ClinicalTrials.gg
RecruitingNCT03866382Updated Nov 4, 2026

Testing the Effectiveness of Two Immunotherapy Drugs (Nivolumab and Ipilimumab) With One Anti-cancer Targeted Drug (Cabozantinib) for Rare Genitourinary Tumors

A Phase 2 interventional study of Biospecimen Collection and Bone Scan in Bladder Adenocarcinoma, Bladder Clear Cell Adenocarcinoma and Bladder Mixed Adenocarcinoma, sponsored by National Cancer Institute (NCI). Recruiting at 582 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started May 2019; still recruiting 7 years 5 months later.
Updated Nov 4, 2026Site recruiting status changed3 sites added+1 moreGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
314
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase II trial studies how well cabozantinib works in combination with nivolumab and ipilimumab in treating patients with rare genitourinary (GU) tumors that has spread from where it first started (primary site) to other places in the body. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving cabozantinib, nivolumab, and ipilimumab may work better in treating patients with genitourinary tumors that have no treatment options compared to giving cabozantinib, nivolumab, or ipilimumab alone.

Read the detailed description

PRIMARY OBJECTIVE:

I. To evaluate the efficacy of cabozantinib s-malate (cabozantinib) combined with nivolumab and ipilimumab in the first or second-line (and beyond) setting for patients within each of the rare genitourinary (GU) variant histology group of interest, as measured by objective response rate (ORR).

SECONDARY OBJECTIVES:

I. To estimate the progression-free survival (PFS) for patients treated with cabozantinib combined with nivolumab and ipilimumab within each rare variant histology.

II. To estimate the overall survival (OS) for patients treated with cabozantinib combined with nivolumab and ipilimumab within each rare variant histology.

III. To estimate the clinical benefit rate (defined as complete response [CR] or partial response [PR] or stable disease [SD]) for patients treated with cabozantinib combined with nivolumab and ipilimumab within each rare variant histology.

IV. To assess the safety of treating patients with rare variant histologies with cabozantinib combined with nivolumab and ipilimumab.

V. To support tissue banking and collection of clinical follow-up data for GU tract rare histological variants.

EXPLORATORY OBJECTIVE:

I. To assess effects of treatment in patients with bone-only disease by bone scan.

OUTLINE:

Patients receive cabozantinib orally (PO) once daily (QD) on days 1-21 of cycles 1-4 and on days 1-28 of subsequent cycles. Patients also receive nivolumab intravenously (IV) over 30 minutes on day 1 and ipilimumab IV over 90 minutes on day 1 of cycles 1-4. Patients then receive nivolumab IV over 30 minutes on day 1 of subsequent cycles. Treatment repeats every 21 days for cycles 1-4 and every 28 days for subsequent cycles for 2 years in the absence of disease progression or unacceptable toxicity. Patients may undergo echocardiography during screening and undergo computed tomography (CT) or magnetic resonance imaging (MRI), bone scan and blood and urine sample collection throughout the trial and may undergo positron emission tomography (PET)/CT throughout the trial.

After completion of study treatment, patients are followed up every 2 months for up to 5 years.

02

Conditions studied

  • Bladder Adenocarcinoma
  • Bladder Clear Cell Adenocarcinoma
  • Bladder Mixed Adenocarcinoma
  • Bladder Neuroendocrine Carcinoma
  • Bladder Small Cell Neuroendocrine Carcinoma
  • Bladder Squamous Cell Carcinoma
  • Chromophobe Renal Cell Carcinoma
  • Collecting Duct Carcinoma
  • Invasive Bladder Giant Cell Urothelial Carcinoma
  • Invasive Bladder Lymphoepithelioma-Like Carcinoma
  • Invasive Bladder Nested Urothelial Carcinoma
  • Invasive Bladder Plasmacytoid Urothelial Carcinoma
  • Invasive Bladder Sarcomatoid Urothelial Carcinoma
  • Invasive Bladder Urothelial Carcinoma
  • Kidney Medullary Carcinoma
  • Large Cell Neuroendocrine Carcinoma
  • Malignant Testicular Leydig Cell Tumor
  • Malignant Testicular Sertoli Cell Tumor
  • Metastatic Bladder Carcinoma
  • Metastatic Bladder Clear Cell (Glycogen-Rich) Urothelial Carcinoma
  • Metastatic Bladder Giant Cell Urothelial Carcinoma
  • Metastatic Bladder Large Cell Neuroendocrine Carcinoma
  • Metastatic Bladder Lipid-Rich Urothelial Carcinoma
  • Metastatic Bladder Micropapillary Urothelial Carcinoma
  • Metastatic Bladder Plasmacytoid Urothelial Carcinoma
  • Metastatic Bladder Sarcomatoid Urothelial Carcinoma
  • Metastatic Bladder Small Cell Neuroendocrine Carcinoma
  • Metastatic Bladder Squamous Cell Carcinoma
  • Metastatic Chromophobe Renal Cell Carcinoma
  • Metastatic Kidney Medullary Carcinoma
  • Metastatic Malignant Genitourinary System Neoplasm
  • Metastatic Papillary Renal Cell Carcinoma
  • Metastatic Penile Carcinoma
  • Metastatic Prostate Small Cell Neuroendocrine Carcinoma
  • Metastatic Sarcomatoid Renal Cell Carcinoma
  • Metastatic Urethral Carcinoma
  • Papillary Renal Cell Carcinoma
  • Sarcomatoid Renal Cell Carcinoma
  • Stage IV Bladder Cancer AJCC v8
  • Stage IV Penile Cancer AJCC v8
  • Stage IV Renal Cell Cancer AJCC v8
  • Stage IV Urethral Cancer AJCC v8
  • Stage IVB Prostate Cancer AJCC v8
  • Urachal Adenocarcinoma
  • Urethral Clear Cell Adenocarcinoma
03

In context

Carcinoma, Renal Cell

2,037 studies on the registry are indexed under Carcinoma, Renal Cell; 395 are open to participants now.

