Purpose
This study assessed the efficacy and safety of linifanib in patients with advanced renal cell carcinoma (RCC) who were previously treated with sunitinib.
Materials and Methods
This open-label, multicenter, phase 2 trial of oral linifanib 0.25 mg/kg/day enrolled patients who had prior nephrectomy and adequate organ function. The primary endpoint was objective response rate (ORR) per RECIST by central imaging. Secondary endpoints were progression-free survival (PFS), overall survival (OS), and time to progression (TTP). Safety was also assessed.
Results
Fifty-three patients, median age 61 years (range 40–80) were enrolled (August 2007 to October 2008) across 12 North-American centers. Median number of prior therapies was two (range 1–4); 42 patients (81%) had clear-cell histology. ORR was 13.2%, median PFS was 5.4 months (95% CI: 3.6, 6.0) and TTP was the same; median OS was 14.5 months (95% CI: 10.8, 24.1). The most common treatment-related adverse events (AEs) were diarrhea (74%), fatigue (74%), and hypertension (66%), and the most common treatment-related Grade 3/4 AE was hypertension (40%).
Conclusions
Linifanib demonstrated clinically meaningful activity in patients with advanced RCC after sunitinib failure. At 0.25 mg/kg/day, significant dose modifications were required. An alternative, fixed-dosing strategy is being evaluated in other trials.