A Study of Atezolizumab as Adjuvant Therapy in Participants With Renal Cell Carcinoma (RCC) at High Risk of Developing Metastasis Following Nephrectomy (IMmotion010)

• ClinicalTrials.gov Identifier: NCT03024996
• Recruitment Status: Terminated
• First Posted: January 19, 2017
• Results First Posted: August 3, 2023
• Last Update Posted: August 3, 2023
• Sponsor: Hoffmann-La Roche
• Information provided by (Responsible Party): Hoffmann-La Roche

Tracking Information

• First Submitted Date: January 17, 2017
• First Posted Date: January 19, 2017
• Results First Submitted Date: April 18, 2023
• Results First Posted Date: August 3, 2023
• Last Update Posted Date: August 3, 2023
• Actual Study Start Date: January 3, 2017
• Actual Primary Completion Date: May 3, 2022 (Final data collection date for primary outcome measure)

Current Primary Outcome Measures (submitted: July 14, 2023)

Investigator-assessed Disease-Free Survival (DFS) [ Time Frame: From baseline up to first occurence of event by investigator assessment (up to approximately 64 months) ]

Investigator-assessed DFS, defined as the time from randomization to death from any cause or the first documented recurrence assessed by investigator, whichever occurred first. Recurrence was defined as any of the following: Local recurrence of renal cell carcinoma (RCC), new primary RCC, or distant metastasis of RCC. Investigator-assessed DFS was analyzed similarly to the analysis of IRF-assessed DFS.

Original Primary Outcome Measures (submitted: January 17, 2017)

Disease-Free Survival (DFS) [ Time Frame: From Baseline until first occurrence of DFS event (up to approximately 64 months) ]

DFS is defined as the time from randomization to the first documented DFS event. DFS event includes any of the following: Local recurrence of RCC, New primary RCC, Distant metastasis of RCC, or Death from any cause. Tumor assessment will be as per investigator on the basis of radiographic evidence and whenever possible supported/confirmed by biopsy results.

Current Secondary Outcome Measures (submitted: July 14, 2023)