This study's planned enrollment of 314 is above the median of 43 across 1,564 interventional studies indexed under Carcinoma, Renal Cell.

Browse Carcinoma, Renal Cell studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,556 studies on the registry; 336 are open to participants now.

Of its 411 completed or terminated interventional studies of FDA-regulated products, 373 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • disease defined as new or progressive lesions on cross-sectional imaging or bone scan. Patients must have at least:

    • One measurable site of disease as per (RECIST) version (v) 1.1
    • One bone lesion on bone scan (tec99 or sodium fluoride [NaF] PET/CT, CT or MRI) for the bone-only cohort.
    • confirmed diagnosis of one of the following metastatic cohorts:

      • Small cell/ neuroendocrine carcinoma of the bladder (Cohort A)- All urothelial carcinomas with any amount of neuroendocrine differentiation (including small cell differentiation) will be included. If the tumor is purely neuroendocrine, metastasis from another site of origin should be clinically excluded
      • Adenocarcinoma of the bladder, or urachal adenocarcinoma, or bladder/urethra clear cell adenocarcinoma (Cohort B) - must be pure (per World Health Organization [WHO] definition), (i.e. urothelial carcinoma with glandular differentiation is not considered a pure adenocarcinoma
      • Squamous cell carcinoma of the bladder (Cohort C) - must be pure (i.e. urothelial carcinoma with squamous differentiation is not considered a pure squamous cell carcinoma)
      • Plasmacytoid urothelial carcinoma (Cohort D) - Tumor should show predominantly > or equal \~ 50% plasmacytoid histology (including all types of discohesive growth, such as tumors with signet-ring and/or rhabdoid features as well)
      • Any penile cancer (Cohort E)
      • Sarcomatoid renal cell carcinoma (Cohort F) - Tumor should be predominantly sarcomatoid \~ 50% (including rhabdoid differentiation) is also unclassified renal cell carcinomas (RCCs): all (assuming they are high grade with metastasis) malignant angiomyolipomas are allowed
      • Other miscellaneous histologic variants of the urothelial carcinoma, such as, but not limited to (Cohort G) : Micropapillary (Tumor should show predominantly > or equal 50% micropapillary architecture), giant cell, lipid-rich, clear cell and nested variants (Tumor should predominantly > or equal 50% show these features), large cell neuroendocrine carcinoma, lymphoepithelioma-like carcinoma and mixed patterns will be considered, as well as small cell neuroendocrine prostate cancer (Only treatment-naïve primary small cell of prostate with any amount of small cell component allowed. Post-treatment small cell prostatic carcinomas are not allowed), Malignant testicular Sertoli or Leydig cell tumors, and papillary and chromophobe RCC

        • Note: Translocation positive renal cell carcinoma patients are eligible. However, AREN1721 should be considered before this trial
      • Sarcomatoid urothelial carcinoma (Cohort H) - Tumor should show predominantly \~ 50% sarcomatoid differentiation
      • Renal medullary carcinoma (Cohort I) - Per World Health Organization (WHO) definition, ideally confirmed with immunostains
      • Bone-only metastatic GU tumors (non-prostate) (Cohort J) - All genitourinary histologies, except prostate are eligible
      • Renal Collecting Duct Carcinoma (Cohort K) - Per WHO definition (medullary involvement, predominant tubular morphology, desmoplastic stromal reaction, high grade cytology, infiltrative growth pattern, and absence of other renal cell carcinoma subtype or urothelial carcinoma)
      • Urethra carcinoma (Cohort L) - May be of any histology but if urothelial carcinoma then must be isolated to the urethra and not have metachronous or synchronous urothelial carcinoma of the bladder
    • H\&E slides from diagnostic tumor tissue for retrospective central pathology review
  • Patients may have received up to 2 systemic anti-cancer treatments or be treatment naive. Patients with small cell carcinoma should have received a platinum-based combination regimen either as , adjuvant or treatment). Patients in the bone-only cohort may be urothelial carcinoma histology but must receive standard cisplatin-based chemotherapy (if cisplatin-eligible)
  • Age >= 18 years
  • Patients must be able to swallow oral formulation of the tablets
  • performance status >= 80%
  • (ANC) >= 1,000/mcL
  • count >= 75,000/mcL
  • Total =\< 1.5 x (ULN). For subjects with known Gilbert's disease or similar syndrome with slow conjugation of bilirubin, total bilirubin =\< 3.0 mg/dL
  • (AST)/alanine aminotransferase (ALT) =\< 3.0 x institutional upper limit of normal (ULN) (or =\< 5 x ULN for patients with liver metastases or Gilbert's disease)
  • Creatinine =\< 1.5 x upper limit of normal (ULN) OR >= 40 mL/min/1.73 m\^2 (calculated using the Chronic Kidney Disease Epidemiology [] equation or Cockcroft-Gault formula) for patients with creatinine levels above institutional normal
  • >= 9 g/dL (transfusion of packed red blood cells [PRBCs] allowed)
  • Serum albumin >= 3.2 g/dL
  • Lipase and amylase =\< 2.0 x ULN and no radiologic (on baseline anatomical imaging) or clinical evidence of pancreatitis
  • Prior treatment with MET or VEGFR inhibitors is allowed. However, prior cabozantinib will not be allowed. Also, patients that have received both prior MET or VEGF and prior /PD-L1/CTLA-4 (sequentially or in combination) are also not allowed
  • No prior treatment with any therapy on the PD-1/PD-L1 axis or anti- CTLA-4/CTLA-4 inhibitors with the exception of patients with "urothelial carcinoma" histology (cohorts D, H, J, L)
  • (HIV)-positive patients are eligible if on stable dose of highly active antiretroviral therapy (HAART), no drug-drug interactions are anticipated with the current HAART regimen, are greater than 350 and viral load is undetectable
  • Patients with rheumatoid arthritis and other rheumatologic arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication only and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies etc. are eligible but should be considered for rheumatologic evaluation for the presence of target organ involvement and potential need for systemic treatment
  • Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones or medications (e.g. thyroiditis managed with propylthiouracil [PTU] or methimazole) including physiologic oral are eligible
  • Patients who have evidence of active or acute diverticulitis, intra-abdominal abscess, and gastrointestinal (GI) obstruction, within 12 months are not eligible
  • Women of must have a negative pregnancy test =\< 7 days prior to registration

