways to give cabozantinib, sometimes with nivolumab.
- What's involved
- Not specified in the trial record.
- Compensation
- Not stated in the trial record.
- Follow-up
- The study will track how participants are doing for up to 2 years, depending on the group they are in.
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NCT05263050
Trial of an Alternative Cabozantinib Dosing Schedule in Metastatic Renal Cell Carcinoma and Neuroendocrine Tumors
Recruiting
PHASE2Ages 18+InterventionalTreatmentFox Chase Cancer CenterInvestigator-initiated
~111 participants
Updated 2026-07-28 on ClinicalTrials.gov
What's tested:CabozantinibNivolumab
At a glance
Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Cohort A: Average daily dose of cabozantinib > 42.8 mg in at least 70% of patients
Measured over 2 years
+2 more outcomes measured
Conditions
Where it's being run
1 sites across 1 statesPennsylvania1
Study leadership
- Matthew Zibelman, MD · PRINCIPAL_INVESTIGATOR · Fox Chase Cancer Center
Who to contact
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Do you actually qualify for this trial?
Add a private profile and we'll compare every criterion below against your situation — and tell you which ones are met, uncertain, or excluding.
Eligibility criteria
Inclusion
Cohorts A and B: Histologically or cytologically confirmed advanced RCC with any clear cell or non-clear cell component. 100% sarcomatoid is permissible.
Cohorts A and B: Patient may have had any number of prior therapies for Cohort A, but for Cohort B patients must not have received any systemic therapy in the metastatic setting
Patients who have received prior (neo)adjuvant immunotherapy with pembrolizumab or similar are eligible for Cohort B IF they completed the adjuvant therapy \> 12 months from start of trial therapy
Treatment naïve patients may be treated in Cohort A if deemed not candidates for nivolumab or if felt single agent cabozantinib most appropriate by the treating clinician
Cohort C: Well differentiated NET, grades 1-3 (any primary site) who have progressed on or are not eligible for somatostatin analogs per treating physician discretion
Cohort C: Disease progression within prior 12 months
Cohort C: Prior or concurrent treatment with somatostatin analogue allowed but no limit on lines of therapy (stable dose of somatostatin for 2 months)
At least one measurable lesion as defined by RECIST version 1.1
No evidence of pre-existing uncontrolled hypertension as assessed by investigator. Patients may undergo adjustments or additions to their antihypertensive regimen before or during screening to achieve optimal BP control.
Age \> 18 years.
ECOG performance status 0 - 2
Patients must have normal organ and marrow function as defined below
Leukocytes, \> 2,000/mcL
Absolute neutrophil count, \> 1,500/mcL
Platelets, \> 100,000/mcL
Hgb, \> 9 g/dL (\>90 g/L)
Total bilirubin, ≤ 1.5 x ULN (with the exception of of individuals with Gilberts syndrome who may have a bilirubin \<3.0 mg/dL)
AST/ALT (SGOT/SGPT)/ALP, \< 3 x ULN ALP ≤ 5x ULN with documented bone metastases.
Albumin, \> 2.8 g/dL
Creatinine clearance, \> 30 Ml/min/1.73 m2 for patients with creatinine levels above institutional normal
PT/INR or PTT, \< 1.3 x the laboratory ULN
Ability to understand and willingness to sign a written informed consent and HIPAA consent document
Sexually active fertile subjects and their partners must agree to use medically accepted methods of contraception (e.g., barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study treatment
Exclusion
Patients who have had systemic anti-cancer therapy or radiotherapy within 14 days or five half-lives, whichever is shorter, prior to entering the study.
Radiation therapy for bone metastases within 2 weeks, any other radiation therapy within 4 weeks, or systemic treatment with radionuclides within 6 weeks before first dose of study treatment. Ongoing clinically relevant complications from prior radiation therapy would preclude eligibility.
Patients with prior therapy with cabozantinib.
Prior systemic therapy directed at advanced RCC is not allowed for patients enrolled to Cohort B (treatment-naïve group).
Cohort B only: Active, known or suspected autoimmune disease. Subjects are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger
Cohort B only: Patients have a condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone or equivalent) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses \> 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
Patients may not be receiving any other investigational agents
History of allergic reactions or hypersensitivity attributed to compound of similar chemical or biologic composition to the agent(s) used in this study
Current use or anticipated need for treatment with drugs or foods that are known strong CYP3A4 inhibitors and inducers. Refer to Section 5.3.2 for detailed information. The topical use of these medications (if applicable), such as 2% ketoconazole cream, is allowed.
Concomitant anticoagulation with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct factor Xa inhibitor betrixaban, or platelet inhibitors (e.g., clopidogrel). Allowed anticoagulants are the following:
Prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH).
Therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, or apixaban in subjects without known brain metastases who are on a stable dose of the anticoagulant for at least 1 week before first dose of study treatment without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor.
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Cardiovascular disorders:
Congestive heart failure New York Heart Association Class 3 or 4, unstable angina pectoris, serious cardiac arrhythmias.
QTcF \> 500 msec within 28 days before first dose of study treatment.
Uncontrolled hypertension defined as sustained blood pressure (BP) \> 160 mm Hg systolic or \> 100 mm Hg diastolic despite optimal antihypertensive treatment.
Stroke (including transient ischemic attack \[TIA\]), myocardial infarction (MI), or other ischemic event, or thromboembolic event (e.g., deep venous thrombosis, pulmonary embolism) within 6 months before first dose of study treatment.
Subjects with a diagnosis of incidental, sub-segmental PE or DVT within 6 months are allowed if stable, asymptomatic, and treated with a stable dose of permitted anticoagulation (see exclusion criterion #6) for at least 1 week before first dose of study treatment.
Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation:
The subject has evidence of tumor invading the GI tract, active peptic ulcer disease, inflammatory bowel disease (e.g., Crohn's disease), diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis, acute pancreatitis, acute obstruction of the pancreatic duct or common bile duct, or gastric outlet obstruction.
Abdominal fistula, GI perforation, bowel obstruction, or intra-abdominal abscess within 6 months before first dose of study treatment.
Cavitating pulmonary lesion(s) or known endotracheal or endobronchial disease manifestation.
Lesions invading or encasing any major blood vessels. Subjects with lesions invading the intrahepatic vasculature, including portal vein, hepatic vein, and hepatic artery, are eligible.
What this trial measures
- Cohort A: Average daily dose of cabozantinib > 42.8 mg in at least 70% of patients2 years
To show that alternative cabozantinib dosing can improve average daily dose compared to historical controls
- Cohort B: 75% of patients alive and progression free at 12 months1 year
Cohort B: To show that alternative cabozantinib dosing + nivolumab (standard dose) can improve 12-month rate of progression-free survival over standard dose cabozantinib + nivolumab
- Cohort C: Decreased rate of grade ≥ 3 adverse events compared to 75% reported in CABINET trial2 years
Cohort C: To show that alternative cabozantinib dosing can improve rates of grade \> 3 adverse events compared to the grade 3-5 adverse events reported in the CABINET trial