• Overall Survival (OS) [ Time Frame: From baseline up to death due to any cause (up to approximately 64 months) ]
  OS was defined as the time from randomization to death from any cause.
• Investigator-assessed DFS in Participants With Tumor-Infiltrating Immune Cell (IC) 1/2/3 [ Time Frame: From baseline until first occurrence of DFS event (up to approximately 64 months) ]
  Investigator assessed DFS for participants with PD-L1 expression of IC1/2/3 vs IC0, defined as the time from randomization to death from any cause or the first documented recurrence assessed by investigator, whichever occurred first. Investigator-assessed DFS was analyzed similarly to the analysis of IRF-assessed DFS. PD-L1 IC0 was defined as <1% and IC1/2/3 was defined as >=1% of tumor-infiltrating IC expressing PD-L1 as assessed by immunohistochemistry using SP142 assay. Recurrence was defined as any of the following: Local recurrence of renal cell carcinoma (RCC), new primary RCC, or distant metastasis of RCC.
• Independent Review Facility (IRF)-Assessed DFS [ Time Frame: From baseline until first documented recurrence event (up to approximately 64 months) ]
  IRF-assessed DFS was defined as the time from randomization to death from any cause or the first documented recurrence assessed by IRF, whichever occurred first.
• IRF-assessed DFS in Participants With Tumor-Infiltrating IC 1/2/3 [ Time Frame: From baseline until first occurrence of DFS event (up to approximately 64 months) ]
  IRF-assessed DFS was defined as the time from randomization to death from any cause or the first documented recurrence assessed by IRF, whichever occurred first. PD-L1 IC0 was defined as <1% and IC1/2/3 was defined as >=1% of tumor-infiltrating IC expressing PD-L1 as assessed by immunohistochemistry using SP142 assay.
• IRF-assessed Event-free Survival (EFS) [ Time Frame: From baseline until first documented recurrence event (up to approximately 64 months) ]
  IRF-assessed EFS was defined as the time from randomization to death from any cause, or the first documented recurrence in participants without baseline disease by IRF or the first documented disease progression in participants identified as having baseline disease by IRF, whichever occurred first. Disease progression was defined as either unequivocal progression of baseline disease or new unequivocal lesions.
• Disease-Specific Survival [ Time Frame: From baseline up to death due to RCC (up to approximately 64 months) ]
  Disease-specific survival was defined as the time from randomization to death from renal cell carcinoma (RCC).
• Distant Metastasis-Free Survival [ Time Frame: From baseline up to date of diagnosis of distant metastases or death due to any cause (up to approximately 64 months) ]
  Distant metastasis-free survival, defined as the time from randomization to death from any cause or the date of diagnosis of distant (i.e., non-locoregional) metastases assessed by the investigator, whichever occurred first.
• Percentage of Participants Who Are Alive and IRF-assessed Recurrence Free at Year 1, 2, and 3 [ Time Frame: Up to 3 years ]
  IRF-assessed DFS was defined as the percentage of participants being alive and free of recurrence assessed by IRF at Year 1, 2, and 3 after randomization.
• Percentage of Participants Who Are Alive and Investigator-assessed Recurrence Free at Year 1, 2, and 3 [ Time Frame: Up to 3 years ]
  Investigator-assessed DFS rate was defined as the percentage of participants being alive and free of recurrence assessed by investigator at Year 1, 2, and 3 after randomization.
• Percentage of Participants With Adverse Events [ Time Frame: From baseline up to death due to any cause (up to approximately 71 months) ]
  An adverse event (AE) was defined as any untoward medical occurrence in a participant administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any unfavorable and unitended sign (including an abnormal laboratory finding), symptom or disease temporally associated with the use of a pharmaceutical product whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as a AEs.
• Maximum Serum Concentration (Cmax) of Atezolizumab [ Time Frame: Predose (Hour[hr]0), 0.5 hr after end of infusion (infusion duration=1 hr) on Cycle 1 Day 1; predose (hr 0) on Day 1 of Cycles 2, 3, 4, 8; at treatment discontinuation (up to 1 year); 90-120 days after last dose (last dose = up to 1 year) (Cycle=21 days) ]
• Minimum Serum Concentration (Cmin) of Atezolizumab [ Time Frame: Predose (Hour[hr]0), 0.5 hr after end of infusion (infusion duration=1 hr) on Cycle 1 Day 1; predose (hr 0) on Day 1 of Cycles 2, 3, 4, 8; at treatment discontinuation (up to 1 year); 90-120 days after last dose (last dose = up to 1 year) (Cycle=21 days) ]
• Percentage of Participants With Anti-Drug Antibodies (ADA) to Atezolizumab [ Time Frame: Predose (hr 0) on Day 1 of Cycles 1, 2, 3, 4, 8; at treatment discontinuation (up to 1 year); 90-120 days after last dose (last dose = up to 1 year) (Cycle=21 days) ]

Original Secondary Outcome Measures (submitted: January 17, 2017)