    • Women of childbearing potential include women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or are not . Post menopause is defined as amenorrhea >= 12 consecutive months. Note: women who have been amenorrheic for 12 or more months are still considered to be of childbearing potential if the amenorrhea is possibly due to prior chemotherapy, antiestrogens, ovarian suppression or any other reversible reason
  • Pregnant women may not participate in this study because with cabozantinib, nivolumab, and ipilimumab have potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with cabozantinib, nivolumab, and ipilimumab, breastfeeding should be discontinued if the mother is treated with these agents
  • The patient has received no cytotoxic chemotherapy (including cytotoxic chemotherapy) or biologic agents (e.g., cytokines or antibodies) within 2 weeks before the first dose of study treatment
  • The patient has received no radiation therapy:

    • To the lungs and mediastinum or abdomen within 4 weeks before the first dose of study treatment, or has ongoing complications, or is healing from prior radiation therapy
    • To within 3 weeks for whole-brain radiotherapy (WBXRT), and 2 weeks for stereotactic body radiation therapy (SBRT) before the first dose of study treatment
    • To the abdomen within 4 weeks before the first dose of study treatment, or has ongoing complications, or is healing from prior radiation therapy
    • To any other site(s) within 2 weeks before the first dose of study treatment
  • The patient has received no radionuclide treatment within 6 weeks of the first dose of study treatment
  • The patient has received no prior treatment with a small molecule kinase inhibitor within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment
  • The patient has received no prior treatment with hormonal therapy within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment. Subjects receiving gonadotropin-releasing hormone (GnRH) agonists and antagonists are allowed to participate
  • The patient has not received any other type of investigational agent within 14 days before the first dose of study treatment
  • The patient must have recovered to baseline or (CTCAE) =\< grade 1 from toxicity due to all prior therapies except alopecia, neuropathy and other non-clinically significant adverse events (AEs) defined as lab elevation with no associated symptoms or sequelae
  • The patient may not have active brain metastases or epidural disease. Patients with brain metastases previously treated with whole brain radiation or radiosurgery who are asymptomatic and do not require steroid treatment for at least 2 weeks before starting study treatment are eligible. Neurosurgical resection of brain metastases or brain is permitted if completed at least 3 months before starting study treatment. Baseline brain imaging with contrast-enhanced CT or MRI scans for subjects with known brain metastases is required to confirm eligibility
  • No concomitant treatment with warfarin. Aspirin (up to 325 mg/day), thrombin or factor Xa inhibitors, low-dose warfarin (=\< 1 mg/day), prophylactic and therapeutic low molecular weight heparin (LMWH) are permitted
  • No chronic concomitant treatment with strong inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, and St. John's wort) or strong CYP3A4 inhibitors

    • Because the lists of these agents are constantly changing, it is important to regularly consult medical reference texts such as the Physicians' Desk Reference may also provide this information. As part of the enrollment/ procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product
  • The patient has not experienced any of the following:

    • Clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment
    • Hemoptysis of >= 0.5 teaspoon (2.5 mL) of red blood per day within 1 months before the first dose of study treatment
    • Any other signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment
  • The patient has no tumor invading any major blood vessels
  • The patient has no evidence of tumor invading the GI tract (esophagus, stomach, small or large bowel, rectum or anus), or any evidence of endotracheal or endobronchial tumor within 28 days before the first dose of cabozantinib. Patients with rectal tumor masses are not eligible
  • The patient has no uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:

    • Cardiovascular disorders including:

      • Congestive heart failure (CHF): (NYHA) class III (moderate) or class IV (severe) at the time of screening.
      • Concurrent uncontrolled hypertension defined as sustained blood pressure (BP) > 150 mm Hg systolic, or > 90 mm Hg diastolic despite optimal antihypertensive treatment within 7 days of the first dose of study treatment
      • The subject has a interval calculated by the Fridericia formula (QTcF) > 500 ms within 28 days before randomization. Note: if initial QTcF is found to be > 500 ms, two additional (EKGs) separated by at least 3 minutes should be performed. If the average of these three consecutive results for QTcF is =\< 500 ms, the subject meets eligibility in this regard
      • Any history of congenital long QT syndrome
      • Any of the following within 6 months before registration of study treatment:

        • Unstable angina pectoris
        • Clinically-significant cardiac arrhythmias (patients with atrial fibrillation are eligible)
        • Stroke (including [TIA], or other ischemic event)
        • Myocardial infarction
        • Cardiomyopathy
    • No significant gastrointestinal disorders particularly those associated with a high risk of perforation or fistula formation including:

      • Any of the following that have not resolved within 28 days before the first dose of study treatment:

        • Active peptic ulcer disease
        • Acute diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis, or malabsorption syndrome
      • None of the following within 2 years before the first dose of study treatment:

        • Abdominal fistula or genitourinary fistula
        • Gastrointestinal perforation
        • Bowel obstruction or gastric outlet obstruction
        • Intra-abdominal abscess. Note: Complete resolution of an intra-abdominal abscess must be confirmed prior to initiating treatment with cabozantinib even if the abscess occurred more than 2 years before the first dose of study treatment
    • Disorders associated with a high risk of fistula formation including percutaneous endoscopic gastrostomy (PEG) tube placement are not eligible
    • No other clinically significant disorders such as:

      • Severe active infection requiring IV systemic treatment within 14 days before the first dose of study treatment
      • Serious non-healing wound/ulcer/bone fracture within 28 days before the first dose of study treatment
      • History of organ or stem cell transplant
      • Concurrent uncompensated hypothyroidism or thyroid dysfunction within 7 days before the first dose of study treatment (for asymptomatic patients with an elevated thyroid-stimulating hormone [TSH], thyroid replacement may be initiated if clinically indicated without delaying the start of study treatment)
    • No history of major surgery as follows:

      • Major surgery within 3 months of the first dose of cabozantinib; however, if there were no wound healing complications, patients with rapidly growing aggressive cancers, may start as soon as 6 weeks if wound has completely healed post-surgery
      • Minor surgery within 1 month of the first dose of cabozantinib if there were no wound healing complications or within 3 months of the first dose of cabozantinib if there were wound complications excluding core biopsies and mediport placement
      • Complete wound healing from prior surgery must be confirmed before the first dose of cabozantinib irrespective of the time from surgery
  • No history of severe reaction to any monoclonal antibody
  • No evidence of active , requiring systemic treatment within 2 years of registration
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to cabozantinib, nivolumab, ipilimumab or other agents used in study
  • No positive test for virus surface antigen (HBV sAg) or virus ribonucleic acid (HCV antibody) indicating acute or chronic infection. If HBV sAG is positive, subsequent ribonucleic acid (RNA) polymerase chain reaction (PCR) must be negative
  • No patients with active disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids. These include, but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome should be excluded because of the risk of recurrence or exacerbation of disease
Terms in these criteria, in plain language(37)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

CD4 count

The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
314 participants (estimated)

Study arms

  • Experimental
    Treatment (cabozantinib, nivolumab, ipilimumab)

    Patients receive cabozantinib PO QD on days 1-21 of cycles 1-4 and on days 1-28 of subsequent cycles. Patients also receive nivolumab IV over 30 minutes on day 1 and ipilimumab IV over 90 minutes on day 1 of cycles 1-4. Patients then receive nivolumab IV over 30 minutes on day 1 of subsequent cycles. Treatment repeats every 21 days for cycles 1-4 and every 28 days for subsequent cycles for 2 years in the absence of disease progression or unacceptable toxicity. Patients may undergo echocardiography during screening and undergo CT or MRI, bone scan and blood and urine sample collection throughout the trial and may undergo PET/CT throughout the trial.

    Procedure: Biospecimen Collection · Procedure: Bone Scan · Drug: Cabozantinib S-malate · Procedure: Computed Tomography · Procedure: Echocardiography Test · Biological: Ipilimumab · Procedure: Magnetic Resonance Imaging · Biological: Nivolumab · Procedure: Positron Emission Tomography

Interventions

  • ProcedureBiospecimen Collection

    Undergo blood and urine sample collection

    Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection

  • ProcedureBone Scan

    Undergo bone scan

    Also known as: Bone Scintigraphy

  • Given PO

    Also known as: BMS-907351, Cabometyx, Cometriq, XL 184, XL-184, XL184

  • ProcedureComputed Tomography

    Undergo CT and/or PET/CT scan

    Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, Computerized Tomography (CT) scan, CT, CT Scan, Diagnostic CAT Scan, Diagnostic CAT Scan Service Type, tomography

  • ProcedureEchocardiography Test

    Undergo echocardiography

    Also known as: EC, Echocardiography

  • BiologicalIpilimumab

    Given IV

    Also known as: Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody, BMS 734016, BMS-734016, BMS734016, Ipilimumab Biosimilar CS1002, MDX 010, MDX-010, MDX-CTLA4, MDX010, Yervoy

  • ProcedureMagnetic Resonance Imaging

    Undergo MRI

    Also known as: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, MRIs, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging, sMRI, Structural MRI

  • BiologicalNivolumab

    Given IV

    Also known as: ABP 206, BCD-263, BMS 936558, BMS-936558, BMS936558, CMAB819, MDX 1106, MDX-1106, MDX1106, NIVO, Nivolumab Biosimilar ABP 206, Nivolumab Biosimilar BCD-263, Nivolumab Biosimilar CMAB819, ONO 4538, ONO-4538, ONO4538, Opdivo

  • ProcedurePositron Emission Tomography

    Undergo PET/CT scan

    Also known as: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure), Positron Emission Tomography Scan, Positron-Emission Tomography, PT

06

What researchers measure

Primary outcomes

  1. Objective response rate (ORR)

    An objective response is defined as a confirmed complete response (CR) or partial response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. A confirmed tumor response is defined to be either a CR or PR noted as the objective status on 2 consecutive evaluations at least 4 weeks apart. Will be estimated by the number of confirmed objective responses divided by the total number of evaluable patients. Confidence intervals for the true ORR will be calculated.

    Time frame: Up to 5 years

Secondary outcomes

  1. Duration of response

    Defined for all evaluable patients who have achieved an objective response as the date at which the patient's earliest best objective status is first noted to be either a CR or PR to the earliest date progression is documented.

    Time frame: From time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 5 years

  2. Progression-free survival (PFS)

    The median its 95% confidence interval will be determined and will be summarized using the Kaplan-Meier estimator.

    Time frame: From start of treatment to time of progression or death, whichever occurs first, assessed up to 5 years

  3. Overall survival

    The median its 95% confidence interval will be determined and will be summarized using the Kaplan-Meier estimator.

    Time frame: Up to 5 years

  4. Clinical benefit rate (CBR)

    A confirmed clinical benefit is defined to be either a CR or PR noted as the objective status on 2 consecutive evaluations at least 4 weeks apart or a confirmed stable disease at two consecutive tumor assessments at least 3 months apart. The CBR will be estimated by the number of patients with confirmed clinical benefit divided by the total number of evaluable patients. Confidence intervals for the true CBR will be calculated using exact binomial confidence intervals.