• Overall Survival [ Time Frame: From Baseline up to death due to any cause (up to approximately 88 months) ]
• DFS in Participants With Tumor-Infiltrating Immune Cell (IC) 1/2/3 [ Time Frame: From Baseline until first occurrence of DFS event (up to approximately 88 months) ]
  DFS is defined as the time from randomization to the first documented DFS event. DFS event includes any of the following: Local recurrence of RCC, New primary RCC, Distant metastasis of RCC, or Death from any cause. Tumor assessment will be as per investigator on the basis of radiographic evidence and whenever possible supported/confirmed by biopsy results.
• Disease-Specific Survival [ Time Frame: From Baseline up to death due to RCC (up to approximately 88 months) ]
• Distant Metastasis-Free Survival [ Time Frame: From Baseline up to date of diagnosis of distant metastases or death due to any cause (up to approximately 88 months) ]
• Percentage of Participants Who Are Alive and Recurrence Free at Year 3 [ Time Frame: Year 3 ]
  Recurrence assessment will be as per investigator on the basis of radiographic evidence and whenever possible supported/confirmed by biopsy results.
• Percentage of Participants With Adverse Events [ Time Frame: From Baseline up to 90 days after last dose of study drug or until initiation of new systemic anti-cancer therapy, whichever occurs first (last dose = up to approximately 1 year) ]
• Maximum Serum Concentration (Cmax) of Atezolizumab [ Time Frame: Predose (Hour[hr]0), 0.5 hr after end of infusion (infusion duration=1 hr) on Cycle 1 Day 1; predose (hr 0) on Day 1 of Cycles 2, 3, 4, 8; at treatment discontinuation (up to 1 year); 90-120 days after last dose (last dose = up to 1 year) (Cycle=21 days) ]
• Minimum Serum Concentration (Cmin) of Atezolizumab [ Time Frame: Predose (Hour[hr]0), 0.5 hr after end of infusion (infusion duration=1 hr) on Cycle 1 Day 1; predose (hr 0) on Day 1 of Cycles 2, 3, 4, 8; at treatment discontinuation (up to 1 year); 90-120 days after last dose (last dose = up to 1 year) (Cycle=21 days) ]
• Percentage of Participants With Anti-Therapeutic Antibodies (ATA) to Atezolizumab [ Time Frame: Predose (hr 0) on Day 1 of Cycles 1, 2, 3, 4, 8; at treatment discontinuation (up to 1 year); 90-120 days after last dose (last dose = up to 1 year) (Cycle=21 days) ]

• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: A Study of Atezolizumab as Adjuvant Therapy in Participants With Renal Cell Carcinoma (RCC) at High Risk of Developing Metastasis Following Nephrectomy
• Official Title: A Phase III, Multicenter, Randomized, Placebo-Controlled, Double-Blind Study of Atezolizumab (Anti-PD-L1 Antibody) as Adjuvant Therapy in Patients With Renal Cell Carcinoma at High Risk of Developing Metastasis Following Nephrectomy
• Brief Summary: This is a Phase III, multicenter, randomized, placebo-controlled, double-blind study to evaluate the efficacy and safety of atezolizumab versus placebo in participants with RCC who are at high risk of disease recurrence following nephrectomy.
• Detailed Description: Not Provided
• Study Type: Interventional
• Study Phase: Phase 3
• Study Design: Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: Double (Participant, Investigator); Primary Purpose: Treatment
• Condition: Renal Cell Carcinoma

Intervention

• Drug: Atezolizumab
  Atezolizumab 1200 mg IV infusion q3w
• Other: Placebo
  Placebo matching to atezolizumab q3w

Study Arms

• Experimental: Atezolizumab
  Participants will receive atezolizumab 1200 milligrams (mg) intravenous (IV) infusion every 3 weeks (q3w) for 16 cycles (each cycle=21 days) or 1 year (whichever occurs first).
  Intervention: Drug: Atezolizumab
• Placebo Comparator: Placebo
  Participants will receive placebo matching to atezolizumab q3w for 16 cycles (each cycle=21 days) or 1 year (whichever occurs first).
  Intervention: Other: Placebo

Publications *

• Pal SK, Uzzo R, Karam JA, Master VA, Donskov F, Suarez C, Albiges L, Rini B, Tomita Y, Kann AG, Procopio G, Massari F, Zibelman M, Antonyan I, Huseni M, Basu D, Ci B, Leung W, Khan O, Dubey S, Bex A. Adjuvant atezolizumab versus placebo for patients with renal cell carcinoma at increased risk of recurrence following resection (IMmotion010): a multicentre, randomised, double-blind, phase 3 trial. Lancet. 2022 Oct 1;400(10358):1103-1116. doi: 10.1016/S0140-6736(22)01658-0. Epub 2022 Sep 10.
• Marconi L, Sun M, Beisland C, Klatte T, Ljungberg B, Stewart GD, Dabestani S, Choueiri TK, Bex A. Prevalence, Disease-free, and Overall Survival of Contemporary Patients With Renal Cell Carcinoma Eligible for Adjuvant Checkpoint Inhibitor Trials. Clin Genitourin Cancer. 2021 Apr;19(2):e92-e99. doi: 10.1016/j.clgc.2020.12.005. Epub 2021 Jan 7.