    Time frame: Up to 5 years

  5. Incidence of adverse events (AE)

    Will be assessed using Common Terminology Criteria for Adverse Events version 5.0. The maximum of a particular AE will be determined for each patient. Tables will summarize the number and relative frequency of patients observing an AE as well as the number and relative frequency of patients experiencing any AE of grade 3 or greater.

    Time frame: Up to 5 years

Other outcomes

  1. Effects of treatment in patients with bone-only disease

    The bone-only tumor patients will be evaluated in an exploratory fashion (if no RECIST measurements are available). A maximum of 15 patients with bone-only disease will be enrolled and evaluated using PFS for a descriptive analysis of the effect of treatment.

    Time frame: Up to 5 years

07

Study locations

222 of 582 sites recruiting
  • University of Alabama at Birmingham Cancer Center
    Birmingham, Alabama 35233, United States
    Recruiting
  • Anchorage Associates in Radiation Medicine
    Anchorage, Alaska 98508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Anchorage Radiation Therapy Center
    Anchorage, Alaska 99504, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Alaska Breast Care and Surgery LLC
    Anchorage, Alaska 99508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Alaska Oncology and Hematology LLC
    Anchorage, Alaska 99508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Alaska Women's Cancer Care
    Anchorage, Alaska 99508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Anchorage Oncology Centre
    Anchorage, Alaska 99508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Katmai Oncology Group
    Anchorage, Alaska 99508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Providence Alaska Medical Center
    Anchorage, Alaska 99508, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Kingman Regional Medical Center
    Kingman, Arizona 86401, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Cancer Center at Saint Joseph's
    Phoenix, Arizona 85004, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Mayo Clinic Hospital in Arizona
    Phoenix, Arizona 85054, United States
    Recruiting
    • Site Public Contact · Contact855-776-0015
    • Lance C. Pagliaro · Principal investigator
  • Mayo Clinic in Arizona
    Scottsdale, Arizona 85259, United States
    Recruiting
    • Site Public Contact · Contact855-776-0015
    • Lance C. Pagliaro · Principal investigator
  • University of Arizona Cancer Center-Orange Grove Campus
    Tucson, Arizona 85704, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Banner University Medical Center - Tucson
    Tucson, Arizona 85719, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • University of Arizona Cancer Center-North Campus
    Tucson, Arizona 85719, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Mercy Hospital Fort Smith
    Fort Smith, Arkansas 72903, United States
    Suspended

    Not enrolling at this site — choose another above.

  • CHI Saint Vincent Cancer Center Hot Springs
    Hot Springs, Arkansas 71913, United States
    Suspended

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  • Mission Hope Medical Oncology - Arroyo Grande
    Arroyo Grande, California 93420, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • PCR Oncology
    Arroyo Grande, California 93420, United States
    Suspended

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  • Providence Saint Joseph Medical Center/Disney Family Cancer Center
    Burbank, California 91505, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Community Cancer Institute
    Clovis, California 93611, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • University Oncology Associates
    Clovis, California 93611, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Epic Care-Dublin
    Dublin, California 94568, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Bay Area Breast Surgeons Inc
    Emeryville, California 94608, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Epic Care Partners in Cancer Care
    Emeryville, California 94608, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Marin Cancer Care Inc
    Greenbrae, California 94904, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Keck Medicine of USC Koreatown
    Los Angeles, California 90020, United States
    Recruiting
    • Site Public Contact · Contact213-388-0908
    • Anishka D'Souza · Principal investigator
  • Los Angeles General Medical Center
    Los Angeles, California 90033, United States
    Recruiting
  • USC / Norris Comprehensive Cancer Center
    Los Angeles, California 90033, United States
    Recruiting
    • Site Public Contact · Contact323-865-0451
    • Anishka D'Souza · Principal investigator
  • UCLA / Jonsson Comprehensive Cancer Center
    Los Angeles, California 90095, United States
    Completed

    Not enrolling at this site — choose another above.

  • Contra Costa Regional Medical Center
    Martinez, California 94553-3156, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • USC Norris Oncology/Hematology-Newport Beach
    Newport Beach, California 92663, United States
    Recruiting
    • Site Public Contact · Contact323-865-0451
    • Anishka D'Souza · Principal investigator
  • Alta Bates Summit Medical Center - Summit Campus
    Oakland, California 94609, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Bay Area Tumor Institute
    Oakland, California 94609, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Pacific Central Coast Health Center-San Luis Obispo
    San Luis Obispo, California 93401, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Mission Hope Medical Oncology - Santa Maria
    Santa Maria, California 93444, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Epic Care Cyberknife Center
    Walnut Creek, California 94597, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Penrose-Saint Francis Healthcare
    Colorado Springs, Colorado 80907, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Rocky Mountain Cancer Centers-Penrose
    Colorado Springs, Colorado 80907, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • AdventHealth Porter
    Denver, Colorado 80210, United States
    Suspended

    Not enrolling at this site — choose another above.

  • CommonSpirit Cancer Center Mercy
    Durango, Colorado 81301, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Mercy Medical Center
    Durango, Colorado 81301, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • CommonSpirit Saint Anthony Hospital Cancer Center
    Lakewood, Colorado 80228, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • AdventHealth Littleton
    Littleton, Colorado 80122, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Longmont United Hospital
    Longmont, Colorado 80501, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Rocky Mountain Cancer Centers-Longmont
    Longmont, Colorado 80501, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • AdventHealth Parker
    Parker, Colorado 80138, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Saint Mary Corwin Medical Center
    Pueblo, Colorado 81004, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • MedStar Georgetown University Hospital
    Washington D.C., District of Columbia 20007, United States
    Recruiting
    • Site Public Contact · Contact202-444-2223
    • Nancy A. Dawson · Principal investigator
  • Mount Sinai Comprehensive Cancer Center at Aventura
    Aventura, Florida 33180, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Holy Cross Hospital
    Fort Lauderdale, Florida 33308, United States
    Recruiting
  • Mount Sinai Medical Center
    Miami Beach, Florida 33140, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Orlando Health Cancer Institute
    Orlando, Florida 32806, United States
    Recruiting
  • Emory University Hospital Midtown
    Atlanta, Georgia 30308, United States
    Recruiting
    • Site Public Contact · Contact888-946-7447
    • Mehmet A. Bilen · Principal investigator
  • Emory University Hospital/Winship Cancer Institute
    Atlanta, Georgia 30322, United States
    Recruiting
    • Site Public Contact · Contact404-778-1868
    • Mehmet A. Bilen · Principal investigator
  • Emory Saint Joseph's Hospital
    Atlanta, Georgia 30342, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Emory Johns Creek Hospital
    Johns Creek, Georgia 30097, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Saint Alphonsus Cancer Care Center-Boise
    Boise, Idaho 83706, United States
    Recruiting
  • Saint Luke's Cancer Institute - Boise
    Boise, Idaho 83712, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Saint Alphonsus Cancer Care Center-Caldwell
    Caldwell, Idaho 83605, United States
    Recruiting
  • Kootenai Health - Coeur d'Alene
    Coeur d'Alene, Idaho 83814, United States
    Recruiting
    • Site Public Contact · Contactmccinfo@mtcancer.org · 406-969-6060
    • John M. Schallenkamp · Principal investigator
  • Walter Knox Memorial Hospital
    Emmett, Idaho 83617, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Saint Luke's Cancer Institute - Fruitland
    Fruitland, Idaho 83619, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Idaho Urologic Institute-Meridian
    Meridian, Idaho 83642, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Saint Luke's Cancer Institute - Meridian
    Meridian, Idaho 83642, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Saint Alphonsus Cancer Care Center-Nampa
    Nampa, Idaho 83687, United States
    Recruiting
    • Site Public Contact · Contactmccinfo@mtcancer.org · 406-969-6060
    • Tareq Al baghdadi · Principal investigator
  • Saint Luke's Cancer Institute - Nampa
    Nampa, Idaho 83687, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Kootenai Clinic Cancer Services - Post Falls
    Post Falls, Idaho 83854, United States
    Recruiting
    • Site Public Contact · Contactmccinfo@mtcancer.org · 406-969-6060
    • John M. Schallenkamp · Principal investigator
  • Kootenai Clinic Cancer Services - Sandpoint
    Sandpoint, Idaho 83864, United States
    Recruiting
    • Site Public Contact · Contactmccinfo@mtcancer.org · 406-969-6060
    • John M. Schallenkamp · Principal investigator
  • Saint Luke's Cancer Institute - Twin Falls
    Twin Falls, Idaho 83301, United States
    Suspended

    Not enrolling at this site — choose another above.

  • OSF Saint Anthony's Health Center
    Alton, Illinois 62002, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Rush-Copley Medical Center
    Aurora, Illinois 60504, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Bloomington
    Bloomington, Illinois 61704, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Loyola Center for Health at Burr Ridge
    Burr Ridge, Illinois 60527, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Canton
    Canton, Illinois 61520, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Memorial Hospital of Carbondale
    Carbondale, Illinois 62902, United States
    Suspended

    Not enrolling at this site — choose another above.

  • SIH Cancer Institute
    Carterville, Illinois 62918, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Carthage
    Carthage, Illinois 62321, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Northwestern University
    Chicago, Illinois 60611, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Rush MD Anderson Cancer Center
    Chicago, Illinois 60612, United States
    Recruiting
  • University of Illinois
    Chicago, Illinois 60612, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • University of Chicago Comprehensive Cancer Center
    Chicago, Illinois 60637, United States
    Recruiting
  • Carle at The Riverfront
    Danville, Illinois 61832, United States
    Recruiting
    • Site Public Contact · ContactResearch@Carle.com · 800-446-5532
    • Vamsi K. Vasireddy · Principal investigator
  • Cancer Care Specialists of Illinois - Decatur
    Decatur, Illinois 62526, United States
    Recruiting
  • Decatur Memorial Hospital
    Decatur, Illinois 62526, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Dixon
    Dixon, Illinois 61021, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Carle Physician Group-Effingham
    Effingham, Illinois 62401, United States
    Recruiting
    • Site Public Contact · ContactResearch@carle.com · 800-446-5532
    • Vamsi K. Vasireddy · Principal investigator
  • Crossroads Cancer Center
    Effingham, Illinois 62401, United States
    Recruiting
  • Illinois CancerCare-Eureka
    Eureka, Illinois 61530, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Galesburg
    Galesburg, Illinois 61401, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Western Illinois Cancer Treatment Center
    Galesburg, Illinois 61401, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Loyola Medicine Homer Glen
    Homer Glen, Illinois 60491, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Kewanee Clinic
    Kewanee, Illinois 61443, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Northwestern Medicine Lake Forest Hospital
    Lake Forest, Illinois 60045, United States
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Illinois CancerCare-Macomb
    Macomb, Illinois 61455, United States
    Suspended

    Not enrolling at this site — choose another above.

  • Carle Physician Group-Mattoon/Charleston
    Mattoon, Illinois 61938, United States
    Recruiting
    • Site Public Contact · ContactResearch@carle.com · 800-446-5532
    • Vamsi K. Vasireddy · Principal investigator
  • Loyola University Medical Center
    Maywood, Illinois 60153, United States
    Recruiting
    • Site Public Contact · Contact708-226-4357
    • Joseph I. Clark · Principal investigator
  • Marjorie Weinberg Cancer Center at Loyola-Gottlieb
    Melrose Park, Illinois 60160, United States
    Suspended

    Not enrolling at this site — choose another above.

  • SSM Health Good Samaritan
    Mount Vernon, Illinois 62864, United States
    Suspended

    Not enrolling at this site — choose another above.

Showing the first 100 of 582 sites across 2 countries. Choose a country and city above to see the rest.