Recruitment Information

• Recruitment Status: Terminated
• Actual Enrollment (submitted: April 8, 2019): 778
• Original Estimated Enrollment (submitted: January 17, 2017): 664
• Actual Study Completion Date: December 8, 2022
• Actual Primary Completion Date: May 3, 2022 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

• ECOG performance status of less than or equal to (</=) 1
• Pathologically confirmed RCC with a component of either clear cell histology or sarcomatoid histology that has not been previously treated in the adjuvant or neoadjuvant setting and classified as being at high risk of RCC recurrence
• Radical or partial nephrectomy with lymphadenectomy in select participants
• Absence of residual disease and absence of metastasis, as confirmed by a negative baseline computed tomography (CT) of the pelvis, abdomen, and chest no more than 4 weeks prior to randomization. Confirmation of disease-free status will be assessed by an independent central radiologic review of imaging data.
• Absence of brain metastasis, as confirmed by a negative CT with contrast or magnetic resonance imaging (MRI) scan of the brain, no more than 4 weeks prior to randomization. Applicable only to metastasectomy participants
• Full recovery from nephrectomy or metastasectomy within 12 weeks from randomization following surgery

Exclusion Criteria:

• Bilateral synchronous tumors with inheritable forms of RCC including von Hippel-Lindau
• Any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment
• Treatment with any other investigational agent or participation in another clinical study with therapeutic intent within 28 days or five half-lives of the investigational agent, whichever is longer, prior to enrollment
• Malignancies other than RCC within 5 years prior to Cycle 1, Day 1
• History of autoimmune disease
• Participants with prior allogeneic stem cell or solid organ transplantation
• History of idiopathic pulmonary fibrosis (including pneumonitis), drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan
• Positive test for HIV
• Participants with active hepatitis B or hepatitis C
• Active tuberculosis
• Severe infections within 4 weeks prior to randomization including but not limited to hospitalization for complications of infection, bacteremia, or severe pneumonia
• Major surgical procedure within 4 weeks prior to randomization or anticipation of need for a major surgical procedure during the course of the study other than for diagnosis
• Administration of a live, attenuated vaccine within 4 weeks before Cycle 1, Day 1
• Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the participant at high risk from treatment complications
• Prior treatment with cluster of differentiation (CD)137 agonists, anti-cytotoxic T-lymphocyte-associated protein-4 (anti-CTLA-4), anti-programmed death-1 (anti-PD-1), or anti-programmed death-ligand 1 (anti-PD-L1) therapeutic antibody or pathway-targeting agents
• Treatment with systemic immunostimulatory agents (including but not limited to interferons or interleukin-2) within 6 weeks or five half-lives of the drug, whichever is shorter, prior to randomization
• Treatment with systemic immunosuppressive medications (including but not limited to corticosteroids, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor agents) within 2 weeks prior to randomization or anticipated need for systemic immunosuppressive medications during the study

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 18 Years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, China, Czechia, Denmark, France, Germany, Ireland, Israel, Italy, Japan, Korea, Republic of, Netherlands, Poland, Russian Federation, Serbia, Spain, Taiwan, Thailand, Turkey, Ukraine, United Kingdom, United States
• Removed Location Countries: Czech Republic, Uruguay

Administrative Information

• NCT Number: NCT03024996
• Other Study ID Numbers: WO39210; 2016-001881-27 ( EudraCT Number )
• Has Data Monitoring Committee: Yes
• U.S. FDA-regulated Product: Not Provided
• IPD Sharing Statement: Not Provided
• Current Responsible Party: Hoffmann-La Roche
• Original Responsible Party: Same as current
• Current Study Sponsor: Hoffmann-La Roche
• Original Study Sponsor: Same as current
• Collaborators: Not Provided

Investigators

• Study Director: Clinical Trials; Hoffmann-La Roche

• PRS Account: Hoffmann-La Roche
• Verification Date: July 2023