08

References and documents

Publications

  • Girardi DM, Niglio SA, Mortazavi A, Nadal R, Lara P, Pal SK, Saraiya B, Cordes L, Ley L, Ortiz OS, Cadena J, Diaz C, Bagheri H, Redd B, Steinberg SM, Costello R, Chan KS, Lee MJ, Lee S, Yu Y, Gurram S, Chalfin HJ, Valera V, Figg WD, Merino M, Toubaji A, Streicher H, Wright JJ, Sharon E, Parnes HL, Ning YM, Bottaro DP, Cao L, Trepel JB, Apolo AB. Cabozantinib plus Nivolumab Phase I Expansion Study in Patients with Metastatic Urothelial Carcinoma Refractory to Immune Checkpoint Inhibitor Therapy. Clin Cancer Res. 2022 Apr 1;28(7):1353-1362. doi: 10.1158/1078-0432.CCR-21-3726. PubMed 35031545 ↗

Individual participant data

Plan to share: Yes — NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page

Data sharing details ↗ · grants.nih.gov

09

Timeline

14 registry updates since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started May 2019 (actual). Primary completion is estimated for Feb 2027, 93 months after the start.

Of 183 non-industry phase 2 interventional studies under Carcinoma, Renal Cell, half reached primary completion within 67 months of starting (the median), counting those still running; a quarter within 41 and three quarters within 98. This study's planned 93 months is above that.

Counting every sponsor, half of 230 studies reached it within 58 months; a quarter within 33 and three quarters within 94.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 6, 2019
First posted
Mar 7, 2019
StartActual
May 13, 2019
Primary completionEst.
Feb 28, 2027
CompletionEst.
Feb 28, 2027
Last update
Nov 4, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Sites
3 sites added, 2 sites removed. 10 sites changed recruiting status (4 now recruiting, 3 now suspended, …)
Show 10 sites
  • NYU Langone Hospital - Long Island · Mineola, United StatesActive, not recruiting→Suspended
  • OptumCare Cancer Care at Charleston · Las Vegas, United StatesRecruiting→Suspended
  • OptumCare Cancer Care at Fort Apache · Las Vegas, United StatesRecruiting→Suspended
  • Orlando Health Cancer Institute · Orlando, United StatesSuspended→Recruiting
  • University of Alabama at Birmingham Cancer Center · Birmingham, United StatesActive, not recruiting→Recruiting
  • Providence Newberg Medical Center · Newberg, United StatesSuspended→Recruiting
  • Providence Willamette Falls Medical Center · Oregon City, United StatesSuspended→Recruiting
  • Greater Regional Medical Center · Creston, United StatesSuspended→Active, not recruiting
  • Mercy Medical Center · Springfield, United StatesSuspended→Active, not recruiting
  • University of Kentucky/Markey Cancer Center · Lexington, United StatesRecruiting→Active, not recruiting
Show 3 added (3 United States)
  • Saint Anne Hospital · Burien, United States
  • Trinity Health IHA Medical Group-Alice Gustafson Center · Pontiac, United States
  • Minnesota Oncology - Edina · Edina, United States
Show 2 removed
  • Highline Medical Center-Main Campus · Burien, United States
  • Newland Medical Associates-Pontiac · Pontiac, United States
across 14 updates, Sep 29, 2026 – Nov 4, 2026
Site contacts
Changed at 14 sites. See the sites
Show 14 sites
  • Providence Portland Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • Providence Saint Vincent Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • Kadlec Clinic Hematology and Oncology · Kennewick, United StatesContact added r•••@kadlecmed.org · •••4637Contact added (no phone or email listed)
  • Lahey Clinic · Burlington, United StatesContact person changed (no phone or email listed)
  • Lahey Clinic Peabody · Peabody, United StatesContact person changed (no phone or email listed)
  • OptumCare Cancer Care at Charleston · Las Vegas, United StatesContact removed r•••@sncrf.org · •••0013Contact removed (no phone or email listed)
  • OptumCare Cancer Care at Fort Apache · Las Vegas, United StatesContact removed r•••@sncrf.org · •••0013Contact removed (no phone or email listed)
  • Margaret R Pardee Memorial Hospital · Hendersonville, United StatesContact added p•••@unchealth.unc.edu · •••4716Contact added (no phone or email listed)
  • Valley Medical Center · Renton, United StatesContact person changed (no phone or email listed)
  • Orlando Health Cancer Institute · Orlando, United StatesContact added C•••@orlandohealth.com · •••7246Contact added (no phone or email listed)
  • Providence Newberg Medical Center · Newberg, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • Providence Willamette Falls Medical Center · Oregon City, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • University of Alabama at Birmingham Cancer Center · Birmingham, United StatesContact added g•••@uabmc.eduContact added (no phone or email listed)
  • University of Kentucky/Markey Cancer Center · Lexington, United StatesContact removed •••3379Contact removed (no phone or email listed)
across 11 updates, Sep 29, 2026 – Nov 4, 2026
Show all 14 updates
  1. Nov 4, 2026
    Orlando Health Cancer Institute is now Recruiting
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Orlando Health Cancer Institute · Orlando, United StatesContact added C•••@orlandohealth.com · •••7246Contact added (no phone or email listed)
  2. Oct 30, 2026
    University of Kentucky/Markey Cancer Center is now Active, not recruiting
    Site contacts Changed at 1 site. See the sites
    Show the site
    • University of Kentucky/Markey Cancer Center · Lexington, United StatesContact removed •••3379Contact removed (no phone or email listed)
  3. Oct 28, 2026
    2 sites changed recruiting status (1 now recruiting, 1 now active, not recruiting)
    Show 2 sites
    • University of Alabama at Birmingham Cancer Center · Birmingham, United StatesSuspended→Recruiting
    • Mercy Medical Center · Springfield, United StatesSuspended→Active, not recruiting
    Site contacts Changed at 1 site. See the sites
    Show the site
    • University of Alabama at Birmingham Cancer Center · Birmingham, United StatesContact added g•••@uabmc.eduContact added (no phone or email listed)
  4. Oct 27, 2026
    Greater Regional Medical Center is now Active, not recruiting
  5. Oct 26, 2026
    2 sites added, 1 site removed
    Show 2 added (2 United States)
    • Trinity Health IHA Medical Group-Alice Gustafson Center · Pontiac, United States
    • Minnesota Oncology - Edina · Edina, United States
    Show 1 removed
    • Newland Medical Associates-Pontiac · Pontiac, United States
  6. Oct 22, 2026
    1 site added, 1 site removed
    Show site
    • Saint Anne Hospital · Burien, United States
    Show 1 removed
    • Highline Medical Center-Main Campus · Burien, United States
  7. Oct 19, 2026
    Orlando Health Cancer Institute is now Suspended
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Orlando Health Cancer Institute · Orlando, United StatesContact removed C•••@orlandohealth.com · •••7246Contact removed (no phone or email listed)
  8. Oct 14, 2026
    5 sites changed recruiting status (4 now recruiting, 1 now suspended)
    Show 5 sites
    • University of Alabama at Birmingham Cancer Center · Birmingham, United StatesActive, not recruiting→Suspended
    • Providence Newberg Medical Center · Newberg, United StatesSuspended→Recruiting
    • Providence Willamette Falls Medical Center · Oregon City, United StatesSuspended→Recruiting
    • Providence Portland Medical Center · Portland, United StatesSuspended→Recruiting
    • Providence Saint Vincent Medical Center · Portland, United StatesSuspended→Recruiting
    Site contacts Changed at 4 sites. See the sites
    Show 4 sites
    • Providence Newberg Medical Center · Newberg, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
    • Providence Willamette Falls Medical Center · Oregon City, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
    • Providence Portland Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
    • Providence Saint Vincent Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  9. Oct 9, 2026
    Orlando Health Cancer Institute is now Recruiting
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Orlando Health Cancer Institute · Orlando, United StatesContact added C•••@orlandohealth.com · •••7246Contact added (no phone or email listed)
  10. Oct 8, 2026
    2 sites changed recruiting status (2 now recruiting)
    Show 2 sites
    • Margaret R Pardee Memorial Hospital · Hendersonville, United StatesSuspended→Recruiting
    • Kadlec Clinic Hematology and Oncology · Kennewick, United StatesSuspended→Recruiting
    Site contacts Changed at 3 sites. See the sites
    Show 3 sites
    • Margaret R Pardee Memorial Hospital · Hendersonville, United StatesContact added p•••@unchealth.unc.edu · •••4716Contact added (no phone or email listed)
    • Kadlec Clinic Hematology and Oncology · Kennewick, United StatesContact added r•••@kadlecmed.org · •••4637Contact added (no phone or email listed)
    • Valley Medical Center · Renton, United StatesContact person changed (no phone or email listed)
  11. Oct 7, 2026
    3 sites changed recruiting status (3 now suspended)
    Show 3 sites
    • Margaret R Pardee Memorial Hospital · Hendersonville, United StatesRecruiting→Suspended
    • Providence Portland Medical Center · Portland, United StatesRecruiting→Suspended
    • Providence Saint Vincent Medical Center · Portland, United StatesRecruiting→Suspended
    Site contacts Changed at 3 sites. See the sites
    Show 3 sites
    • Margaret R Pardee Memorial Hospital · Hendersonville, United StatesContact removed p•••@unchealth.unc.edu · •••4716Contact removed (no phone or email listed)
    • Providence Portland Medical Center · Portland, United StatesContact removed C•••@providence.org · •••2614Contact removed (no phone or email listed)
    • Providence Saint Vincent Medical Center · Portland, United StatesContact removed C•••@providence.org · •••2614Contact removed (no phone or email listed)
  12. Oct 6, 2026
    2 sites changed recruiting status (2 now suspended)
    Show 2 sites
    • OptumCare Cancer Care at Charleston · Las Vegas, United StatesRecruiting→Suspended
    • OptumCare Cancer Care at Fort Apache · Las Vegas, United StatesRecruiting→Suspended
    Site contacts Changed at 2 sites. See the sites
    Show 2 sites
    • OptumCare Cancer Care at Charleston · Las Vegas, United StatesContact removed r•••@sncrf.org · •••0013Contact removed (no phone or email listed)
    • OptumCare Cancer Care at Fort Apache · Las Vegas, United StatesContact removed r•••@sncrf.org · •••0013Contact removed (no phone or email listed)
  13. Sep 30, 2026
    NYU Langone Hospital - Long Island is now Suspended
    Site contacts Changed at 2 sites. See the sites
    Show 2 sites
    • Lahey Clinic · Burlington, United StatesContact person changed (no phone or email listed)
    • Lahey Clinic Peabody · Peabody, United StatesContact person changed (no phone or email listed)
  14. Sep 29, 2026
    Kadlec Clinic Hematology and Oncology is now Suspended
    Site contacts Changed at 3 sites. See the sites
    Show 3 sites
    • Providence Portland Medical Center · Portland, United StatesContact person changed (no phone or email listed)
    • Providence Saint Vincent Medical Center · Portland, United StatesContact person changed (no phone or email listed)
    • Kadlec Clinic Hematology and Oncology · Kennewick, United StatesContact removed r•••@kadlecmed.org · •••4637Contact removed (no phone or email listed)

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03866382
Responsible party
Sponsor
First posted
Mar 7, 2019
Start date
May 13, 2019
Primary completion
Feb 28, 2027 (estimated)
Completion
Feb 28, 2027 (estimated)
Last update
Nov 4, 2026

Study contacts

Andrea B Apolo
principal investigator · Alliance for Clinical Trials in Oncology

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Cabozantinib · Ipilimumab · Nivolumab

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